The impact of third molar symptoms, pain, and swelling on oral health-related quality of life

J Oral Maxillofac Surg. 2004 Sep;62(9):1118-24. doi: 10.1016/j.joms.2003.11.014.


Purpose: This study was designed to assess the impact of "pain and swelling" associated with third molars on patients' quality of life before surgery.

Patients and methods: The data for these analyses were obtained from a larger ongoing study designed to examine the surgical and medical management of problems associated with third molars. Data from 480 patients with 4 third molars scheduled for removal were used in the analysis. Questionnaires administered presurgery assessed patients' medical and dental history, their reasons for seeking third molar removal, and sociodemographic characteristics. Adverse impacts on oral health-related quality of life were measured using the 14-item Oral Health Impact Profile (OHIP) questionnaire. The primary outcome variable was the percentage of people reporting 1 or more of the 12 non-pain-specific OHIP items "fairly often" or "very often" during the 3 months before enrollment.

Results: One third (178 of 480) of patients said they were seeking third molar surgery because of current or previous symptoms of pain/swelling, and 17% reported 1 or more of the 12 non-pain-specific OHIP items. In the multivariate logistic regression model, the odds of one or more impacts was greater for people who presented because of symptoms (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.7 to 4.8), who were aged 25 years or more (OR, 1.9; 95% CI, 1.1-3.3), and who had a self-reported history of tooth loss due to pathology or trauma (OR, 2.9; 95% CI, 1.9 to 5.5).

Conclusions: Adverse impacts on quality of life occurred for 1 in 8 patients seeking third molar surgery, and the odds increased 3-fold for patients who had experienced pain/swelling compared with those who were asymptomatic.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Attitude to Health
  • Chi-Square Distribution
  • Cohort Studies
  • Edema / psychology*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Molar, Third / pathology*
  • Molar, Third / surgery
  • Patient Acceptance of Health Care
  • Prospective Studies
  • Quality of Life*
  • Tooth Extraction
  • Tooth Loss / etiology
  • Toothache / psychology*