An interesting editorial titled “Outcomes after 3rd molar surgery: what about quality of life?” written by Ogden appears in the 2014 edition of Oral Surgery (vol. 7, pp. 1-2). The article discusses how there are many complications that can occur after wisdom teeth removal and many of these are mentioned to the patient prior to surgery as part of the informed consent process. Such complications that can occur after wisdom teeth removal are discussed over at http://www.teethremoval.com/complications.html and the informed consent process has been discussed before for example in the post Informed Consent in Dentistry: Can Change Impact Personal Injury Cases? and also http://www.teethremoval.com/legal_system_medical_malpractice. However the article by Ogden dives deep and addresses how patient quality of life outcomes should be disclosed as complications in the informed consent process.
The author mentions a 1997 study which showed that 1 week after wisdom teeth surgery one in seven patients lose self-confidence, one in there patients have a disinterest in socializing, one in two patients needs to take a week off work, one in two patients continue to have pain even when on pain killer medications, and many patients lose their ability to eat the foods they typically do. The author also mentions a 1998 study he conducted which showed dentists and oral and maxillofacial surgeons rank pain as the most significant factor to affect a patient after wisdom teeth surgery; however, patients rank the ability to enjoy to eating food as the most significant factor to affect them after wisdom teeth surgery. The author also mentions a 1999 study which showed that patients underestimate the time they need to make a recovery from wisdom teeth surgery and the effect such surgery will have on their quality of life. The author states while addressing his oral surgeon audience:
“All of the above point to a need for us to be clearer in our communication with our patients when we brief them about the operation and what to expect, especially when it comes to issues such as lowered self-esteem, reduced confidence, time off work, ability to eat and enjoyment of food (as well as all the other risks, e.g. nerve damage, trismus, swelling, we commonly include).”
Although not mentioned in the article by Ogden typically when the more common complications such as nerve damage are disclosed dentists and oral surgeons do not really go into quality of life impacts of these injuries either. This has been discussed in the post Quality of Life Following Injury to the Inferior Alveolar Nerve or Lingual Nerve During Wisdom Teeth Surgery. The two most common nerve injuries resulting from wisdom teeth removal are to the inferior alveolar nerve and lingual nerve. Such nerve injuries are associated with altered sensation, pain, drooling, biting of the tongue, and interface with daily activities such as speaking, eating, drinking, speaking, shaving, and kissing. Such information regarding the impact nerve injuries after wisdom teeth removal have on quality of life comes out in dental malpractice lawsuits, see for example http://teethremoval.com/dental_malpractice.html. Such nerve injuries and also thermal burn injuries that can occur can be associated with changes in facial appearance and thus could have a permanent negative impact on self-confidence. In one case a change in facial appearance lead to constant teasing see the post Wisdom Teeth Removal can Lead to Teasing and Unwanted Nicknames.
Ultimately it appears the merely mentioning that a complication like nerve damage, increasing swelling, or reduced mouth opening can occur with wisdom teeth surgery is not enough. More efforts should be made to disclose the impact such complications can have on a persons quality of life and their psychological state after wisdom teeth surgery.