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

This was a randomised controlled trial (RCT) conducted in the US.

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.

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.

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).

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.