Routine follow-up visits not necessary after third molar removal under sedation

Abstract

DESIGN: This was a randomised controlled trial (RCT) conducted in the US. INTERVENTION: People were recruited to the trial who required surgical removal of at least two impacted third molars under intravenous sedation on an outpatient basis. They were treated by board-certified oral and maxillofacial surgeons. Participants were divided randomly into two groups: the first was given a 2-week postoperative follow-up appointment, and the other had no follow-up. All patients received postoperative instructions and were contacted by telephone on the day after surgery. At 2 weeks postoperatively, all patients either returned to the clinic or were interviewed by telephone. OUTCOME MEASURE: Patients were asked to answer a questionnaire on postoperative day 1 and at 2 weeks after their treatment. The questionnaire was originally proposed by Worrall(1) but was modified for use in this study. RESULTS: Of the 60 consecutive patients who underwent third molar removal, only 48 were included. The mean age was 20 years (range, 15-33 years). There were no significant differences in the number of patients and gender between the groups receiving clinic or telephone follow-up. Seventy-three per cent (35 out of 48) out of all the patients preferred telephone follow-up, and 27% (13 out of 48) of patients preferred clinic follow-up. Eighty-five per cent (29 out of 34) of patients who did not have any complaints on postoperative day 1 preferred telephone follow-up (P<0.01). CONCLUSIONS: A routine follow-up visit following third molar removal under intravenous sedation is not necessary in patients aged between 15 and 35 years. Pre-operative and postoperative instructions should be clear, however. A selective review policy may be appropriate if a patient is mentally retarded, is taking psychoactive drugs, or has an intra-operative complications or a has made a complaint via telephone.