# Pediatric dental treatment under general anesthesia: a retrospective analysis of clinical indications and a survey of pediatric dentist referral practices

## TL;DR

This study examines why general anesthesia is used for children's dental treatments and how dentists decide to refer patients for it.

## Contribution

The study combines clinical data and dentist survey responses to provide insights into referral practices and clinical indications for pediatric dental general anesthesia.

## Key findings

- Extensive treatment needs and young age were the most common reasons for using general anesthesia in pediatric dental care.
- Dentists who perform general anesthesia are less likely to consider parental preference alone as a valid indication.
- Younger children often require general anesthesia due to severe dental decay, while older children are referred for behavioral or medical reasons.

## Abstract

The utilization of general anesthesia for pediatric dental treatments has increased. This study aimed to investigate the reasons for dental general anesthesia use in a pediatric dentistry department and to survey pediatric dentists' perspectives on dental general anesthesia indications.

A retrospective cohort study analyzed electronic medical records of patients undergoing dental general anesthesia. Additionally, a questionnaire was distributed to pediatric dentists at professional conferences, collecting responses to seven questions regarding dental general anesthesia indications.

The cohort consisted of 245 dental records. The primary reasons for dental general anesthesia were extensive treatment needs (56%), young age (41%), parental preference (39%), lack of cooperation (27%), and medical comorbidities (23%). Parental preference correlated with the child's behavior during examination (p = 0.030). Younger children (<5 years) more frequently underwent dental general anesthesia due to extensive caries, while older children (>5 years) were more likely referred due to behavioral issues and medical comorbidities. Of the 110 dentists who completed the survey, those performing dental general anesthesia were more likely to require a sedation visit before referral (p = 0.003) and less likely to consider parental preference alone as an indication (p = 0.010) compared to those not performing dental general anesthesia. Dentists performing moderate sedation were less likely to consider multiple visits (p = 0.042), multiple extractions (p = 0.028), multiple crowns (p = 0.047), or parental preference alone (p = 0.021) as indications for dental general anesthesia compared to those who did not perform moderate sedation.

Partnership with parents and taking their preferences into account are essential in decision-making regarding dental general anesthesia.