Pediatric Dentists’ Preferences for Local Anesthesia Use under General Anesthesia: A Cross-Sectional Study

Aim: General anesthesia (GA) is a widely used behavior management technique for pediatric patients unable to tolerate dental treatment in conventional settings. However, there is no established consensus on the routine use of local anesthesia during dental procedures under GA. Conflicting evidence regarding its benefits and risks continues to influence clinical practice. This study aims to explore pediatric dentists' preferences regarding local anesthesia (LA) administration during GA and to identify the factors affecting their decisions.Methods: A twenty-item survey, the Pediatric Dentists’ Local Anesthesia Preference Questionnaire (PD-LAPQ), was specifically developed and validated for this study. Content and face validity were confirmed through expert review and pilot testing. The test-retest reliability was strong (ICC = 0.89; Cronbach’s alpha = 0.80). The questionnaire assessed demographics, clinical preferences, and rationale for LA use or avoidance. A convenience sample of pediatric dentists was invited to participate. Statistical analyses included chi-square, Mann-Whitney U, and Kruskal-Wallis tests (p < 0.05).Results: Of the 450 invited dentists, 210 responded (46%). Of these, 20% always used LA under GA, 1.9% never used it, and 78.1% decided its use based on each case. Most respondents were female (90.5%) with over five years of clinical experience (70.5%). Infiltration was the most common technique (52.1%), followed by regional blocks (29.5%) and intraligamentary injections (12.4%). Experience level and institution type were significantly associated with decisions on LA use (p < 0.05).Conclusion: Findings reveal considerable variation in LA practices under GA among pediatric dentists. Developing standardized, evidence-based guidelines could enhance clinical decision-making and promote safer, more consistent patient care.