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Alveolar iodine tampon packing after impacted third molar surgery improves oral health-related quality of life835IntroductionSurgical removal of an impacted lower third molar violates the integrity of soft tissues and bone, resulting in postoperative pain, swelling, and trismus and thus negatively impacts quality of life (QoL) [1–5]. A significant reduced QoL as a result of pain has been reported with patients experiencing their greatest pain on the first postoperative day slowly decreasing during the week [3-4, 6-8]. Postoperative complications like alveolitis and surgical site infection are associated with more and longer lasting postoperative pain [3].Many efforts have been studied to prevent or reduce complications after third molar surgery. Antibiotic prophylaxis, chlorhexidine (CHX) mouth rinses, and local corticosteroids have been used to avoid infectious complications and ameliorate pain after mandibular third molar surgery [9-13]. Different studies have reported a beneficial effect of a locally applied gauze drain after the surgical removal of a mandibular third molar on alveolar osteitis, pain and swelling [14-17]. In a recent cross-over design study of our research group we found that insertion of an iodine-containing tampon into the extraction alveolus had a positive effect on oral health-related quality of life (OHRQoL), pain, trismus, and several self-care behaviors during the first postoperative week after surgical removal of a mandibular third molar [8]. Recently, a multicenter randomized controlled trial analyzing 333 surgically removed mandibular third molars in 280 patients demonstrated that rinsing out the surgical wound with a Monoject syringe significantly reduced alveolar osteitis and pain [18]. In the present randomized design, we hypothesized that we would find the same positive effects in patients who received an iodine-containing alveolar tampon on the oral health-related quality of life and pain scores, as well as improved postoperative self-care and discomfort, compared with patients who rinsed the extraction alveolus with a disposable syringe (Monoject) after wisdom tooth removal as was propagated in the Ghaeminia study [18].