Intervention Review

Sedation versus general anaesthesia for provision of dental treatment in under 18 year olds

  1. Paul F Ashley1,*,
  2. Catherine ECS Williams2,
  3. David R Moles3,
  4. Jennifer Parry4

Editorial Group: Cochrane Anaesthesia Group

Published Online: 14 NOV 2012

Assessed as up-to-date: 31 JUL 2012

DOI: 10.1002/14651858.CD006334.pub3


How to Cite

Ashley PF, Williams CECS, Moles DR, Parry J. Sedation versus general anaesthesia for provision of dental treatment in under 18 year olds. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD006334. DOI: 10.1002/14651858.CD006334.pub3.

Author Information

  1. 1

    UCL Eastman Dental Institute, Unit of Paediatric Dentistry, London, UK

  2. 2

    Guy's and St Thomas' NHS Foundation Trust, Dept Paediatric Dentistry, London, SE1, UK

  3. 3

    Peninsula Dental School, Oral Health Services Research, Plymouth, UK

  4. 4

    Sussex Community Trust, Haywards Heath Health Centre, Special Care Dentistry, Haywards Heath, UK

*Paul F Ashley, Unit of Paediatric Dentistry, UCL Eastman Dental Institute, 256 Grays Inn Road, London, WC1X 8LD, UK. p.ashley@eastman.ucl.ac.uk.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 14 NOV 2012

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary

Background

A significant proportion of children have caries requiring restorations or extractions, and some of these children will not accept this treatment under local anaesthetic. Historically this has been managed in children by the use of a general anaesthetic, however use of sedation may lead to reduced morbidity and cost. The aim of this review is to compare the efficiency of sedation versus general anaesthesia for the provision of dental treatment for children and adolescents aged under 18 years.This review was originally published in 2009 and updated in 2012.

Objectives

We evaluated the intra- and postoperative morbidity, effectiveness and cost effectiveness of sedation versus general anaesthesia for the provision of dental treatment for under 18 year olds.

Search methods

In this updated review we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 7); MEDLINE (Ovid) (1950 to July 2012); EMBASE (Ovid) (1974 to July 2012); System for information on Grey Literature in Europe (SIGLE) (1980 to October 2008), Latin American & Caribbean Health Sciences Literature (LILACS) (1982 to July 2012), and ISI Web of Science (1945 to October 2008). The searches were updated to July 2012. The original search was performed in October 2008.

We also carried out handsearching of relevant journals to July 2012. We imposed no language restriction.

Selection criteria

We planned to include randomized controlled clinical trials of sedative agents compared to general anaesthesia in children and adolescents aged up to 18 years having dental treatment. We excluded complex surgical procedures and pseudo-randomized trials.

Data collection and analysis

Two authors assessed titles and abstracts for inclusion in the review. We recorded information relevant to the objectives and outcome measures in a specially designed 'data extraction form'.

Main results

We identified 15 studies for potential inclusion after searching the available databases and screening the titles and abstracts. We identified a further study through personal contacts. Following full text retrieval of the studies, we found none to be eligible for inclusion in this review.

Authors' conclusions

Randomized controlled studies are required comparing the use of dental general anaesthesia with sedation to quantify differences such as morbidity and cost.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary

Comparing sedation with general anaesthesia to manage children who need to have dental treatment

This updated Cochrane systematic review aimed to look at any evidence comparing sedation with general anaesthesia for the delivery of dental care to children aged up to 18 years. At present children who are unable to cope with dental care under local anaesthetic may be given general anaesthesia or sedation, which is dependent on factors such as preference, economic constraints or the local regulatory framework. There is a suggestion that undertaking this work under sedation might make the experience more comfortable for the patient and could even be cheaper for the funding body. In our original review we searched the databases until October 2008. In this updated review we searched the following databases to July 2012, CENTRAL, MEDLINE, EMBASE, LILACS and ISI Web of Science. Unfortunately the search could not identify any randomized controlled trials on this topic. Therefore we recommend that these trials be carried out.