Aim: The aim is to evaluate the effectiveness of dexamethasone given submucosally and intramuscularly on postoperative complications after removal of impacted third molars in a preliminary randomised prospective clinical trial.

Patients and methods: Thirty patients, each of whom required removal of a single impacted mandibular third molar under local anaesthesia, were randomly divided into 3 groups of 10 each. For the first group, 1 ml (4 mg) dexamethasone was added to 0.5 ml articaine hydrochloride and administered by submucosally with local anesthesics while applying buccal nerve block. For the second group, dexamethasone was injected intramuscularly one hour before the operation. The third group was consisted of control patients who received no dexamethasone. Facial swelling and maximal interincisal distance were measured preoperatively and at 2 and 7 days postoperatively. Pain was measured by counting the number of rescue analgesic tablets taken, and from the patients’ response to a visual analogue scale (VAS).

Result: Dexamethasone groups showed significant reductions in swelling, pain and trismus ( p < 0.05). Submucosal dexamethasone resulted in significantly less facial swelling on second day; pain on second and third days; trismus on second and seventh days postoperatively ( p < 0.05). Submucosal dexamethasone resulted in significant differences than intramuscular dexamethasone except trismus on day 2 postoperatively.

Conclusion: Dexamethasone 4 mg given submucosally is an effective way of minimising swelling, trismus, and pain after removal of impacted lower third molars, and is comparable with the intramuscular route. It offers a simple, safe, painless, non-invasive, and cost-effective treatment in moderate to severe cases.

Conflict of interest: None declared.