Oral hygiene and postoperative pain after mandibular third molar surgery

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Sep;92(3):260-4. doi: 10.1067/moe.2001.115722.


Objective: The purpose of this study was to evaluate the association between oral hygiene before surgery and pain, inflammation, and trismus after the surgical removal of 190 impacted lower third molars.

Study design: Patient hygiene was assessed by the simplified oral hygiene index. The maximum active interincisal oral opening was determined before surgery by using a millimeter scale, from the upper incisive edge to the lower incisive edge. Pain and inflammation were in turn recorded in written form by each patient 2, 6, and 12 hours after the operation and every day thereafter for 7 days.

Results: Maximum postoperative pain was recorded 6 hours after extraction, with peak inflammation after 24 hours. The patients with the poorest oral hygiene reported higher pain levels throughout the postoperative period and more analgesic consumption in the first 48 hours. In contrast, oral hygiene appeared to exert no influence on either trismus or inflammation.

Conclusions: Poor oral hygiene before the surgical removal of 190 impacted lower third molars is correlated with greater postoperative pain.

MeSH terms

  • Adult
  • Analgesics / administration & dosage
  • Analgesics / therapeutic use
  • Analysis of Variance
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Dipyrone / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammation
  • Male
  • Mandible / physiology
  • Mandible / surgery*
  • Molar, Third / surgery*
  • Movement
  • Oral Hygiene Index
  • Oral Hygiene*
  • Osteotomy / adverse effects
  • Pain, Postoperative / etiology*
  • Postoperative Complications
  • Statistics, Nonparametric
  • Surgical Flaps
  • Tooth Extraction* / adverse effects
  • Tooth, Impacted / surgery*
  • Trismus / etiology


  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal
  • Dipyrone