Dental Treatment Under General Anesthesia: A Three-Year Retrospective Cohort Study

Objectives: Pediatric patients with tooth decay are often treated under general anesthesia (GA). Previous studies show poor outcomes after surgery but have not compared these results to a non-GA population. A retrospective cohort study was conducted to investigate the dental caries relapse rate of GA and non-GA patients and its association with the sociodemographic characteristics of these patients.
Methods: Electronic charts of children 0-10 years old at the University of Washington’s Center for Pediatric Dentistry from January 2012 through April 2015 were reviewed. Participants were categorized as having received dental treatment under GA or not. An initial baseline period of six months after the first GA visit or the first exam visit was established for GA and non-GA participants respectively. Participants were followed through April 2015 or until first relapse occurred. Relapse was defined as any extraction, restoration or endodontic treatment present after the baseline period.
Results: Relapse rates were higher for GA (n=1,633) than for non-GA (n=8,648) participants. Relapse occurred earlier for GA (M=0.90 ± 0.63 years) than non-GA participants (M=1.29 ± 0.66 years), p<0.001. GA participants had lower maximum follow-up times (non-GA: 0.95 ± 1.04 years versus GA: 0.36 ± 0.57 years, p<0.001). Age for non-GA participants was the only factor that affected relapse rates.
Conclusions: GA and non-GA participants exhibited different dental outcomes. Age was a factor in relapse rates for only non-GA participants; no other demographic or patient characteristics had any effect. With higher rates of relapse, shorter follow-up times, and earlier relapse rates for GA versus non-GA participants, GA participants are at a continued high risk of dental caries relapse after dental treatment under GA. Due to the short follow-up period, the true relapse rates of GA participants remain uncertain with possible relapses occurring without follow-up.