Is putting children ‘under’ safe?

It is not uncommon for parents to express concern regarding the effects of sedatives and anaesthetics on the neurocognitive development of their child.

In 2016, a US Food and Drug Administration (FDA) Drug Safety Communication stated recent evidence suggests a single, relatively short exposure to general anaesthetic and sedation drugs in infants or toddlers is not likely to compromise learning and behavior.

This was supported by a classic study at the same time called The Pediatric Anesthesia Neurodevelopment Assessment (PANDA). This study found among healthy children with a single anaesthesia exposure before age 36 months, compared with healthy siblings with no anaesthesia exposure, there were no statistically significant differences in IQ scores in later childhood.

More recently, in 2018 and 2019, researchers carried out two benchmark studies on the neurologic effects of anaesthetic exposure in young children:

The Mayo Anesthesia Safety in Kids (MASK) study found that anaesthesia exposure before age 3 yr was not associated with deficits in general intelligence. Although other effects maybe possible. They suggest that multiple, but not single, exposures are associated with a pattern of changes behaviour and learning.
The General Anaesthesia Compared to Spinal Anaesthesia (GAS) found that slightly less than 1 h of general anaesthesia in early infancy does not alter neurodevelopmental outcome at age 5 years.

So what should you do if your child requires dental treatment and is afraid to get it?

Try to talk them into seeing the dentist without going ‘under’. More often than not, we can manage children by just walking them through their treatment using simple metaphors and illustrations.
Use ‘lighter’ forms of sedations, such as nitrous oxide (laughing) gas before resorting to heavier methods such as sedative medication.
If none of these work, and your child has to be put under general anaesthesia for treatment, do not worry, everything will be fine. Once under general anaesthesia, dentists typically treat all your child’s teeth in one appointment, so your child will come out with a healthy dentition. From that point onwards, try to improve homecare and bring your children to the dentist for routine check-ups. Because if problems are caught early, dental treatments are usually simple and quick and children will tolerate them without sedation or general anaesthesia.