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Introduction: The extraction of the lower impacted third molar teeth is always associated with varying degrees of inflammation that may have a social impact for the patients.

Objective:  To compare the effectiveness of dexamethasone and serratiopeptidase in the control of swelling following surgical extraction of impacted mandibular third molar.

Methodology: This non-randomised controlled trial was conducted among 180 individuals undergoing extraction of mandibular third molar in the Oral Surgery department of Kathmandu Medical College and Teaching Hospitals (KMCTH) at Duwakot, Bhaktapur and at Sinamangal, Kathmandu, Nepal from 2021 October to 2022 February. Among them, 90 patients received dexamethasone and 90 received serratiopeptidase. Effectiveness of these drugs in post-operative swelling were evaluated. Data were analysed in SPSS version 20. Mean standard deviation, median, frequency and percentage were calculated. Wilcoxon Sign Rank test was done for pairwise comparison of each medication. Mann-Whitney U test was done for comparing pre- and post-operative swelling among two medications.

Result: Significant differences were observed in both the groups when preoperative gonion to corner of mouth (p <0.001), tragus to corner of mouth (p <0.001), outer canthus to gonion (p <0.001), and cheek girth measurements (p <0.001) were compared with three consecutive post-operative period measurements. However, when two groups were compared, there was no significant differences observed in these measurements in either preoperative or three post-operative observation periods.

Conclusion: The findings of this study showed that both dexamethasone and serratiopeptidase were equally effective in controlling the post-operative swelling.

Dexamethasone; impaction; oedema; serratiopeptidase.