title: Patients' perception of recovery after third molar surgery.
abstract: OBJECTIVE
  This study evaluated patients' perceptions of recovery after third molar surgery.
  
  
  METHODS
  Two hundred forty-nine patients (age 13 to 37 years) at 2 clinical centers were enrolled in a prospective study before the surgical removal of third molars. Each patient was given a 21-item Health-Related Quality of Life instrument (HRQOL) to be completed each postoperative day (POD) for 14 days. The instrument was designed to assess patients' perception of recovery: pain, oral function, general activity measures, and other symptoms. Pain dimensions were recorded with a 7-point Likert-type scale; all other conditions were measured on 5-point Likert-type scales. The impact of each predictor variable such as age, gender, and length of surgery on recovery was assessed with Cochran-Mantel-Haenszel statistics, controlling for clinical center.
  
  
  RESULTS
  After the 14-day postoperative period, 201 of the original 249 patients returned the completed HRQOL instrument; the 48 patients who did not return their diary had third molar conditions and surgery similar to the 201 patients who responded. On POD 1, 63.5% of patients reported their worst pain as severe (score, 5 to 7/7) at some time during the day. By POD 7, only 15% of patients reported their worst pain as severe. Average pain levels were much less; 29% reported their average pain as severe (score, 5 to 7/7) on POD 1, decreasing to 5.5% by POD 7. Patients experienced substantial interference in oral function; chewing, 85%; mouth opening 78.5%, and speaking 37.5% on POD 1. By POD 6, oral function had improved; chewing, 19%, mouth opening, 15%; and speaking, 1.5%. General measures also were affected on POD 1; social activity, 61.5%; recreation, 70.5%; and daily routine, 60%. Patients assumed a more normal lifestyle by POD 5. Swelling seemed to be at its maximum on PODs 1 and 2 (day 1, 53%; day 2, 61%) and decreased markedly by POD 5 (10%). Food collection in the surgical sites posed the biggest problem for patients on POD 9 (20%). Age was not a predictor of prolonged recovery. However, surgery time 30 minutes or longer, or having all third molars below the occlusal plane, did prolong recovery. Females also reported a longer recovery period.
  
  
  CONCLUSIONS
  This information is valuable to patients deciding on third molar surgery and to clinicians providing informed consent.
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill 27599-7450, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Conrad
authors.forename: G H
authors.initials: GH
authors.lastname: Blakey
authors.forename: D A
authors.initials: DA
authors.lastname: Shugars
authors.forename: R D
authors.initials: RD
authors.lastname: Marciani
authors.forename: C
authors.initials: C
authors.lastname: Phillips
authors.forename: R P
authors.initials: RP
authors.lastname: White
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D003657:Decision Making; D004435:Eating; D005260:Female; D006801:Humans; D008297:Male; D008409:Mastication; D008964:Molar, Third / Q000601:surgery*; D016017:Odds Ratio; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012737:Sex Factors; D012890:Sleep; D013060:Speech; D011795:Surveys and Questionnaires; D013997:Time Factors; D014081:Tooth Extraction / Q000523:psychology*