Reasons for repeat dental treatment under general anesthesia for the healthy child.

Purpose: This study investigated reasons a healthy child may need repeat dental treatment under general anesthesia (GA). Methods: Experimental subjects were 23 healthy children who received dental treatment under GA twice; controls were 23 healthy children requiring a single dental treatment session under GA. Records review determined demographics, intraoperative information, diagnosis, and treatment provided. Parents of 11 subjects and 9 controls competed a questionnaire and were interviewed. Results: Many factors differed between subject and control children. Common characteristics of children requiring repeat care under GA (subjects) were: (1) 100% percent caries involvement of maxillary central incisors at time of initial treatment; (2) majority of central incisors were nonrestorable; (3) still using nursing bottle at the time of GA; (4) child responsible for brushing own teeth; (5) poor cooperation in the medical and dental setting; (6) difficult personality as described by parent; (7) dysfunctional social situation; and (8) lack of follow-up dental care. Stainless steel crowns were the most successful restoration placed. Conclusions: A number of predictors were found to help identify high-risk children. Best outcomes following dental rehabilitation under GA may result from aggressive treatment of caries, active follow-up, and education of parents. (Pediatr Dent. 2003;25:546-552)