Quality of Life Outcomes, Pericoronitis Symptoms, and Third Molar Removal

Objectives: Assess the impact of 3^rd molar removal on quality of life in subjects with mild symptoms of pericoronitis.

Methods: 60 Subjects with pericoronitis affecting at least 1 mandibular 3^rd molar were recruited for an IRB-approved study between 2006 and 2011, with follow-up at least three months after 3^rd molar removal.

Inclusion criteria were ASA I-II, 18-35 years of age, with minor symptoms of pericoronitis affecting at least one mandibular 3^rd molar. Subjects with major symptoms of pericoronitis, generalized periodontal disease, BMI >29, taking antibiotics, or using tobacco were excluded.

Clinical, demographic, and QOL data were collected at enrollment. Gross debris was then removed from the symptomatic 3^rd molar sites. No attempt was made to mechanically remove all non-sheddable biofilm. No antibiotics were prescribed. Subjects were recalled and QOL data colleted at least three months after 3^rd molar removal: a condition-specific QOL instrument with 3 domains (lifestyle, function, and pain) and the Gracely Scale.

Results: Median age was 21.9 years (IQ 20.2-24.7 years). Median post-surgery follow-up was 7.7 months (IQR 6.0-12.4 mo.). The percent of subjects reporting worst pain as severe decreased from 32% at enrollment to 3% post-surgery. Subjects responding none for worst pain increased 10% to 78%. Fifteen percent of subjects reported pain intensity as “nothing”, “faint” or “very weak” at enrollment increasing to 96% post-surgery. A third of subjects reported the unpleasantness of pain as “neutral”, “slightly unpleasant”, or “slightly annoying” at enrollment increasing to 96% post-surgery. Twenty two percent and 18% of subjects at enrollment, but less than 2% post-surgery, reported “quite a bit” or “lots of difficulty” with eating desired foods and chewing foods. 

Conclusions: Removal of 3^rd molars positively influenced quality of life outcomes in subjects who presented with minor symptoms of pericoronitis of at least 1 mandibular 3^rd molar.