Effects of Single-Session Treatment of Primary Teeth Under General Anesthesia Versus At-Office Multi-session Treatment on Permanent Molar Caries Status: Nonrandomized Clinical Trial

Objectives

Effects of treatment under general anesthesia versus several sessions of at-office treatment on the transition of caries prevalence from primary to permanent dentitions have not been assessed. Moreover, other gaps exist in the literature.

Material and Methods

This 4-group non-randomized clinical trial was performed on 280 children 8–10 years old in 4 groups, including both negative and positive controls: children with a history of caries in primary teeth who were (1) treated routinely in office (n = 60) versus (2) under general anesthesia versus (n = 110) (3) similar children undergoing no treatment versus (positive control, n = 60) (4) children without a history of primary teeth caries (negative caries, n = 50). A clinical assessment was performed to assess dmft (caries and restoration statuses of primary teeth), OHI-S (oral hygiene), and ICDAS indexes (caries and restoration statuses of permanent molars). Data were analyzed (α = 0.05).

Results

There were significant, positive correlations among dmft, caries component of ICDAS, and OHI-S (p-values = 0.000). The dmft scores were significantly different across 4 groups (Kruskal–Wallis p = 0.000), with children treated under general anesthesia followed by in-office treatment and no-treatment positive control group having the highest dmft scores (all Bonferroni-adjusted p-values ≤ 0.013). The ICDAS-caries of the general anesthesia group was significantly greater than the negative control, but also significantly smaller than both positive control and in-office treatment group (all Bonferroni-adjusted p-values ≤ 0.009). Groups were different in terms of OHI-S (Kruskal–Wallis p = 0.000); hygiene was the worst in positive-control and in-office groups, followed by the anesthesia group and the negative control.

Conclusions

Although children who underwent treatment with general anesthesia had the worst dmft scores, treatment under general anesthesia considerably reduced caries of their permanent first molars (as indicated by ICDAS scores) and oral hygiene (as indicated by OHI-S) compared to children who were treated routinely in the office. Primary tooth caries might be a decisive predictor of permanent molar caries formation.