Dental treatments under general anesthesia for functional oral rehabilitation in children with and without developmental disorder

Management of dental disease in pediatric patients depends on the extent of tooth decay and children’s ability to cooperate, influenced by age and cognitive development. For some children, general anesthesia (GA) may be required to provide safe and effective care. This retrospective study aimed to compare dental treatments performed under GA in children with and without developmental disorders, according to age. Data collected from surgical reports of all children who underwent treatment under GA between January 2019 and December 2023 at the special care unit of a French University Hospital were analyzed. Mean age was compared between children with and without DD using a Student’s t-test, stratified by age (under and above 7 years old). The mean number of each type of treatment performed (restorative procedures, pulp therapies and extractions) was compared with a Student’s t-test. The distribution of the geographic distance and of each types of treatment was compared using a Chi-square test. Seven hundred eighty-two children (mean age: 6.66 ± 3.24 years old) consisting of 549 children without DD and 223 children with DD were included. Children with DD were older and received significantly fewer dental treatments (including extractions) than children without DD (9.18 ± 5.37 treatments versus 12.99 ± 5.59, respectively; Student’s t-test, p < 0.001), independently of their age. In children aged 7 and older, the distribution of the different types of treatments was statistically different between children with and without DD (Chi-square test, p < 0.001). In particular, children with DD received proportionally fewer pulpotomies and stainless-steel crowns than children without DD. Children without DD with multiple caries required the same care management strategies and specific technical facilities to avoid treatment failure as children with DD reinforcing the idea that these children should be recognized as having special needs. Treatments choices should not only be based on children’s systemic conditions but also on their actual needs. Evidence-based guidelines for dental treatment under general anesthesia to support oral functional rehabilitation for all children in need of special care should be developed in order to improve their development and quality of life.