Patterns and Potential Risk Factors for Repeated Dental General Anesthesia in Pediatric Patients in Alberta, Canada

Purpose: To examine dental general anesthesia (DGA) utilization patterns among children in Alberta, Canada, and identify factors contributing to the need for multiple DGAs (between 2010 and 2020). Methods: This retrospective population-based cohort study utilized administrative health data to investigate DGA usage among children (younger than 18 years). The study considered all children receiving DGA for oral and dentalrelated issues in publicly funded facilities, regardless of medical status. A descriptive statistic, binary logistic regression, Cox proportional regression, and Kaplan-Meier survival analysis were employed. Results: Among 30,523 children receiving DGA, the majority were younger than six years old (62.8 percent), were from low-income families (54.6 percent), and received treatment at urban hospitals. Most were medically healthy (91.2 percent) and received treatment for dental caries (77.1 percent), with restorations and extractions being the most frequent procedures. Significant predictors of multiple DGA events included younger age at first DGA, identification as having special health care needs (SHCNs), and the type of dental procedures performed during the first DGA. Conclusions: The findings of this study highlight the importance of considering patient characteristics and treatment factors when planning and delivering pediatric dental care. Special health care needs status emerged as a key factor associated with the likelihood of repeated dental general anesthesia, highlighting the need for tailored interventions and resource allocation to improve oral health equity in this population.