The authors examined time to need new treatment of primary second molars in very young
children treated under general anesthesia (GA).
During this retrospective chart review, the authors examined patients aged 2 through
4 years with severe early childhood caries (ECC) who received dental treatment under
GA. Primary second molars were tracked in periodic recall visits after GA for 6 through
89 months. Using a random-effects Cox proportional hazards model, the authors compared
hazards of teeth requiring new treatment based on treatments received at GA.
Of 3,166 primary second molars included in the study, 367 (12%) were not erupted,
77 (2%) received topical fluoride only, 873 (28%) received a pit and fissure sealant,
242 (8%) received a composite restoration, and 1,607 (50%) received a stainless steel
crown (SSC) at GA. SSCs had a survival probability of 98% by 84 months after GA, significantly
higher than all other groups (
P < .0001). The second molars that were not erupted at GA had the highest hazard, especially
within the first 24 months after GA. Teeth that received sealant had longer time to
need new treatment than nonsealed teeth; however, at 84 months after GA, only 33%
of the sealed teeth did not require additional treatment.
Preventive or restorative treatments other than SSCs resulted in need for new treatment
in a substantial number of teeth. SSCs had the highest success in this population
with severe ECC treated under GA and should be chosen over other restorative options
to reduce risk of undergoing repeat dental treatment.
Aggressive treatment with SCC should be considered for young children with severe
ECC especially those who are treated under GA at a young age.