Page 178 - Demo

Chapter 10176Chapter 3 describes the use of low-level laser light therapy (LLLT) on the injection site, prior to administering local anesthesia before the removal of a third molar in the upper or lower jaw. We did not find that this technique had a positive effect on either the experienced pain or anxiety rate in our patients. We did find that women had higher rates of pain expectation and anxiety, and also experienced more pain when the injection was administered. Unfortunately, the distribution of the procedures was skewed towards the removal of the lower wisdom tooth. This could have influenced the outcomes of this technique regarding, for example, the administration of the palatal injection, which is widely known as a more painful injection than are other forms of infiltration anesthesia. In Chapter 4, a cross-over study design was used to obtain data on postoperative pain after removal of the lower wisdom tooth, using iodine-tampon packing. The advantage of such a study design is that each patient is their own control. The use of an iodine tampon can lead to reduced inflammation at the extraction site, and thus less pain and swelling and fewer functional problems. In the OHIP-14 scores collected at 7 days, we found better outcomes for pain in the iodine-tampon group than in the non-tampon group. In females, we found a slightly longer recovery time than in males. Including enough patients for this study was difficult. The position of the lower impacted wisdom tooth had to meet de Gregory-Pell grade 3B criteria on both sides. In total we included 54 patients for this study. One might argue with the results on the basis of the low number of participants; finding these participants among the patients of a small outpatient clinic proved to be quite challenging. Chapter 5 describes a randomized study. We included patients scheduled for removal of the lower wisdom tooth and randomized their selection for the treatment protocol. In the first group, we administered a 2-cm iodine-tampon packing in the extraction socket for 1 week. In the second group, patients were instructed to use a syringe, Monoject, to irrigate the wound postoperatively 2 times a day, using only tap water. We found a significant reduction in the overall OHIP-14 scores in the iodine-tampon group compared with those of the non-tampon group. Improper syringe use could have influenced our results. Improperly performed irrigation could have led to more inflammation and more pain in the syringe group. An additional control appointment after