The Clinical Effectiveness of Using Kinesio Tape Following Wisdom Teeth Extraction

Surgical removal of third molars (3M) is a routine, low risk procedure. Common post-surgical symptoms are typically swelling, pain and trismus. Kinesiology Taping (KT) is a relatively new treatment option in musculoskeletal pathologies and some of the hypotheses of KT is that it reduces pain, oedema and increases blood low; however current evidence does not support its use. Patient A underwent a routine removal of 3 third molars via general anaesthetic. A post-surgical lymphatic drainage KT application was applied to the patient’s lower mandible and masseter region. Results showed a signiicant reduction in pain, swelling and trismus was also reduced. The post op recovery time was decreased from the post op material of 10 days to 5 days; therefore suggesting that KT is potentially an effective treatment following surgical removal of wisdom teeth. operatively. Facial oedema was measured using a ive-line measurement again measured daily [11]. he measurements which were taken for facial oedema are as stated in [11] “Line 1 was the most posterior point of the tragus to the most lateral point of the lip commissure, line 2 was the most posterior point of the tragus to the pogonium, line 3 was the most posterior point of the tragus to the lateral canthus of the eye, line 4 was the lateral canthus of the eye to the most inferior point angle of the mandible, and line 5 the most inferior point angle of the mandible to the midpoint of the nasal bone”. Kinesio Tex Gold (KTG) was applied immediately ater Patient A had come around from the general anaesthetic by a Kinesio Taping Practitioner (KTP) assisted by a Certiied Kinesio Taping Practitioner (CKTP) (Figure 1). KTG was measured from Patient A’s supraclavicular to the point of maximum swelling into 3 strips. KTG followed the lymphatic and circulatory protocols devised by Kase [4,10] using 10% tension, directed to the supraclavicular nodes and gently rubbed to activate the adhesive and remained on Patient A for 5 days. A change of tape was not necessary. Patient A was also prescribed an antibiotic which needed to be taken daily which is standard protocol following invasive surgery [1] and codeine 30 mg if required. he application efects aimed to reduce oedema, decrease trismus and pain by the physiological outcomes outlined by Kase [4,10]. Patient A had no side efects of the KTG. he success of the treatment was assessed by measurements of trismus, pain and oedema; furthermore, photographs were also taken as a visual and comparative guide for the patient (Figure 1-3). Table 1 shows values for Trismus, Pain and Oedema. hese were taken immediately post-surgery and continued for 7 days post-operative. Citation: Henderson S, Alexanders J, Shaw T (2016) The Clinical Effectiveness of Using Kinesio Tape Following Wisdom Teeth Extraction. Physiother Rehabil 1: 103.


Introduction
Removal of third molars (3M) is a routine procedure that is performed daily within dentistry [1,2] afecting over 75,000 patients in the UK per year [3] and up to 5 million in the United States [2]. Research has demonstrated that common symptoms associated with 3M are namely pain, swelling, discomfort and morbidity being the most common symptoms [1][2][3]. Currently, there are a number of approaches including advances in dentistry surgical tools, analgesics and hands on techniques which aim to reduce the post-operative morbidity, oedema and trismus, conversely with no signiicant diference. Consequently, new approaches need to be considered to efectively reduce these postoperative symptoms. Kinesio Taping (KT) has become a prevalent therapeutic tool in musculoskeletal (MSK), neurological and lymphatic conditions [4][5][6][7][8]. KT originated in the 1970's by Kenso Kase [9,10]. Subsequent scientiic research states that KT can improve blood low and lymphatic drainage by removing lymphatic luid and haemorrhages [10] however not all current evidence supports its use and thus far there have been no high quality studies to outline its physiological efects. It is therefore plausible that KT has the potential to reduce morbidity, trismus and oedema; of which this case study supports.

Case
Patient A (Female, 26) presented with 3M's which was for an elective surgical extraction all of which were impacted, 2 3M were lingual and 1 was palatal. Patient A had sufered with wisdom teeth pain for 3 years with subsequent extraction aiming to decrease symptoms. Postoperative discussions between Patient A and the consultant revealed that it was highly likely that Patient A would sufer from severe oedema, pain and trismus. Patient A was placed under general anaesthetic to complete the extractions. Patient A had no previous medical conditions and was a healthy non-smoker.
Following two consultations, Patient A was admitted to receive extraction of three 3M due to all being impacted meaning they do not have enough room to emerge or develop normally. Pain scores were measured using a subjective 10 level visual analogue scale (VAS) where 0 indicates no pain, 5 moderate pain and 10, severe pain, these were taken pre and post operatively and then every day post operatively. Trismus was measured using a tape measure and was measured daily post

Abstract
Surgical removal of third molars (3M) is a routine, low risk procedure. Common post-surgical symptoms are typically swelling, pain and trismus. Kinesiology Taping (KT) is a relatively new treatment option in musculoskeletal pathologies and some of the hypotheses of KT is that it reduces pain, oedema and increases blood low; however current evidence does not support its use. Patient A underwent a routine removal of 3 third molars via general anaesthetic. A post-surgical lymphatic drainage KT application was applied to the patient's lower mandible and masseter region. Results showed a signiicant reduction in pain, swelling and trismus was also reduced. The post op recovery time was decreased from the post op material of 10 days to 5 days; therefore suggesting that KT is potentially an effective treatment following surgical removal of wisdom teeth.
operatively. Facial oedema was measured using a ive-line measurement again measured daily [11]. he measurements which were taken for facial oedema are as stated in [11] (Figure 1). KTG was measured from Patient A's supraclavicular to the point of maximum swelling into 3 strips. KTG followed the lymphatic and circulatory protocols devised by Kase [4,10] using 10% tension, directed to the supraclavicular nodes and gently rubbed to activate the adhesive and remained on Patient A for 5 days. A change of tape was not necessary. Patient A was also prescribed an antibiotic which needed to be taken daily which is standard protocol following invasive surgery [1] and codeine 30 mg if required. he application efects aimed to reduce oedema, decrease trismus and pain by the physiological outcomes outlined by Kase [4,10]. Patient A had no side efects of the KTG. he success of the treatment was assessed by measurements of trismus, pain and oedema; furthermore, photographs were also taken as a visual and comparative guide for the patient (Figure 1-3). Table  1 shows values for Trismus, Pain and Oedema. hese were taken immediately post-surgery and continued for 7 days post-operative.

Discussion
hus far, only one study has investigated the use of KT with wisdom teeth extraction [11]. Numerous studies have researched the efects of KT with MSK conditions; however little investigations into the swelling aspects to Kase's hypothesis has yet to be explored. It has been concluded KT should be used for patients following wisdom teeth extraction following a clinical trial [11] and this case report supports this study; however further trials should be conducted to validate results further which could potentially inform post-operative protocols. With this type of surgery occurring regularly within dentistry, a review of post-surgical protocols should be addressed to enhance the patient's perceptions and experience and post-surgical care to accelerate recovery which could reduce days of sick taken by the patients, reducing costs. Due to the tapings simplistic application and lasting duration for lymphatic