Primary Second Molar Treatment as a Predictor of Repeat General Anesthesia

Purpose: The purpose of this study was to investigate an association between treatments on the primary second molars (PSMs) under general anesthesia (GA) and odds of repeat GA. Methods: This was a retrospective study of children who received dental treatment under GA between the ages of 24 to 48 months. Descriptive statistics and logistic regression models (P<0.05) were used to test the association between the treatment of PSMs at the first dental GA visit (GA1) and the odds of receiving GA a second time (GA2) within the next 55 months post-GA1. Results: A total of 819 children (53 percent male) with a mean (±SD) age of 36 (±seven SD) months and 3,276 PSMs were included. Only three percent of children with all PSMs covered at GA1 received GA2. The odds of GA2 significantly increased for children with any uncovered PSMs. Among children with four uncovered PSMs, 19 percent (odds ratio [OR] equals 13; 95 percent confidence interval [95% CI] equals 5.8 to 33.5; P<0.001) and among those with unerupted PSMs at GA1, 51 percent received GA2 (OR equals 62.9; 95% CI equals 23.5 to 189.2; P<0.001). In the group that received GA2, 79.1 percent of uncovered PSMs at GA1 eventually received a stainless steel crown at GA2. Conclusions: Restorative treatments other than stainless steel crowns were associated with higher odds of repeat general anesthesia. These findings support the preferential use of full-coverage restorations for the treatment of carious primary molars in young children undergoing GA to minimize the risk of the need for repeat GA.