Third molar surgery: an audit of the indications for surgery, post-operative complaints and patient satisfaction.

A prospective investigation was undertaken of 522 patients undergoing third molar surgery. Data relating to indications for surgery and quality of care were collected on both pre- and post-operative proformas. This investigation showed that over half of the patients did not have clinically sound indications for surgery. The incidence of post-operative complications was approximately the same as other studies on third molar surgery. Patient satisfaction was at a high level, although this study revealed that a percentage of symptom-free patients undergoing third molar surgery sustained nerve damage some of which remains unreported. Clear and well defined indications for third molar surgery do exist and should be adhered to. Operating on patients without good reason involves unnecessary expenditure to purchasing authorities, cost to the patient in both time off work and post-operative complications and further, may result in potentially avoidable legal problems for practitioners. A reappraisal of the impacted third molar is indicated prior to committing the patient to surgery, such that the indications for surgery are compatible with current views on quality assurance, health service economics and medico-legal common sense.