Measurement of generic compared with disease-specific quality of life after removal of mandibular third molars: a patient-centred evaluation

Published:February 16, 2017DOI:


      Our aim was to evaluate patients’ perceptions and their responsiveness to a generic quality of life (QoL) scale after removal of mandibular third molars. We asked 40 consecutive patients who met NICE guidelines for removal of third molars to rank items from the generic EuroQuol three-dimensional questionnaire (EQ 5D 3L) and the disease-specific Oral Health Impact Profile (OHIP-14) based on what they perceived to be important outcomes. Each item was then assigned a numerical value that depended on its rank, and an overall score calculated. Fifty consecutive patients were then invited to complete a paper-based EQ 5D 3L QoL questionnaire daily for seven days after removal of third molars. Most of the generic QoL items ranked more highly than disease-specific ones. The generic EQ 5D 3L questionnaire indicated an initial fall in QoL after removal of the teeth, before improving for all participants over the first seven postoperative days. The responses to questions about “overall QoL”, “pain/discomfort”, and “anxiety/depression” in the EQ 5D 3L tool were strongly correlated. The EQ 5D 3L is used to assess fluctuations in QoL during the early postoperative period after removal of third molars, and describes items that are perceived by patients to be more important than those recorded by the disease-specific OHIP-14 QoL questionnaire. It is therefore more relevant for counselling patients preoperatively. Development of measures of early outcomes after removal of third molars should incorporate generic items to remain useful.


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        • Kanatas A.N.
        • Rogers S.N.
        A systematic review of patient self-completed questionnaires suitable for oral and maxillofacial surgery.
        Br J Oral Maxillofac Surg. 2010; 48: 579-590
        • Valderas J.M.
        • Alonso J.
        Patient reported outcome measures: a model-based classification system for research and clinical practice.
        Qual Life Res. 2008; 17: 1125-1135
        • Tschiesner U.
        • Rogers S.N.
        • Harreus U.
        • et al.
        Content comparision of quality of life questionnaires used in head and neck cancer based on the international classification of functioning, disability and health: a systematic review.
        Eur Arch Otorhinolaryngol. 2008; 265: 627-637
      1. Feeny DH, Eckstrom E, Whitlock EP, et al. A primer for systematic reviewers on the measurement of functional status and health-related quality of life in older adults. Agency for Healthcare Research and Quality (US); 2013 Sep, Rockville, MD. Available from URL: Last accessed 5 January 2017.

        • Thomas D.
        • Walker R.
        • Smith A.
        • et al.
        The provision of oral surgery services in England and Wales 1984–1991.
        Br Dent J. 1994; 176: 215-219
        • McGrath C.
        • Comfort M.B.
        • Lo E.C.
        • et al.
        Changes in life quality following third molar surgery - the immediate postoperative period.
        Br Dent J. 2003; 194: 265-268
        • Negreiros R.M.
        • Biazevic M.G.
        • Jorge W.A.
        • et al.
        Relationship between oral health-related quality of life and the position of the lower third molar: postoperative follow-up.
        J Oral Maxillofac Surg. 2012; 70: 779-786
        • Chopra D.
        • Rehan H.S.
        • Mehra P.
        Changes in quality of life after surgical removal of impacted mandibular third molar teeth.
        J Maxillofac Oral Surg. 2009; 8: 257-260
        • Conrad S.M.
        • Blakey G.H.
        • Shugars D.A.
        • et al.
        Patients’ perception of recovery after third molar surgery.
        J Oral Maxillofac Surg. 1999; 57: 1288-1296
        • Savin J.
        • Ogden G.R.
        Third molar surgery − a preliminary report on aspects affecting quality of life in the early postoperative period.
        Br J Oral Maxillofac Surg. 1997; 35: 246-253
        • McGrath C.
        • Comfort M.B.
        • Lo E.C.
        • et al.
        Patient-centred outcome measures in oral surgery: validity and sensitivity.
        Br J Oral Maxillofac Surg. 2003; 41: 43-47
        • Slade G.D.
        • Foy S.P.
        • Shugars D.A.
        • et al.
        The impact of third molar symptoms, pain, and swelling on oral health-related quality of life.
        J Oral Maxillofac Surg. 2004; 62: 1118-1124
        • Tang D.T.
        • Phillips C.
        • Proffit W.R.
        • et al.
        Effect of quality of life measures on the decision to remove third molars in subjects with mild pericoronitis symptoms.
        J Oral Maxillofac Surg. 2014; 72: 1235-1243
        • Bradshaw S.
        • Faulk J.
        • Blakey G.H.
        • et al.
        Quality of life outcomes after third molar removal in subjects with minor symptoms of pericoronitis.
        J Oral Maxillofac Surg. 2012; 70: 2494-2500
        • D’Cruz L.
        • Kaney H.
        Consent − a new era begins.
        Br Dent J. 2015; 219: 57-59