The Use of a Patient Education Program to Enhance Third Molar Surgery Expectations. Is This the Necessary Tool to Decrease Preoperative and Postoperative Surgical Extractions Related-Anxiety to Improve Health-Quality of Life and Recovery?

The effect of preoperative and postoperative anxiety on a patient’s surgical experience has been determined as non-surgical factors associated with longer surgical time, more postoperative complications, increased recovery period, and lower patient satisfaction levels.  Relatively few studies have been conducted regarding patient preparation programs prior to third molar surgery, but their limited results suggest that a program which incorporates accurate expectations and coping strategies which improve postoperative pain levels and patient satisfaction should be developed.  The purpose of this study is to compare the effects on recovery of a patient education software program compared with the traditional surgeon delivered preoperative information. By assessing the effects of a readily available patient education program on clinical and health-related quality of life measures postoperatively, we hope to enhance the surgeon’s ability to inform prospective patients about what to expect following surgery and to improve the recovery experience. A prospective clinical trial was designed and implemented.  After patients consented to participate in the study but before being consented for the surgery itself, baseline demographic data was recorded.  For the treatment group, the patient was presented with the Patient’s Guide to Third Molar Surgery DVD endorsed by AAOMS.  The patient then consented for the procedure itself and returned as scheduled for their surgery.  For the control group, the patient was given the traditional surgeon administered standardized preoperative and postoperative preparation program.  The patient was then consented for the procedure and returned as scheduled for their surgery. The patient and patient’s escort were given explicit instructions to complete each page of the diary on each consecutive day following surgery for 7 days. Statistical analysis with independent-samples t tests and analysis of variance (ANOVA) were conducted to asses for possible demographic or clinical differences between groups. Thirty-three patients (F=23, 69.7%; M=10, 30.3%) median age 20+5.49 met inclusion criteria. Most subject population race was Caucasian n=21, 65.6%; most subjects highest level of education was Secondary/High school n=21, 65.6%. Patients who were presented with the education software program, compared with those whose preoperative surgical information was provided by the surgeon, recalled less pain and anxiety 1-week postoperatively. Additionally, the control group anticipated more procedural anxiety. In summary, the use of a patient education program had the desired effect of lower recalled pain and anxiety with improved overall subjective surgical experience associated with surgical extractions at 1 week following surgery. Based on these preliminary results, we concluded that this outcome may potentially produce important savings in the cost of health care for the patients following surgical dental extractions, insurance providers and healthcare providers via fewer appointments: medications and the use of other diagnostic tools.

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