Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations: a systematic review and meta-analysis.

BACKGROUND: Restoring vital teeth with indirect restorations may threaten dental pulp integrity. However, the incidence of and influential factors on pulp necrosis and periapical pathosis in such teeth are still unknown. Therefore, this systematic review and meta-analysis aimed to investigate the incidence of and influential factors on pulp necrosis and periapical pathosis of vital teeth following indirect restorations. METHODS: The search was conducted in five databases, using MEDLINE via PubMed, Web of Science, EMBASE, CINAHL, and Cochrane Library. Eligible clinical trials and cohort studies were included. The risk of bias was assessed using Joanna Briggs Institute's critical appraisal tool and Newcastle-Ottawa Scale. The overall incidences of pulp necrosis and periapical pathosis following indirect restorations were calculated using a random effects model. Subgroup meta-analyses were also performed to determine the potential influencing factors for pulp necrosis and periapical pathosis. The certainty of the evidence was assessed using the GRADE tool. RESULTS: A total of 5,814 studies were identified, of which 37 were included in the meta-analysis. The overall incidences of pulp necrosis and periapical pathosis following indirect restorations were determined to be 5.02% and 3.63%, respectively. All studies were assessed as having a moderate-low risk of bias. The incidence of pulp necrosis following indirect restorations increased when the pulp status was objectively assessed (thermal/electrical testing). The presence of pre-operative caries or restorations, treatment of anterior teeth, temporization for more than two weeks, and cementation with eugenol-free temporary cement, all increased this incidence. Final impression with polyether and permanent cementation with glass ionomer cement both increased the incidence of pulp necrosis. Longer follow-up periods (> 10 years) and treatment provided by undergraduate students or general practitioners were also factors that increased this incidence. On the other hand, the incidence of periapical pathosis increased when teeth were restored with fixed partial dentures, the bone level was < 35%, and the follow-up was > 10 years. The certainty of the evidence overall was assessed as low. CONCLUSIONS: Although the incidences of pulp necrosis and periapical pathosis following indirect restorations remain low, many factors affect these incidences that should thus be considered when planning indirect restorations on vital teeth. DATABASE REGISTRATION: PROSPERO (CRD42020218378).

The Incidence of Devitalization of Vital Teeth Associated with Pathologies of the Jaws Following Surgical Intervention: A Mixed-case Study.

AIM: The purpose of this mixed-case study is to explore the incidence of pulp necrosis of vital teeth after surgical treatment of adjacent lesions of the jaws. MATERIALS AND METHODS: The records of 341 biopsies submitted to the institute's histopathology laboratory were reviewed to include cases that met the inclusion criteria. About 84 biopsies collected from patients during surgical enucleation of lesions in proximity to healthy vital teeth were included of which 22 patients were recalled. Adjacent teeth were examined clinically and radiographically to assess their pulpal and periapical status after at least 8 months of follow-up. RESULTS: There were 7 different pathological lesions diagnosed histologically. The follow-up period ranged between 8 and 72 months; 12 cases (54.6%) have developed pulpal necrosis for at least one tooth after surgical enucleation of the lesion. The other 10 cases (45.4%) showed normal responses to sensibility testing for all the teeth adjacent to the lesion. Ten out of the 12 cases (83%) that underwent pulpal necrosis were associated with odontogenic cysts, whereas the remaining 2 were associated with periapical granuloma and fibrous dysplasia. CONCLUSION: Pulp necrosis is high in vital teeth associated with lesions without pulpal involvement. These teeth may benefit from root canal treatment prior to surgical enucleation of the lesion, which may prevent impaired healing or recurrence of infection. CLINICAL SIGNIFICANCE: Careful treatment planning and thorough discussion should take place between the surgeons, endodontists, and patients prior to executing the treatment. The patient should be aware that there is a possibility that they may need root canal treatment as a preventative measure to enhance the chances of healing following the surgical procedures and in case the patients opted not to perform root canal treatment beforehand, close follow-up in the future should take place to monitor the vitality of the teeth in the follow-up visits.

Traumatic dental injuries and pulp sequelae in an adolescent population.

BACKGROUND/AIMS: Traumatic dental injuries (TDI) occur frequently and may result in pulp sequelae. This includes pulp necrosis with infection, pulp canal obliteration and root resorption. The aim of this study was to assess the prevalence and risk factors of pulp sequelae after TDI among Norwegian adolescents. MATERIAL AND METHODS: A retrospective longitudinal study, including historical clinical data, was conducted with 16-year-old pupils in western Norway. All first-grade pupils, born in 1997 (n = 5184), attending public high schools, were invited to participate and to respond to an electronically administered closed-ended questionnaire (response rate 39.6%, n = 2055). Consent was given to access the dental records in the Public Dental Health Service in Hordaland, where information regarding TDI (diagnosis and treatment) and radiographs were interpreted. Only TDIs to anterior teeth were recorded (canine to canine in the maxilla and mandible). Outcome variables of TDI were registered and analysed using logistic regression, Kaplan-Meier survival estimates and log-rank test. RESULTS: The prevalence of TDI in the sample population was 16.4% (338 pupils), with a total of 637 teeth involved. The number of included teeth for analysis was 571 (90.5%). The prevalence of pulp necrosis with infection was 7.5%. Moderate and severe TDI was associated with a higher frequency of pulp necrosis with infection. Pulp canal obliteration and root resorption were found in 2.8% and 2.3% of teeth with TDI, respectively. Dental hard tissue injuries were more prone to the development of pulp necrosis than luxation injuries and combination injuries. The relationship between root development stage and development of pulp necrosis with infection was not statistically significant. CONCLUSIONS: Occurrence of different pulp sequelae among teeth affected with TDI was low. Moderate and severe TDI were more at risk of developing pulpal complications and hard tissue injuries were at higher risk of developing pulp necrosis with infection.

Indications for root canal treatment in a Swedish county dental service: patient- and tooth-specific characteristics.

AIM: To study patient- and tooth-specific characteristics of teeth indicated for root canal treatment, in the public dental service of the county of Västra Götaland, Sweden. METHODOLOGY: During a designated 8-week period, general dental practitioners working at 20 different public dental clinics consecutively registered indications for undertaking root canal treatment. The patients' subjective level of pain was also registered (visual analogue scale) at the very first appointment. The following information was retrieved from computerized dental records and radiographs: gender, age, number of remaining teeth, tooth group, previous restoration, number of restored surfaces, dental caries and tooth substance loss. Gender and age were compared using both descriptive and analytical statistics. RESULTS: The material comprised 243 teeth in 243 patients: 128 (52.7%) women and 115 (47.3%) men, mean age 48.3 years. Molar teeth predominated (47.7%). Most of the teeth (83.5%) had previously been restored and exhibited significant loss of tooth substance, more than a third of the crown (71.3%). Dental caries was present in 127 teeth (62.9%). Dental trauma was implicated in only seven cases (2.9%). Initial treatment was frequently undertaken at an emergency visit, for relief of symptoms (64.9%). The most commonly registered indication was pulpal necrosis with apical periodontitis (38.1%), followed by pulpitis (37.7%). Retreatment of a root filled tooth was reported in 18 teeth (7.4%). CONCLUSIONS: In the general Public Dental Service of Sweden, root canal treatment is most frequently undertaken in molars. The primary indication is relief of symptoms. Retreatment of root filled teeth is uncommon.

Profile of intrusive luxation and healing complications in deciduous and permanent teeth - a retrospective study.

OBJECTIVE: This retrospective study analyse the profile of intrusion in deciduous (DT) and permanent teeth (PT), the occurrence of healing complications (HC), type of treatments and predisposing factors. METHODS: The records of patients attended from 2005 to 2011 were analysed. Records of patients who had one or more intruded DT or PT were included in the study. Data collected from dental records included age, gender, attendance (immediate/mediate), healing complications and type of treatment. A Chi-square test and Logistic regression (p ≤ .05) were performed to evaluate the associations between the type of teeth and presence of HC, as well as to explore the interactions between predisposing factors. RESULTS: The intrusion prevalence was 9.98% in DT and 2.45% in PT. Partial intrusion (57.3%) with palatal direction of the crown (61.8%) was most prevalent in DT, while complete intrusion (56.7%) with buccal direction of the crown (58.1%) was predominant for PT. Mobility was the most common HC in DT compared to root resorption in PT. Minimally invasive treatments were the most common therapy for DT compared to invasive treatments for PT. PT demonstrated increased HC when compared to DT (p = .004). A logistic regression illustrated that the level of intrusion and crown direction during the trauma did not influence the occurrence of HC (p > .05). CONCLUSION: Intrusion's profile in DT and PT are different. PT showed more HC than DT, however the level of intrusion and crown direction were not associated with the presence of HC.

A prospective study of the incidence of asymptomatic pulp necrosis following crown preparation.

AIM: To determine the incidence of asymptomatic pulp necrosis following crown preparation as well as the positive predictive value of the electric pulp testing. METHODOLOGY: A total of 120 teeth with healthy pulps scheduled to receive fixed crowns (experimental teeth) were included. Teeth were divided into two groups according to the preoperative crown condition (intact teeth and teeth with preoperative caries, restorations or crowns) and into four groups according to tooth type (maxillary anterior teeth, maxillary posterior teeth, mandibular anterior teeth and mandibular posterior teeth). Experimental and control teeth were submitted to electric pulp testing on three different occasions before treatment commencement (stage 0), at the impression making session (stage 1) and just before the final cementation of the crown (stage 2). Teeth that were considered to contain necrotic pulps were submitted to root canal treatment. Upon access, absence of bleeding was considered as a confirmation of pulp necrosis. Data were analysed using bivariate (chi-square) and multivariate analysis (logistic regression). All reported probability values (P-values) were based on two-sided tests and compared to a significance level of 5%. RESULTS: The overall incidence of pulp necrosis was 9%. Intact teeth had a significantly lower incidence of pulp necrosis (5%) compared with preoperatively structurally compromised teeth (13%) [(OR: 9.113, P = 0.035)]. No significant differences were found amongst the four groups with regard to tooth type (P = 0.923). The positive predictive value of the electric pulp testing was 1.00. CONCLUSIONS: The incidence of asymptomatic pulp necrosis of teeth following crown preparation is noteworthy. The presence of preoperative caries, restorations or crowns of experimental teeth correlated with a significantly higher incidence of pulp necrosis. Electric pulp testing remains a useful diagnostic instrument for determining the pulp condition.

Dental and Oral Lesions in HIV-Positive Individuals in East Bohemia--Czech Republic, Single Centre Experience.

BACKGROUND: Human immunodeficiency virus (HIV) continues to be a serious health issue and one of the world most devastating epidemics. An estimated 1.5 million people died from AIDS-related illnesses in 2013, and an estimated 37 million people with AIDS have died worldwide since the epidemic has begun. HIV infection is known for its oral manifestations which causes discomfort and pain for infected individuals. The objective of this study was to document oral conditions of HIV positive patients and the pattern and frequency of oral and dental lesions. METHODS: All patients with confirmed HIV infection who were treated at the Department of Dentistry, University Hospital in Hradec Králové, were examined. RESULTS: During the study period, 29 HIV positive patients were examined and treated--19 men, 10 women, with mean age of 32.9 years (range 22-58 years). 72.41% patients received ART. In total, all patients underwent 186 visits. The most frequent treatments were associated with teeth and periodontal lesions (71.80%), oral mucosal lesions were diagnosed and treated only in 3.96% cases. CONCLUSION: Since the introduction of ART, the frequency of oral mucosal lesions is minimal in patients with HIV infection.

[The prevalance of herpesviruses in human apical periodontitis samples]. / Herpeszvírusok elofordulása humán periodontitis apicalis mintákban.

Apical periodontitis is primarily initiated by the endodonto-patogen bacteria spreading from the inflamed or necrotic pulp tissues to the periapical area. Nevertheless, findings within the past years have established a pathogenic role of human herpesviruses such as Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) in periapical inflammations. The authors analysed the prevalence, activity and disease association of EBV, HCMV and human herpesvirus 6 (HHV-6) in 40 apical periodontitis samples and 40 healthy pulp controls. Based on the viral DNA results, EBV (29/40) was the most frequent herpesvirus in apical periodontitis, followed by HHV-6 (8/40) and HCMV (4/40). According to the mRNA results approximately two-third of the EBV DNA-positive lesions had active EBV infections. However, the HHV-6 and the HCMV infections seemed to be of latent state. Our findings suggest that EBV and HHV-GB infections primarily occurred in large sized and symptomatic periapical lesions. The co-occurrence of large lesion size and active EBV infection was strongly associated (OR = 8.80) with the symptomatic manifestation of apical periodontitis.

Frequency and distribution of teeth requiring endodontic therapy in an Argentine population attending a specialty clinic in endodontics.

OBJECTIVES: To determine the frequency and distribution of 975 teeth in need of endodontic treatment in an Argentine patient pool and to compare the results with previously published surveys. METHODS: Of the 975 teeth from 860 individuals (age range 7-86 years) were endodontically treated during 2007 by postgraduate students enrolled in a specialisation programme in Endodontics. All patients were examined clinically and radiographically. For each case, information was collected in a questionnaire including location of the affected tooth, age and gender and reasons for endodontic treatment. Data were analysed by the Student t-test, the Fisher exact test, and the chi-square test with a significance of P < 0.05. RESULTS: Of the 975 treated teeth, 543 (55.69%) were maxillary and 432 (44.30%) mandibular teeth. 635 (65.13%) were from females and 340 (34.87%) from males. Significant differences were found between the maxillary and mandibular arch (P = 0.01). Molars and premolars required significantly more frequent endodontic treatment than canines and incisors (P < 0.001). The most frequently treated tooth was the mandibular right first molar (9.12%) followed by the mandibular left first molar (7.07%). The most frequently diagnosed pathosis was irreversible pulpitis (36.00%), pulp necrosis (30.80%), apical periodontitis or the presence of easily discernible periapical radiolucent areas (27.20%). Caries (59.18%) and failure of previous endodontic treatment (26.97%) were responsible for most of the affected teeth. CONCLUSIONS: Comparison with previous surveys revealed that more females than males received endodontic treatment and that mostly molars and premolars were in need of endodontic treatment. The high number of root filled teeth requiring retreatment is in agreement with a pattern similar to that observed in other countries and supports the need for more specialists in endodontics in the Republic of Argentina.

Frequency of intrusive luxation in deciduous teeth and its effects.

The aims of this study were three-fold: First, to determine the prevalence of partial and total intrusion of the primary anterior teeth. Second, to investigate the sequelae of total and partial intrusive luxation in the primary anterior teeth and in their successors and finally, to establish whether the sequelae on both deciduous and permanent teeth were related to the child's age at the time of the intrusion. Data collected from records of 169 boys and 138 girls, all between the ages of zero and 10 years, who were undergoing treatment during the period of March 1996 to December 2004. The sample was composed of 753 traumatized deciduous teeth, of which 221 presented intrusive luxation injury. Children with ages ranging from one to 4 years were the most affected with falls being the main cause of intrusion. Of all intruded teeth 128 (57.9%) were totally intruded and 93 (42.1%) partially. Pulp necrosis/premature loss and color change were the most frequent sequelae in both total and partial intrusions. Concerning permanent dentition, the most common disturbances were color change and/or enamel hypoplasia. Both types of intrusion caused eruption disturbance. Total intrusion was the most frequent type of intrusive luxation. There was no significant correlation between the child's age at the time of intrusion and the frequency of subsequent sequela on primary injured teeth (P = 0.035), between the age at the time of injury and the developmental disturbances on permanent teeth (P = 0.140).

A retrospective study of 889 injured permanent teeth.

The aim of this study was to investigate pre-injury factors, causes of dental injuries and healing complications after traumatic injuries to permanent teeth. The analysed sample comprised 889 permanent teeth of 384 patients, who were treated in the Dentistry Department in Faculty Hospital in Pilsen. Enamel-dentin fractures [233 teeth (26.2%)] and lateral luxations [207 teeth (23.3%)] were the most frequent injuries. The age of the patients at the time of injury varied between 7 and 65 years. Predominantly, children were affected [587 injured teeth (66.0%)]. The most frequent causes of injuries in patients older than 11 years were various sport activities, predominantly bicycling. Pulp necrosis was observed in 239 teeth (26.9%). It was the most frequent post-traumatic complication in all types of dental traumas. Teeth with a completed root formation demonstrated a higher prevalence of pulp necrosis than teeth with an incomplete root formation in all types of luxation injuries. External root resorption was observed in 144 teeth. The rate of inflammatory resorption differed between the various types of luxation injuries (extrusive luxation 5.6%, lateral luxation 11.6%, intrusive luxation 33.3%). Following avulsion and replantation, active inflammatory resorptions were diagnosed in 13 (26.5%) of 49 replanted teeth and ankylosis/replacement resorptions were observed in 21 (42.9%) of 49 replanted teeth. After avulsion, primarily, immature teeth were affected by these complications. Within the observation period of 5 years, 39 teeth (4.4%) had to be removed (16 teeth with root fractures, 19 avulsed and replanted teeth, 3 luxated teeth, 1 tooth with crown-root fracture).

Evaluation of cases of concussion and subluxation in the permanent dentition: a retrospective study.

Objectives This study evaluated the evolution of cases of concussion and subluxation through a retrospective study of 20 years. Material and Methods Were examined clinical and radiographic records of 1,309 patients who underwent treatment of dentoalveolar trauma in the discipline of Integrated Clinic of the School of Dentistry of Araçatuba, UNESP, of which we selected 137 whose patients had concussion and subluxation injuries, with average age of 23.3 (SD - 10.96). The variables collected were: gender, age, history of previous and actual trauma, treatments performed, the presence of necrotic pulp, and time elapsed until the same trauma. The concussion and subluxation groups were subjected to statistical analyses using the SPSS 16.0 version software (α=0.05), Chi-square, and t-tests. Results Of the 301 teeth involved, 49 (16.3%) suffered concussion and 252 (83.7%), subluxation, being the upper anterior teeth the most affected (75.1%) for both conditions. Subluxation and concussion traumas were more prevalent in men aged 10 to 20 years, most caused by cycling accidents (36.2%). There was a concomitant presence of crown fracture in 21% of cases of concussion and 34.7% of subluxation. Pulp necrosis was detected in 16.3% (concussion) and 27.1% (subluxation) (p=0.12), and most occurred within 6 months after the trauma (p=0.29). The pulp necrosis shows a positive correlation with motorcycle accidents (p=0.01), direct impact (p≤0.0001), crown fracture with pulp exposure (p≤0.0001), darkening of the crown (p=0.004) and spontaneous pain (p≤0.0001); and negative correlation with indirect impact (p≤0.0001). Conclusions Although concussion and subluxation traumas are considered of minor degrees, they must be monitored, since the possibility of pulp necrosis exists, and its early treatment favors a good prognosis.

[Endodontic treatment and periapical health in patients of the Institute of Dentistry in Lódz]. / Leczenie endodontyczne a stan zdrowia przyzebia wierzcholkowego pacjentów instytutu stomatologii w lodzi.

OBJECTIVE: Retrospective assessment of periapical health in relation to sex, age and quality of root-canal treatment among adult patients of the Institute of Dentistry in Lódz. Orthopantomograms of 439 subjects were assessed considering the prevalence of endodontic treatment, technical quality of root-canal fillings and the state of periapical tissues. The assessment of orthopantomograms of 174 (39.6%) men and 265 (60.4%) women was carried out. A significant increase (p=0.016) in the mean number of endodontically treated teeth according to age (range from 1.4 in subjects under the age of 20 to 3.4 in those aged 70 years and over) and the mean number of teeth with periapical pathosis (from 0.9 to 2.4, respectively) (p=0.020) was observed. Of 10054 radiographically examined teeth 9.7% was treated endodontically, whereas, 5.5% exhibited periapical pathosis. The percentage of teeth with periapical lesions was significantly higher (p=0.015) in men (6.2%) as compared to women (5.0%). Periapical radiolucency occurred significantly more often (p=0.0001) in endodontically treated teeth (36.4% of cases) than in those with untreated root canals (2.1%). Teeth with inadequately filled root canals significantly more often revealed the presence of periapical pathosis (49.6%) in comparison to teeth with adequately filled root canals (4.2%). CONCLUSIONS: The prevalence of endodontic treatment and apical periodontitis increases with age. The prevalence of apical periodontitis depends on sex - periapical lesions were more often found in men. The quality of endodontic treatment significantly affects periapical health.

Consequences of crown shortening canine teeth in Greenland sled dogs.

OBJECTIVES: To evaluate the consequences of crown shortening, focusing on the prevalence of pulp exposure and periapical pathology in Greenland sled dogs that had had their canine crowns shortened at an early age. METHODS: Five cadaver heads and 54 sled dogs underwent an oral examination for dental fractures and pulp exposure of canines. All canines were radiographed and evaluated for periapical pathology. RESULTS: The prevalence of canine pulp exposure in 12 (5 heads and 7 dogs) crown shortened dogs was 91 · 7%, and 21 · 3% in 47 not-crown shortened dogs. A significant (P < 0 · 001) risk of pulp exposure of the canines in the crown shortened group compared to the not-crown shortened group was seen with a relative risk of 4 · 3 on a dog basis and a relative risk of 12 · 2 on a tooth basis. In dogs with pulp exposure of canines (n = 51) the prevalence of periapical pathology was 82 · 4%, but only 0 · 8% in dogs without pulp exposure (n = 133) resulting in a significant (relative risk, 109 · 5; P < 0 · 001) risk of periapical pathology in teeth with pulp exposure compared to teeth without pulp exposure. CLINICAL SIGNIFICANCE: The high risk of periapical pathology observed in teeth with pulp exposure confirms that these teeth should not be neglected in affected dogs.

Incidence of pulp necrosis subsequent to pulp canal obliteration from trauma of permanent incisors.

Little long-term data are available on the frequency by which pulp canal obliteration (PCO) subsequent to trauma leads to pulp necrosis (PN). In this study, 82 concussed, subluxated, extruded, laterally luxated, and intruded permanent incisors presenting with PCO were followed for a period of 7 to 22 yr (mean 16 yr). At final clinical examination, 51% of the observed teeth responded normally to electric pulp testing (EPT). An additional 40% of the teeth although not responding to EPT were clinically and radiographically within normal limits. Yellow discoloration was a frequent finding. During the observation period, periapical bone lesions suggesting PN developed in seven teeth (8.5%). Twenty-yr pulp survival rate was 84%, as determined from life-table calculations. There was no higher frequency of PN in obliterated teeth subjected to caries, new trauma, orthodontic treatment, or complete crown coverage than intact teeth. Although the incidence of PN in teeth displaying PCO seems to increase over the course of time, prophylactic endodontic intervention on a routine basis does not seem justified.

Prevalence of Prevotella intermedia and Prevotella nigrescens in infected root canals from a Brazilian population.

The purpose of the present study was to evaluate the prevalence of Prevotella intermedia and Prevotella nigrescens in symptomatic and asymptomatic endodontic infections from a Brazilian population. DNA extracted from samples obtained from 28 cases of endodontic infection were examined by the 16S rDNA-directed Polymerase Chain Reaction (PCR) method. PCR detected P. intermedia in 7.1% of the cases (2 out of 28 teeth) and P. nigrescens in only one sample (3.6%). The low prevalence of P. intermedia and P. nigrescens as reported in the present study is probably justified for geographical reasons.

Localized intrinsic staining of teeth due to pulpitis and pulp necrosis in dogs.

Dental charts and records of 71 dogs were received and 84 intact tooth crowns were noted to have been entirely discolored in shades of pink, purple, grey, or tan. Endodontic therapy was performed on 49 of these teeth allowing gross examination of the entire pulp. In exploratory pulpotomy was performed in 15 teeth prior to exodontic therapy in order to assess the integrity of the coronal pulp. Gross signs of partial or total pulp necrosis were present in 59 (92.2%) of these teeth. The pulp was not observed grossly in 20 teeth which received exodontic therapy. Overall, of the 84 teeth evaluated, 36 (42.9%) had no radiographic signs of endodontic disease. Gross or radiographic signs of endodontic disease were absent in only 2 (4.1%) discolored teeth receiving endodontic therapy. Based on the low incidence of vital, affected teeth in the dogs of this study, endodontic on exodontic therapy is recommended for discolored teeth.

[A statistical study of the interventional results of endodontic treatment performed in the Odontostomatology Department in Dakar]. / Etude statistique des resultats mediats des traitements endodontiques realises au departement odonto-stomatologie de Dakar.

The long-term of endodontic treatment performed by under graduated students in Dakar were assessed. The overall success rate was 83.84% Vital teeth showed better results than the non vital teeth (necrosis).

Is treatment under general anaesthesia associated with dental neglect and dental disability among caries active preschool children?

AIM: To study if treatment under general anaesthesia (GA) is associated with dental neglect or dental disability. STUDY DESIGN: This was a retrospective study. METHODS: Dental records of all children in the age 0-6 years who underwent GA at a specialist paediatric dentistry clinic during 2006-2011 were studied with regard to decayed-missed-filled teeth, traumatic injuries, emergency visits, behaviour management problems and the history of attendance. The final sample consisted of 134 children. Matched controls were selected among recall patients who had not received treatment under GA. STATISTICS: Fishers exact test or Pearson Chi-square test analysed response distribution and comparisons between groups, and for multivariate analyses, logistic regression was used. RESULTS: The results show that children treated under GA had significantly higher caries prevalence, apical periodontitis and infections due to pulpal necrosis. Dental neglect as well as dental disability was significantly more prevalent in the GA group compared to the control group. In a multivariate analysis with dental neglect as independent factor, dental disability was the only significant factor (p = 0.006). CONCLUSIONS: Children treated under general anaesthesia were significantly more often diagnosed with both dental neglect and dental disability. Dental disability was the only factor significantly related to dental neglect. There is a need for improved documentation in the dental records to better identify dental neglect and dental disability, and also a continued training of dentists regarding child protection.