Scientific Online Resource System

Scripta Scientifica Medicinae Dentalis

Full oral rehabilitation of a child under general anesthesia. A case report

Milena Georgieva-Dimitrova, Evgeni Dimitrov


INTRODUCTION: Untreated caries lesions, painful treatment, and emergency cases in children at pre-school age may lead to increased anxiety and fear of future dental treatment. Many children have unfavorable behavior. The main difference in the treatment of children and adults is behavior management. In cases of lack of cooperation from the child and inefficiency of the methods of behavior management it is necessary for the dental treatment to be done under general anesthesia.

AIM: The aim of this article is to show the possibility for high esthetic dental treatment under general anesthesia.

MATERIALS AND METHODS: The object of the clinical study was an uncooperative child with atypical form of early childhood caries (ECC), whose behavior was modified through pharmacological agents. For the restorations of the decayed teeth, a highly esthetic nanohybrid composite Tokuyama Estelite Asteria was used.

RESULTS: A 4-year-old child came to the dental office with pain of dental origin. The child was definitely negative, uncooperative, with strong fear of dental treatment. The lack of cooperation during the examination imposed that the dental restoration of carious lesions with composite restorations and extractions of teeth diagnosed with pulp necrosis should be done under general anesthesia.

CONCLUSION: Тreatment under general anesthesia improves the conditions for highly esthetic nanohybrid restorations and avoids the eventual psychological trauma the child might get during the conventional methods of treatment. Achieving high esthetic and long-lasting results without any complications is the main goal of the treatment under general anesthesia.


general anesthesia, composite restorations, dental treatment

Full Text


Kopel HM. Considerations for the direct pulp capping procedure in primary teeth: A review of the literature. ASDC J Dent Child. 1992;59(2):141-9.

Wondimu B, Dahllof G. Attitudes of Swedish dentists to pain and pain management during dental treatment of children and adolescents. Eur J Paediatr Dent 2005;6(2):66–72.

Rahimtoola S, Van Amerongen E, Maher R, Groen H. Pain related to different ways of minimal intervention in the treatment of small caries lesions. J Dent Child 2000;67(2):123-7, 83.

Ricketts DN, Kidd EA, Innes N, Clarkson J. Complete or ultraconservative removal of decayed tissue in unfilled teeth. Cochrane Database Syst Rev. 2006;(3):CD003808. doi: 10.1002/14651858.CD003808.pub2.

World Health Organization. Basic documents. 39th ed. Geneva: WHO; 1992.

Simonsen R. From prevention to therapy: minimal intervention with sealants and resin composite materials. J Dent. 2011;39 Suppl 2:S27-33. doi: 10.1016/j.jdent.2011.11.001.

Lia EN, Costa VPP. Child behavioral management. In: Leal SC, Takeshita EM, editors. Pediatric restorative dentistry. Vol. 1. 1st ed. Switzerland: Springer Nature; 2019. p. 13–21.

Croll TP. Restorative dentistry materials for children: The 1990s and beyond. J Dent Child. 1993;60(4-5):260-2.

Tate AR, Ng MW, Needleman HL, Acs G. Failure rates of restorative procedures following dental rehabilitation under general anesthesia. Pediatr Dent 2002;24(1):69-71.

Jain V, Sarkar S, Saha S, Haldar S. Basic behaviour guidance factors and techniques for effective child management in dental clinic-an update review. Int J OralHealth Med Res. 2016;2(6):177–82.

Toh SL, Messer LB. Evidence-based assessment of toothcolored restorations in proximal lesions of primary molars. Pediatr Dent. 2007;29(1):8-15.

American Academy of Pediatric Dentistry. Policy on early childhood caries (ECC): classifications, consequences, and preventive strategies. Pediatr Dent. 2015; 37(6): 50-2.

McGrath C, Broder H, Wilson-Genderson M. Assessing the impact of oral health on the life quality of children: Implications for research and practice. Community Dent Oral Epidemiol. 2004; 32(2):81–5. doi: 10.1111/j.1600-0528.2004.00149.x.

Acs G, Shulman R, Ng MW, Chussid S. The effect of dental rehabilitation on the body weight of children with early childhood caries. Pediatr Dent. 1999;21(2):109–13.

Duggal MS, Curzon MEJ, Fayle SA, Pollard MA, Robertson AJ. Restorative techniques in paediatric dentistry. 2nd ed. London: Martin Dunitz; 2002.

Hollister MC, Weintraub JA. The association of oral status with systemic health, quality of life, and economic productivity. J Dent Educ. 1993; 57(12):901–9.

Soxman JA. The handbook of clinical techniques in pediatric dentistry. 1st ed. Wiley-Blackwell; 2015.

Burgess JO, Walker R, Davidson JM. Posterior resin-based composite: Review of the literature. Pediatr Dent. 2002; 24(5):465–79.

Donly KJ, Garcia-Godoy F. The use of resin-based composite in children. Pediatr Dent. 2002; 24(5):480–8.

Berg J, Slayton R. Early Childhood Oral Health. 1st ed. Hoboken, NJ, USA: Wiley–Blackwell; 2009.

Splieth CH. Revolution in pediatric dentistry. 1st ed. Germany: Quintessence; 2011. p. 21-35.

Redford DA, Clarkson BH, Jensen M. The effect of different etching times on the sealant bond strength, etch depth and pattern in primary teeth. Pediatr Dent. 1986. 8:11–15

Rodrigues JA, Casagrande L, Araujo FB, Lanzi TL, Mariath AAS. Restorative materials in pediatric dentistry. In: Leal SC, Takeshita EEM, editors. Pediatric restorative dentistry. Switzerland: Springer Nature; 2019. p. 161-7.

Lenzi TL, Braga MM, Raggio DP. Shortening the etching time for etch-and-rinse adhesives increases the bond stability to simulated caries-affected primary dentin. J Adhes Dent. 2014;16(3):235–41. doi: 10.3290/j.jad.a31103.

Lenzi TL, Mendes FM, De Oliveira Rocha R, Raggio DP. Effect of shortening the etching time on bonding to sound and caries-affected dentin of primary teeth. Pediatr Dent. 2013;35(5):E129–33.

Lenzi TL, Pires CW, Soares FZM, Raggio DP, Ardenghi TM, De Oliveira Rocha R. Performance of universal adhesive in primary molars after selective removal of carious tissue: an 18-month randomized clinical trial. Pediatr Dent. 2017;39(5):371–6.

Mena-Serrano A, Kose C, De Paula EA, Tay LY, Reis A, Loguercio AD, et al. A new universal simplified adhesive: 6-month clinical evaluation. J Esthet Restor Dent. 2013;25(1):55–69. doi:10.1111/jerd.12005.

Grindefjord M, Dahllöf G, Ekström G, Höjer B, Modeer T. Caries prevalence in 2.5-year-old children. Caries Res. 1993; 27(6):505–10. doi: 10.1159/000261589.

Iida H, Auinger P, Billings R, Weitzman M. Association between infant breastfeeding and early childhood caries in the United States. Pediatrics. 2007;120(4): e944–52. doi: 10.1542/peds.2006-0124.

Wendt LK, Hallonsten AL, Koch G. Oral health in preschool children living in Sweden. Part II – A longitudinal study. Findings at three years of age. Swed Dent J. 1992; 16(1-2):41–9.

Schroth RJ, Quiñonez C, Shwart L, Wagar B. Treating early childhood caries under general anesthesia: a national review of Canadian data. J Can Dent Assoc. 2016;82:g20

Guidelines for the use of sedation and general anesthesia by dentists. Chicago: American Dental Association; 2012. p. 1-14.

Davies C, Harrison M, Roberts G. UK national clinical guidelines in paediatric dentistry: guideline for the use of general anaesthesia (GA) in paediatric dentistry. London: Royal College of Surgeons; 2008. p. 1-11.

Jankauskiene B, Virtanen JI, Kubilius R, Narbutaite J. Oral health-related quality of life after dental general anaesthesia treatment among children: a follow-up study. BMC Oral Health. 2014;14:81. doi: 10.1186/1472-6831-14-81.



About The Authors

Milena Georgieva-Dimitrova
Medical University of Varna

Department of Pediatric Dentistry, Faculty of Dental Medicine

Evgeni Dimitrov
Medical University of Varna

Department of Pediatric Dentistry, Faculty of Dental Medicine

Font Size