Nerve morbidity following wisdom tooth removal under local and general anaesthesia

Two hundred and one patients had unilateral removal of the lower third molars under local anaesthesia and a further 234 patients had either bilateral or unilateral removal under general anaesthesia. A total of 634 lower third molars were extracted by four experienced surgeons (two consultants and two senior grade staff). All patients were reviewed independently 1-week postoperatively and any sensory disturbance and its location was recorded. Patients with sensory disturbance were subsequently reviewed at 1 month and again at 6 months if recovery was not complete. This study demonstrated little difference in the adverse event rate per tooth extracted between procedures under local and general anaesthesia. However, within the general anaesthetic group, the few unilateral procedures showed evidence of higher risk, but the number was too small for valid satisfactory analysis. The risk of nerve morbidity was also greater where the duration of the procedure was longer than 15 minutes in unilateral cases.