European Archives of Paediatric Dentistry

, Volume 15, Issue 5, pp 353–360 | Cite as

Analysis of dental care of children receiving comprehensive care under general anaesthesia at a teaching hospital in England

  • J. F. TahmassebiEmail author
  • L. T. Achol
  • S. A. Fayle
Original Scientific Article



This study aimed to analyse the characteristics of comprehensive dental care provided under general anaesthesia (CDGA) and to review the additional treatment required by children over the 6 years subsequent to CDGA.


Information collected from hospital records for the 6-year period following the first CDGA included the types of dental treatment performed at CDGA, the return rates for follow-up appointments, further treatment required subsequent to CDGA and the types of dental treatment performed at repeat DGA.


The study population consisted of 263 children, of whom 129 had a significant medical history, with mean age of 6.7 years. The results revealed that the waiting time for CDGA was significantly shorter in children who had a significant medical history, with 49 % being admitted for CDGA within 3 months of pre-GA assessment, as compared to 29 % of healthy children. 67 % of children had follow-up care recorded, with a slightly higher proportion of children with significant medical history returning for follow-up [70 % (90/129)] compared with 65 % (87/134) of healthy children. Re-treatment rates were 34 % (88/263), the majority of cases being treated under local analgesia (42/88). 34 of 263 children had repeat DGA (12.9 %). Of these 71 % (24/34) were children with significant medical history. The mean age at repeat DGA was 9 years. In 25 of 34 children (74 %), repeat DGA was due to trauma, oral pathology, supernumerary removal, hypomineralized teeth or new caries of previously sound or un-erupted teeth at CDGA. The ratio of extraction over restoration (excluding fissure sealants) performed at repeat DGA was 2.8, compared with the ratio of 1.3 in the initial CDGA.


There was a higher ratio of extraction over restorations at the repeat DGA. This suggests that the prescribed treatments at repeat DGA were more aggressive as compared to the initial CDGA in 1997. The majority of the treatment required at repeat DGA was to treat new disease.


General anaesthesia Children Dental care 


  1. Almeida AG, Roseman MM, Sheff M, Huntington N, Hughes CV. Future caries susceptibility in children with Early Childhood caries following treatment under general anaesthesia. Pediatr Dent. 2000;22:302–6.PubMedGoogle Scholar
  2. Berkowitz RJ, Moss M, Billings RJ, Weinstein P. Clinical outcomes of nursing caries treated under general anaesthesia. J Dent Child. 1997;64:210–1.Google Scholar
  3. Camilleri A, Roberts G, Ashley P, Scheer B. Analysis of paediatric dental care provided under general anaesthesia and levels of dental disease in two hospitals. Br Dent J. 2004;196:219–23.PubMedCrossRefGoogle Scholar
  4. Drummond BK, Davidson LE, Williams SM, Moffat SM, Ayers KM. Outcomes two, three and four years after comprehensive care under general anaesthesia. N Z Dent J. 2004;100:32–7.PubMedGoogle Scholar
  5. Eidelman E, Faibis S, Peretz B. A comparison of restorations for children with early childhood caries treated under general anaesthesia or conscious sedation. Pediatr Dent. 2000;22:33–7.PubMedGoogle Scholar
  6. General Dental Council. Maintaining Standards-guidance to dentists on professional and personal conduct. London: General Dental Council; 1998Google Scholar
  7. Harrison M, Nutting L. Repeat general anaesthesia for pediatric dentistry. Br Dent J. 2000;189:37–9.PubMedGoogle Scholar
  8. Harrison MG, Roberts GJ. Comprehensive dental treatment of healthy and chronically sick children under intubation general anaesthesia during a 5-year period. Br Dent J. 1998;184:503–6.PubMedCrossRefGoogle Scholar
  9. Jamjoom MM, Al-Malik MI, Holt RD, El-Nassry A. Dental treatment under general anaesthesia t a hospital in Jeddah, Saudi Arabia. Int J Paediatr Dent. 2001;11(2):110–6.PubMedCrossRefGoogle Scholar
  10. Kakaounaki E, Tahmassebi JF, Fayle SA. Further dental treatment needs of children receiving exodontia under general anaesthesia at a teaching hospital in the UK. Int J Paediatr Dent. 2006;16:263–9.PubMedCrossRefGoogle Scholar
  11. Keniry AJ. An assessment of child patients requiring general anaesthesia. ASDC J Dent Child. 1974;41(3):194–200.PubMedGoogle Scholar
  12. Mitchell L, Murray JJ, Ryder W. Management of the handicapped and the anxious child: a retrospective study of dental treatment carried under general anaesthesia. J Paediatr Dent. 1985;1:9–14.PubMedGoogle Scholar
  13. Murray JJ. General anaesthesia and children’s dental health: present trends and future needs. Anaesth Pain Control. 1993;2:222–4.Google Scholar
  14. Ng Man Wai, Tate AR, Needleman HL, Acs G. The influence of medical history on restorative procedure failure rates following dental rehabilitation. Pediatr Dent. 2001;23:487–90.PubMedGoogle Scholar
  15. Nunn JH, Davidson G, Gordon PH, Storrs J. A retrospective review of a service to provide comprehensive dental care under general anaesthesia. Spec Care Dent J. 1995;15(3):97–101.CrossRefGoogle Scholar
  16. O’Sullivan EA, Curzon ME. The efficacy of comprehensive dental care for children under general anaesthesia. Br Dent J. 1991;171:56–8.PubMedCrossRefGoogle Scholar
  17. Pitts NB, Evans DJ, Nugent ZN. The dental caries experience of 5 year children in Great Britain. Surveys coordinated by the British Association for the Study of Community Dentistry in 1999/2000. Community Dent Health. 2001;18:49–55.PubMedGoogle Scholar
  18. Rule DC, Winter GB, Goldman V, Brookes RC. Restorative treatment for children under general anaesthesia. The treatment of apprehensive and handicapped children as clinic outpatients. Br Dent J. 1967;123:480–4.PubMedGoogle Scholar
  19. Sheller B, Williams BJ, Hays K, Mancl L. Reasons for repeat dental treatment under general anaesthesia for the healthy child. Pediatr Dent. 2003;25(6):546–52.PubMedGoogle Scholar
  20. Smallridge JA, Al-Ghanim N, Hold RD. The use of general anaesthesia for tooth extraction for child out-patients at a London dental hospital. Br Dent J. 1990;168(11):438–40.PubMedCrossRefGoogle Scholar
  21. Tate AR, Ng Man Wai, Needleman HL, Acs G. Failure rates of restorative procedures following dental rehabilitation under general anaesthesia. Pediatr Dent. 2002;24:69–71.PubMedGoogle Scholar
  22. Thompson WM. Day-stay treatment for dental caries at a New Zealand hospital dental unit: a 5-year retrospective audit. NZ Dent J. 1994;90(402):139–42.Google Scholar
  23. Tyrer GL. Referrals for dental general anaesthesia—how many really need GA? Br Dent J. 1999;187:440–3.PubMedGoogle Scholar
  24. Wong FS, Fearne JM, Brook AH. Planning future general anaesthetic services in paediatric dentistry on the basis of evidence: an analysis of children treated in the Day Stay Centre at the Royal Hospitals NHS Trust, London, between 1985 and 1995. Int Dent J. 1997;47:285–92.PubMedCrossRefGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2014

Authors and Affiliations

  1. 1.Department of Paediatric DentistryLeeds Dental InstituteLeedsUK

Personalised recommendations