Six percent of UK children needing general anaesthetic dentistry have siblings with same treatment
First UK study linking sibling DGA patterns to ethnic and socioeconomic disparities; identifies family-level prevention window at two years between procedures.
Sibling patterns in dental treatment under general anaesthetic
A retrospective cohort study of 11,863 children treated under general anaesthetic (DGA) at a London teaching hospital between 2010 and 2021 found that 730 children (6%) had a sibling who also underwent the procedure. The study examined sociodemographic characteristics, dental diagnoses, treatment patterns and predictors of repeat DGA in 356 families, predominantly two-sibling households.
Ethnic and socioeconomic disparities in severe childhood caries
Strong disparities emerged across the sibling cohort. Eighty-three percent of children lived in the two most deprived deprivation quintiles. Thirty-eight percent were Asian, and 11% had parents requiring interpreter support for 18 different languages. Dental caries was the diagnosis in 92% of cases, with 98% of children undergoing tooth extraction. A mean of 6.15 teeth were extracted per child. Children from the most deprived areas had significantly more extractions (6.3 teeth) than those from the least deprived areas (3.2 teeth).
Shared family risk factors and repeat treatment
Siblings demonstrated remarkable concordance in their DGA experiences. Sibling 1 and Sibling 2 had a mean age difference of only five months at their respective DGA procedures (6.55 years versus 6.97 years), and similar numbers of teeth extracted (6.18 versus 6.04 teeth). The average interval between sibling DGA was 729 days, approximately two years. After adjusting for covariates, four independent predictors of repeat DGA were identified: younger age at first DGA, Black ethnicity, complex developmental conditions, and having teeth restored during the first DGA. Children aged 3 to 6 years were significantly less likely to undergo repeat DGA than children under 3 years old. Children who identified as Black were 2.58 times more likely to require repeat DGA than children of other ethnicities. More than 7% of the cohort underwent repeat DGA during the study period.
Frequently asked questions
What percentage of children needing dental general anaesthetic in the UK have siblings also requiring the procedure?
Six percent of 11,863 children treated under general anaesthetic at the London teaching hospital between 2010 and 2021 had a sibling who also underwent DGA. This represented 730 children from 356 families, with 95% being two-sibling households.
What are the main predictors of repeat dental general anaesthetic in children?
Four independent predictors of repeat DGA were identified: younger age at first DGA (children under 3 years), Black ethnicity (2.58 times more likely), complex developmental conditions (3.37 times more likely), and having teeth restored during the first DGA. More than 7% of the cohort required repeat DGA.
How do socioeconomic factors affect children's need for dental extraction under general anaesthetic?
Children from the most deprived areas had significantly more tooth extractions (mean 6.3 teeth) than those from the least deprived areas (mean 3.2 teeth). Eighty-three percent of the sibling cohort lived in the two most deprived deprivation quintiles, despite access to free NHS dental care.
What is the typical time interval between siblings undergoing dental general anaesthetic?
The average interval between the first and second sibling DGA was 729 days, approximately two years. This represents a critical window of opportunity for family-based preventive interventions before the second sibling requires treatment.
Are there ethnic disparities in repeat dental general anaesthetic requiring?
Yes. Children who identified as Black were significantly more likely to require repeat DGA than children of other ethnicities, with an adjusted odds ratio of 2.58. The authors suggest implicit bias in treatment planning may be a contributing factor and call for further research into racial differences in paediatric dental treatment decisions.
