To evaluate quality of life (QoL) and patients' perceptions of a domiciliary facial cooling system (Hilotherm, Hilotherapy UK Ltd, Coventry, UK), we asked 30 patients to complete a paper-based EQ-5D-3L QoL questionnaire (EuroQol Group 1990, Rotterdam, The Netherlands) each day for seven days after the removal of mandibular third molars. They were returned by 14 of the 20 patients who had not used the system and by all 10 who had. Patients aged between 18 and 25 who had their teeth removed in outpatients (in accordance with National Institute for Health and Care Excellence guidelines) under general anaesthesia (American Association of Anesthesiologists (ASA) class I or II) and did not smoke, were included. They were all treated by the same surgeon in the day surgery unit of a district general hospital. Patients found the system helpful and easy to use. They had no complications, their QoL was significantly improved (p<0.001), and the time taken to return to normal activities was reduced. The Hilotherm domiciliary facial cooling system is safe and helps in the management of postoperative pain and swelling. Our findings confirm recently published meta-analyses that show the effectiveness of hilotherapy after facial surgery.

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When an upper tooth is extracted a possible complication is the creation of an oro-antral communication with the added risk of displacement of tooth roots into the antrum. We present a case of a displaced palatal root of an upper first molar tooth which was found in a superior position in the maxillary antrum having been left in situ for 6 weeks. The root was in a high risk position for complications such as sinusitis, mucocoele formation and the more serious septic thrombosis of the cavernous sinus. This case report describes its safe endoscopic removal and highlights the importance of prompt referral and treatment for similar cases. CPD/Clinical Relevance: Displaced roots in the maxillary antrum during routine extraction can result in complications ranging from sinusitis to more severe complications if not managed appropriately.