Dental Treatment in Children under General Anesthesia: A 24-year Retrospective Study

General anesthesia (GA) is frequently used for pediatric dental treatment in cases of extensive decay, behavioral challenges, or medical conditions that prevent conventional care. This study presents a 24-year retrospective analysis of dental treatments performed under GA at the Children's Hospital.

A retrospective review was conducted on dental treatments performed under GA between January 1, 2001, and December 31, 2024. Data collection included patient age, sex, details on dental procedures, medical status, and postoperative follow-up. Statistical analyses included linear regression, Pearson's correlation, Mann-Kendall trend test, Student's t-tests, Chi-square tests, and descriptive statistics.

Between 2001 and 2024, 4,062 patients underwent dental treatment under GA, representing 1.59% of all admissions. The proportion of treatments under GA increased significantly (p = 0.008). The mean age was 6.29 years for girls and 5.98 years for boys, with a statistically significant difference (p < 0.0001) but a small effect size. Boys (53.77%) were treated under GA more often than girls (p = 1.55 × 10^-6). In total, 39,818 teeth were treated, mainly restorations (65.84%) and extractions (22.68%), with no gender difference. Among patients, 12.08% had a disability, 6.96% had systemic conditions, and 80.96% were healthy. Healthy children had significantly more treated teeth than others (p < 0.0001). Follow-up attendance dropped from 56.57% at 1 month to 3.80% at 9 months, with 43.43% missing all follow-ups. Only 1.87% of patients failed NOOM (nitrous oxide/oxygen mixture) and required GA. Twelve children, mostly with autism or cerebral palsy, underwent multiple GA procedures.

The demand for dental treatment under GA has significantly increased over the past 24 years. While GA remains a crucial option for pediatric patients with extensive dental needs or special conditions, the low postoperative follow-up rates highlight the need for improved follow-up strategies.

Shayegan A, Makanz VM, Abergel C. Dental Treatment in Children under General Anesthesia: A 24-year Retrospective Study. Int J Clin Pediatr Dent 2025;18(9):1134-1139.