The Impact of Prior Use of Corticosteroid to Dental Extraction on Oral Health-Related Quality of Life and Clinical Outcomes: A Randomized Clinical Trial.

Pansard, Heitor B; Prado, Mayara C; Marchi, Gabriel F; Sfreddo, Camila S; Skupien, Jovito A

PURPOSE To evaluate the impact of prior use of corticosteroids before dental extractions on oral health-related quality of life (OHRQoL). METHODS A randomized and triple-blind (patient, surgeon, and examiner) clinical trial was designed. The individuals were randomly allocated to 2 groups: test and placebo. In the test group, 2 capsules of 4 mg dexamethasone were administered orally. In the placebo group, subjects received 2 capsules with the same characteristics. In both groups, the administration took place 1 hour before the procedure. OHRQoL was assessed by the Brazilian version of Oral Health Impact Profile (OHIP-14). The OHIP-14 questionnaire and the assessment methods for clinical parameters were collected preoperatively and postoperatively. Multilevel linear regression models fitted the associations between preoperative use of corticosteroids and overall and domain-specific OHIP-14 scores over time. RESULTS One hundred fourteen patients were selected for study; however, 21 were excluded for not returning to postoperative control on the seventh day, resulting in 93 patients assessed (test = 44 and placebo = 49). The pain had a negative impact on OHRQoL (P < .01); however, the use of the drug had no statistically significant influence on OHRQoL (P = .62) and the clinical outcomes of pain (P = .63), mouth aperture (P = .05), and edema (P = .69). CONCLUSIONS The use of the 8 mg dexamethasone administered orally before the procedure was not effective on the improvement of the quality of life of patients undergoing dental extraction. However, using the medication seems to result in an improvement in the postoperative period of patients who had impacted teeth. Further research involving the analysis of OHRQoL must be performed, and other dosages and means of administration must be tested.