Postoperative pain of impacted mandibular third molar surgery performed by general dental practitioners - a multicenter study.

Abstract

Background: Impacted third molars are common and often require surgical removal, which can lead to postoperative complications, particularly pain. While pain has been extensively studied in specialist settings, data from general dental practice remains limited. This study evaluated postoperative pain over seven days following mandibular third molar surgery performed by general dental practitioners (GDPs), who conduct a significant number of these procedures.

Material and methods: A prospective multi-center cohort study was conducted in three public dental clinics in Luleå, Sweden, from October 2022 to December 2023. Participants (≥18 years old) undergoing mandibular third molar surgery were included, while those requiring referral to an oral maxillofacial surgeon were excluded. Pain intensity was self-reported daily using a numerical rating scale (NRS) from 0-10. Statistical analyses included descriptive statistics, chi-square tests, and t-tests.

Results: Of 133 enrolled participants, 111 submitted valid pain assessments. Pain peaked on the day of surgery (Day 0), with 4% reporting the worst imaginable pain (NRS 10), 34% severe pain (NRS 7-9), and 35% moderate pain (NRS 4-6). Pain significantly declined by Day 1 (p<0.001) and continued to decrease throughout the week. Female participants reported higher pain scores (statistically significant on Days 2-4) and used more analgesics. Sedated patients also reported higher pain scores. Bilateral surgeries showed slightly higher pain levels, though not statistically significant. Postoperative complications were rare (one case of paraesthesia, two infections).

Conclusions: Postoperative pain after third molar surgery performed by GDPs was highest on the day of surgery and declined rapidly. Key words:Postoperative pain, third molar, oral surgery.