Effects of dental treatment under general anesthesia on the oral health quality of life and dental fear of preschool children: a systematic review and meta-analysis.

OBJECTIVES

In this review, we aimed to determine the effects of dental treatment under general anesthesia on the oral health-related quality of life and dental fear of preschool children.

MATERIALS AND METHODS

A comprehensive electronic search of PubMed, Embase, Scopus, and the Cochrane Library was conducted up to July 20, 2023 (updated on April 10, 2024). A manual search and evaluation of the gray literature were also performed. Clinical trials utilizing a before-and-after design to evaluate the effects of dental treatment under general anesthesia (DGA) on oral health-related quality of life (OHRQoL) and dental fear in preschool-aged children were included in this research. To assess study quality, tools specifically designed for "before-after studies without control groups" were employed to determine potential biases. Two independent investigators conducted separate evaluations of the studies' quality assessment processes. A meta-analysis was conducted via the random effects model.

RESULTS

In the final analysis, 13 studies employing a pre-post design were included. The meta-analysis revealed a statistically significant difference in Early Childhood Oral Health Impact Scale (ECOHIS) scores between the pre-evaluation group (n = 1365) and the post-evaluation group (n = 1344) (mean difference [MD] = 9.61, 95% CI: 6.28-12.93; P < 0.00001). However, there was no significant difference in the mean Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) score between the pre-evaluation group (n = 536) and the post-evaluation group (n = 531) (MD = 5.53, 95% CI: -16.48-27.54; P = 0.62).

CONCLUSIONS

This study confirmed that children who received dental treatment with general anesthesia experienced improvements in their oral health-related quality of life. However, there is insufficient evidence to support the claim that dental treatment with general anesthesia can effectively alleviate dental fear in children.

CLINICAL RELEVANCE

Dental treatment with general anesthesia significantly improved the OHRQoL of children. However, methods to improve dental fear in children during this procedure remain to be explored.