An Institutional Audit of The Effect Of Oral Dexamethasone on Post Operative Inflammation, Following Mandibular Third Molar Surgery in Lagos, SW Nigeria

Background: Surgical extraction of impacted mandibular third molar is one of the commonest oral surgical procedures. It is frequently associated with sequelae such as postoperative pain, swelling and trismus, which is known to have an impact on the quality of life of the patients. The aim of this study was to determine the effect of a single dose of pre-operative oral dexamethasone on postoperative pain, swelling and trismus in patients undergoing third molar surgery at the oral and maxillofacial surgery department, Lagos State University Teaching Hospital, Ikeja. Materials and methods: This double-blinded randomized controlled trial was conducted at the Department of Oral/ Maxillofacial Surgery, LASUTH. Fifty patients each that required third molar surgery were randomly allocated into case and control groups. Subjects in case group received a single dose of oral dexamethasone 1 hour preoperatively while the control subjects received lactose tablets. All subjects had their volumetric facial measurements, maximum inter-incisal and pain experience measured pre-operatively and also immediately after surgery on first, second and seventh day post-operatively. Results: There was a significant reduction in the post-operative facial swelling in the test group on the 2 nd day. There was similarly a significant reduction in trismus in the test group compared with the control group immediately after surgery and on the 2 nd and 7 th days postoperatively. A significant reduction was also observed in the pain experienced by the subjects in the case group compared to the control group on the 2 nd and 7 th days post-operatively but not immediately after surgery. Conclusion: In conclusion, a single 8mg dose of oral dexamethasone was effective in significantly reducing facial swelling, pain and trismus immediately after surgery and also on the 2 nd and 7 th days after mandibular third molar surgery. It can thus be recommended that oral dexamethasone be given 1 hour pre-operatively to provide early bioavailability of the medication.