Incidence and treatment of complications in patients who had third molars or other teeth extracted

Br J Oral Maxillofac Surg. 2018 Jun;56(5):388-393. doi: 10.1016/j.bjoms.2018.02.001. Epub 2018 Apr 16.


The aim of this study was to compare the incidence of complications after extraction of third molars (M3) or other teeth, and to describe their management. We made a retrospective cohort study of patients having M3 or other teeth extracted, and recorded complications up to two years' follow-up. A total of 142 complications developed after 2355 procedures (6%) - 7% after extraction of M3 compared with 5% after extractions of other teeth (p=0.024). The three most common complications were wound infection (2%), pain without apparent cause (<1%), and oroantral communication (<1%). Patients who had M3 extracted were at increased risk of complications compared with those who had other teeth extracted (Odds ratio (OR) 1.5, p=0.024), particularly for infection (OR 5.9, p<0.001) and hypoaesthesia (OR 8.4, p=0.027). Half of all patients with a complication were treated with antibiotics orally. The incidence of postoperative bleeding was 0.6% as a result of suboptimal management of antithrombotic drugs in extractions of teeth other than M3. Finally, optimal treatment of the complications was compared with the available evidence. Prevention and treatment of these complications could reduce the incidence, particularly of bleeding.

Keywords: alveolar osteitis; antithrombotics; dental extraction; oral bleeding.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Dry Socket / etiology
  • Dry Socket / therapy
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Hypesthesia / etiology
  • Hypesthesia / therapy
  • Incidence
  • Middle Aged
  • Molar, Third / surgery*
  • Oral Fistula / therapy
  • Pain, Postoperative / drug therapy
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / therapy*
  • Postoperative Hemorrhage / therapy
  • Retrospective Studies
  • Surgical Wound Infection / drug therapy
  • Tooth Extraction / adverse effects*
  • Young Adult


  • Anti-Bacterial Agents
  • Fibrinolytic Agents