Assessing health outcomes after extraction of third molars: the postoperative symptom severity (PoSSe) scale.

A postoperative symptom severity (PoSSe) scale was devised from questions commonly used in the clinical assessment of patients who have had third molars extracted, and divided into subscales corresponding to seven main adverse effects that had been identified in a previous study. Ninety-seven patients completed the 15-item questionnaire at one week, and 71 patients at four weeks, after extraction of impacted third molars. After statistical testing, four items were discarded and the final PoSSe scale achieved a high level of internal reliability. Patients' PoSSe scores were highly correlated with scales that measured six distinct health dimensions. The level of social functioning, together with the number of impacted teeth and number of painkillers taken, explained 62% of the variation in PoSSe scores between patients one week postoperatively. The PoSSe was more responsive than the Short Form 36-item Health Survey. In conclusion, we found the PoSSe Scale to be a reliable, valid and responsive measure of the severity of symptoms after extraction of third molars, and of the impact of those symptoms on patients' perceived health.

Quality of life following third molar removal: a patient versus professional perspective.

AIMS: To identify the adverse effects of third molar surgery having the greatest impact on patients' perceived quality of life; and to compare the rankings between patients, dental practitioners (GDPs) and hospital consultants. METHOD: Seven adverse effects were identified after interviewing 20 patients. A questionnaire was sent to 120 patients whose third molars had been removed and 121 dental surgeons (100 GDPs and 21 consultants in oral and maxillofacial surgery). RESULTS: Response rates for patients, GDPs and consultants were 72.5%, 92% and 76.2% respectively. Patients ranked highest the effects on eating, while dental surgeons ranked 'pain' the highest. The mean rankings of consultants and patients generally showed a closer agreement, than with GDPs. However, no statistically significant differences were detected between the mean rankings of GDPs and consultants. CONCLUSIONS: Dental surgeons' perceptions of the impact of third molar surgery on their patients' quality of life show statistically significant differences from those of patients for four of the seven parameters assessed. Clinicians should consider mentioning the effects on ability to eat when obtaining informed consent, since patients would appear to rank this an important side effect.