{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T13:53:55Z","timestamp":1786629235399,"version":"build-2736575974"},"reference-count":35,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: General anesthesia induces reversible unconsciousness, eliminating sensation and enabling painless medical procedures. Vital for dental care, it addresses patients with medical conditions, those needing extensive procedures, and those unable to cooperate due to fear. Dental care for patients with disabilities is a significant unmet need, with studies showing increased oral disease prevalence. This research aims to analyze postoperative morbidity both in healthy and disabled children undergoing dental procedures under general anesthesia. Materials and Methods: This study involved 96 children aged 3 to 15 with dental caries. Two groups were formed: the control group (CTL) (52.94%) included healthy patients requiring general anesthesia due to unsatisfactory cooperation, and the other group included children with physical or intellectual disabilities (CD) (47.96%). Postoperative complications were monitored 1 h after the procedure and 1, 3, 7, and 14 days after the procedure by contacting parents\/caregivers by phone. The intensity of postoperative pain was assessed using the Wong\u2013Baker faces pain rating scale. General anesthesia was conducted following a standardized protocol for dental procedures. Results: CTL patients complained more often about postoperative pain 1 h after the procedure (p = 0.03). One day after the procedure, oral bleeding (p = 0.04), fever (p = 0.009), and diarrhea (p = 0.037) occurred more often in CD. In the same period, sore throat appeared more often in CTL (p = 0.036). Three days after the dental treatment, there were statistically significant increases in the occurrence of agitation (p = 0.043) and constipation (p = 0.043) in CD. Seven days later, CD demonstrated a higher occurrence of agitation (p = 0.037). According to the Wong\u2013Baker faces pain rating scale, CTL experienced more frequent and intense pain. Conclusions: CD more frequently reported complications like oral bleeding, fever, and diarrhea. In contrast, the CTL group more often reported pain-related symptoms. The conclusion underscores the need for a pain control protocol for CD and emphasizes the importance of frequent monitoring to prevent unwanted consequences during tooth restoration under general anesthesia.<\/jats:p>","DOI":"10.3390\/medicina60040668","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T09:53:52Z","timestamp":1713779632000},"page":"668","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Postoperative Morbidity after Dental Treatment under General Anesthesia in Children with and without Disabilities"],"prefix":"10.3390","volume":"60","author":[{"given":"Marija","family":"\u0160imunovi\u0107-Erpu\u0161ina","sequence":"first","affiliation":[{"name":"Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia"},{"name":"Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1680-1174","authenticated-orcid":false,"given":"Danko","family":"Bakar\u010di\u0107","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia"},{"name":"Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0291-2743","authenticated-orcid":false,"given":"Odri","family":"Cicvari\u0107","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2848-6041","authenticated-orcid":false,"given":"Luka","family":"\u0160imunovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2645-5364","authenticated-orcid":false,"given":"Vlatka","family":"Soto\u0161ek","sequence":"additional","affiliation":[{"name":"Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia"},{"name":"Department of Anesthesiology, Reanimatology, Emergency and Intensive Care Medicine, Faculty of Medicine, University of Rijeka, Bra\u0107e Branchetta 20, 51000 Rijeka, Croatia"},{"name":"Department of Clinical Medical Sciences II, Faculty of Health Studies, University of Rijeka, Rijeka, Viktora Cara Emina 2, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7842-9116","authenticated-orcid":false,"given":"Dorotea","family":"Petrovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2688-0590","authenticated-orcid":false,"given":"Nata\u0161a","family":"Ivan\u010di\u0107 Joki\u0107","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia"},{"name":"Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1017\/S0265021506002092","article-title":"Guidelines for sedation and\/or analgesia by non-anaesthesiology doctors","volume":"24","author":"Knape","year":"2007","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_2","first-page":"E496","article-title":"Criteria for selecting children with special needs for dental treatment under general anaesthesia","volume":"12","year":"2007","journal-title":"Med. Oral Patol. Oral Cir. Bucal."},{"key":"ref_3","unstructured":"American Academy of Pediatric Dentistry (2023). The Reference Manual of Pediatric Dentistry, American Academy of Pediatric Dentistry."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"313","DOI":"10.17245\/jdapm.2019.19.6.313","article-title":"General anesthesia in the management of early childhood caries: An overview","volume":"19","author":"Oubenyahya","year":"2019","journal-title":"J. Dent. Anesth. Pain. Med."},{"key":"ref_5","first-page":"146","article-title":"The Effect of Physician Oral Health Services on Dental Use and Expenditures under General Anesthesia","volume":"5","author":"Meyer","year":"2020","journal-title":"JDR Clin. Trans. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"298","DOI":"10.11604\/pamj.2014.17.298.2714","article-title":"Waiting times before dental care under general anesthesia in children with special needs in the Children\u2019s Hospital of Casablanca","volume":"17","author":"Badre","year":"2014","journal-title":"Pan Afr. Med. J."},{"key":"ref_7","first-page":"107","article-title":"Anaesthesia for children with special needs, including autistic spectrum disorder","volume":"13","author":"Short","year":"2013","journal-title":"BJA Educ."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"203","DOI":"10.17245\/jdapm.2016.16.3.203","article-title":"A survey of dental treatment under general anesthesia in a Korean university hospital pediatric dental clinic","volume":"16","author":"Shin","year":"2016","journal-title":"J. Dent. Anesth. Pain Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e23065","DOI":"10.1097\/MD.0000000000023065","article-title":"Postoperative complications in Chinese children following dental general anesthesia: A cross-sectional study","volume":"99","author":"Zhang","year":"2020","journal-title":"Medicine"},{"key":"ref_10","first-page":"113","article-title":"Postoperative morbidity in pediatric patients following dental treatment under general anesthesia","volume":"53","year":"2019","journal-title":"Eur. Oral Res."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Farsi, N., Ba\u2019akdah, R., Boker, A., and Almushayt, A. (2009). Postoperative complications of pediatric dental general anesthesia procedure provided in Jeddah hospitals, Saudi Arabia. BMC Oral Health, 9.","DOI":"10.1186\/1472-6831-9-6"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Hu, Y.H., Tsai, A., Ou-Yang, L.W., Chuang, L.C., and Chang, P.C. (2018). Postoperative dental morbidity in children following dental treatment under general anesthesia. BMC Oral Health, 18.","DOI":"10.1186\/s12903-018-0545-z"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"World Medical Association (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310, 2191\u20132194.","DOI":"10.1001\/jama.2013.281053"},{"key":"ref_14","first-page":"9","article-title":"Pain in children: Comparison of assessment scales","volume":"14","author":"Wong","year":"1988","journal-title":"Pediatr. Nurs."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1111\/ipd.12173","article-title":"Comparative study of postoperative morbidity in dental treatment under general anesthesia in pediatric patients with and without an underlying disease","volume":"26","year":"2016","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"9606010","DOI":"10.1155\/2022\/9606010","article-title":"Postoperative morbidity of dental paediatric patients treated under general anaesthesia at a university hospital: An observational study","volume":"2022","author":"Rajab","year":"2022","journal-title":"Int. J. Dent."},{"key":"ref_17","first-page":"111","article-title":"Postoperative pain and other sequelae of dental rehabilitations performed on children under general anesthesia","volume":"30","author":"Needleman","year":"2008","journal-title":"Pediatr. Dent."},{"key":"ref_18","first-page":"a116","article-title":"Clinical relevance of access targers for elective dental treatment under general anesthesia in pediatrics","volume":"76","author":"Chung","year":"2010","journal-title":"J. Can. Dent. Assoc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1111\/pan.12983","article-title":"The effect of general anesthesia for amulatory dental treatment on children in Chongqing, Southwest China","volume":"27","author":"Chao","year":"2017","journal-title":"Paediatr. Anaesth."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Xie, Y., Wang, Y., Ma, Q., Li, J., Chen, Y., Yang, R., Huang, R., Zhang, Q., and Zou, J. (2022). Survival analysis of pulpectomy in primary molars performed under dental general anaesthesia: A two-year retrospective study. BMC Oral Health, 22.","DOI":"10.1186\/s12903-022-02553-z"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"225","DOI":"10.2344\/anpr-65-03-04","article-title":"Campbell. Pediatric dental surgery under general anesthesia: Uncooperative children","volume":"65","author":"Campell","year":"2018","journal-title":"Anesth. Prog."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"196","DOI":"10.17796\/1053-4625-44.3.11","article-title":"A retrospective comparison of dental treatment under general anesthesia provided for uncooperative healthy patients and patients with special health care needs","volume":"44","author":"Ciftci","year":"2020","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"819","DOI":"10.4103\/jfmpc.jfmpc_781_19","article-title":"Prevalence and comparison of dental caries experience among 5 to 12 year old school children of Chandigarh using dft\/DMFT and SiC index: A cross-sectional study","volume":"9","author":"Prabakar","year":"2020","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ridd.2017.12.022","article-title":"Access to dental services for children with intellectual and developmental disabilities\u2014A scoping review","volume":"74","author":"Iacono","year":"2018","journal-title":"Res. Dev. Disabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.cden.2008.12.003","article-title":"Issues in access to oral health care for special care patients","volume":"53","author":"Davis","year":"2009","journal-title":"Dent. Clin. North Am."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/j.1834-7819.2001.tb00273.x","article-title":"A study of the dental treatment needs of children with disabilities in Melbourne, Australia","volume":"46","author":"Desai","year":"2001","journal-title":"Aust. Dent. J."},{"key":"ref_27","first-page":"E98","article-title":"Listening to parents: A qualitative look at the dental and oral care experiences of children with autism spectrum disorder","volume":"37","author":"Lewis","year":"2015","journal-title":"Pediatr. Dent."},{"key":"ref_28","first-page":"412","article-title":"A retrospective study of dental treatment under general anesthesia of children with or without a chronic illness and\/or a disability","volume":"29","author":"Tsai","year":"2006","journal-title":"Change Gung Med. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e20171002","DOI":"10.1542\/peds.2017-1002","article-title":"Pain assessment and treatment in children with significant impairment of the central nervous system","volume":"139","author":"Hauer","year":"2017","journal-title":"Pediatrics"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"89","DOI":"10.2334\/josnusd.19-0042","article-title":"Oral hygiene and oral status of institutionalized children with motor and intellectual disabilities","volume":"62","author":"Nasu","year":"2020","journal-title":"J. Oral Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1046\/j.1365-263x.2000.00180.x","article-title":"A comparison of post-operative morbidity following outpatient dental care under general anaesthesia in paediatric patients with and without disabilities","volume":"10","author":"Enever","year":"2000","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"784","DOI":"10.12669\/pjms.304.4807","article-title":"Postoperative discomfort of dental rehabilitation under general anesthesia","volume":"30","author":"Cantekin","year":"2014","journal-title":"Pak. J. Med. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1152\/japplphysiol.00010.2008","article-title":"Human cardiorespiratory and cerebrovascular function during severe passive hyperthermia: Effects of mild hypohydration","volume":"105","author":"Fan","year":"2008","journal-title":"J. Appl. Physiol."},{"key":"ref_34","first-page":"Cd007084","article-title":"Effects of sevoflurane versus other general anaesthesia on emergence agitation in children","volume":"12","author":"Costi","year":"2014","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_35","first-page":"e47325","article-title":"The evaluation of postoperative complications and oral health-related quality of life following dental general anesthesia for early childhood caries","volume":"15","author":"Mathew","year":"2023","journal-title":"Cureus"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/4\/668\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:31:23Z","timestamp":1760106683000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/4\/668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,19]]},"references-count":35,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["medicina60040668"],"URL":"https:\/\/doi.org\/10.3390\/medicina60040668","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,19]]}}}