Parents' perceptions and concerns regarding pediatric dental care under general anesthesia in Riyadh (Saudi Arabia): a cross-sectional study

The prevalence of dental caries in Saudi children is estimated to be 80% for primary dentition and 70% for permanent dentition. Dental treatment under general anesthesia (GA) might be recommended for children with uncooperative behavior or complicated dental treatment requirements. Despite its advantages, some parents have concerns regarding this approach. Nonetheless, little is known about Saudi parents’ perceptions and concerns regarding pediatric dental treatment under GA. The main objective of this study was to determine parents’ concerns and perceptions on pediatric dental treatment under GA in Saudi Arabia. It is a cross-sectional survey study. The inclusion criteria were: Arabic-speaking parents of healthy children aged 1–14 years referred to GA screening for dental treatment in a hospital. The final study cohort comprised 319 participants. The first part of the questionnaire included the children’s and parents’ demographic and clinical input, while the second part comprised the parents’ perceptions and concerns. The survey was distributed in the dental office during GA screening visits. Our findings revealed that most parents were concerned about possible GA-related complications (78%), followed by postoperative pain (51%), intravenous line and cannula (49%) and coma or death (46%). This study highlights that most Saudi parents were concerned about the use of GA in pediatric dental treatment and the need for more awareness regarding the risks, benefits and expected outcomes of pediatric dental care under GA.

Pediatric dental care; General anesthesia; Parental concerns; Cross-sectional

[1] Rajavaara P, Laitala ML, Vähänikkilä H, Anttonen V. Survey of family-related factors of children treated under dental general anaesthesia. European Journal of Paediatric Dentistry. 2018; 19: 139–144.

[2] Park JS, Anthonappa RP, King NM, McGrath CP. The family impact of dental general anaesthesia in children: a meta-analysis. International Journal of Paediatric Dentistry. 2019; 29: 149–161.

[3] Amin MS, Harrison RL. Change in parental oral health practices following a child’s dental treatment under general anaesthesia. European Archives of Paediatric Dentistry. 2006; 7: 77–82.

[4] Nelson TM, Xu Z. Pediatric dental sedation: challenges and opportunities. Clinical, Cosmetic and Investigational Dentistry. 2015; 7: 97–106.

[5] Al Agili DE. A systematic review of population-based dental caries studies among children in Saudi Arabia. The Saudi Dental Journal. 2013; 25: 3–11.

[6] Alhabdan YA, Albeshr AG, Yenugadhati N, Jradi H. Prevalence of dental caries and associated factors among primary school children: a population-based cross-sectional study in Riyadh, Saudi Arabia. Environmental Health and Preventive Medicine. 2018; 23: 60.

[7] Klingberg G, Broberg AG. Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. International Journal of Paediatric Dentistry. 2007; 17: 391–406.

[8] Hua L, Busuttil-Naudi A, Keightley AJ. Do paediatric patient-related factors affect the need for a dental general anaesthetic? British Dental Journal. 2022; 233: 407–412.

[9] Ciftci V, Yazicioglu İ. A retrospective comparison of dental treatment under general anesthesia provided for uncooperative healthy patients and patients with special health care needs. The Journal of Clinical Pediatric Dentistry. 2020; 44: 196–201.

[10] Mallineni SK, Yiu CKY. A retrospective audit of dental treatment provided to special needs patients under general anesthesia during a ten-year period. The Journal of Clinical Pediatric Dentistry. 2018; 42: 155–160.

[11] Cantekin K, Yildirim MD, Cantekin I. Assessing change in quality of life and dental anxiety in young children following dental rehabilitation under general anesthesia. Pediatric Dentistry. 2014; 36: 12E–17E.

[12] White H, Lee JY, Vann WF Jr. Parental evaluation of quality of life measures following pediatric dental treatment using general anesthesia. Anesthesia Progress. 2003; 50: 105–110.

[13] Savanheimo N, Vehkalahti Mm, Pihakari A, Numminen M. Reasons for and parental satisfaction with children’s dental care under general anaesthesia. International Journal of Paediatric Dentistry. 2005; 15: 448–454.

[14] Amin MS, Harrison RL, Weinstein P. A qualitative look at parents’ experience of their child’s dental general anaesthesia. International Journal of Paediatric Dentistry. 2006; 16: 309–319.

[15] Acs G, Pretzer S, Foley M, Ng MW. Perceived outcomes and parental satisfaction following dental rehabilitation under general anesthesia. Pediatric Dentistry. 2001; 23: 419–423.

[16] Srinivas R, Anandakrishna L. Parental issues and concerns for their children treated under general anaesthesia for early childhood caries: a qualitative research approach. Indian Journal of Dental Research. 2021; 32: 158–161.

[17] Koh JH, Daniel P, Bong CL. Parental perception on the effects of early exposure to anaesthesia on neurodevelopment. Anaesthesia. 2019; 74: 51–56.

[18] AlQhtani FA, Pani SC. Parental anxiety associated with children undergoing dental treatment. European Journal of Paediatric Dentistry. 2019; 20: 285–289.

[19] Aldossari GS, Aldosari AA, Alasmari AA, Aldakheel RM, Al-Natsha RR, Aldossary MS. The long-term effect of previous dental treatment under general anaesthesia on children’s dental fear and anxiety. International Journal of Paediatric Dentistry. 2019; 29: 177–184.

[20] Hastings GB, Lawther S, Eadie DR, Haywood A, Lowry R, Evans D. General anaesthesia: who decides, and why? British Dental Journal. 1994; 177: 332–334.

[21] Koh JH, Daniel P, Bong CL. Parental perception on the effects of early exposure to anaesthesia on neurodevelopment. Anaesthesia. 2019; 74: 51–56.

[22] Astuto M, Rosano G, Rizzo G, Disma N, Raciti L, Sciuto O. Preoperative parental information and parents’ presence at induction of anaesthesia. Minerva Anestesiologica. 2006; 72: 461–465.

[23] Farsi DJ, Farsi NJ, El-Housseiny AA, Turkistani JM, Farsi NM. Impact of dental rehabilitation on oral health-related quality-of-life in healthy children and those with special health care needs. The Journal of Contemporary Dental Practice. 2018; 19: 367–374.

[24] El Batawi H, Panigrahi P, Awad M. Perceived outcomes and satisfaction of Saudi parents and their children following dental rehabilitation under general anesthesia: a 2-year follow-up. Journal of International Society of Preventive and Community Dentistry. 2014; 4: S153–S160.