Clinical Profile and Dental Treatment Needs of Children with Special Healthcare Needs Undergoing General Anaesthesia: A Retrospective Study

Abstract

Highlights What are the main findings? ASD was the leading systemic condition in both the outpatient clinic and the subgroup treated under general anaesthesia (outpatient: 25.0%; GA subgroup: 42.9%), a significantly higher prevalence compared with a non-overlapping outpatient-only comparator (p = 0.003); 81.0% of GA patients required two or more procedure types per session (mean 2.5 ± 1.0). Dental caries (61.0%) and root remnants (32.1%) far exceeded general Spanish population rates, indicating a critical preventive deficit in CSHCN. What are the implications of the main findings? Referrals originated from 27 hospitals across the Valencian Community, highlighting the regional referral role of the centre. Caregiver-targeted preventive programmes and expanded hospital dental capacity may reduce reliance on resource-intensive surgical intervention in this population. Abstract Background/Objectives: Children with special healthcare needs (CSHCN) face significant barriers to conventional dental care and frequently require general anaesthesia (GA). Data characterising the clinical and therapeutic profile of this population in the Spanish public health system remain scarce. This study aimed to describe the systemic conditions, oral pathology, and dental procedures performed in CSHCN attending a tertiary-care paediatric oral and maxillofacial surgery service, and to characterise the subgroup of patients requiring treatment under GA relative to the wider clinic population. Methods: A retrospective, descriptive, observational study was conducted at the Hospital Universitario y Politécnico La Fe (Valencia, Spain) from November 2022 to February 2026. Data were extracted from electronic health records for 160 outpatient clinic patients aged 0–14 years (70.6% male), of whom 42—a subgroup, not an independent sample—subsequently underwent dental treatment under GA (76.2% male). Sex, age, and autism spectrum disorder (ASD) status were compared between the GA subgroup and a non-overlapping outpatient-only comparator (n = 118) using Fisher’s exact test and Welch’s t-test. Results: ASD was the most prevalent systemic condition in both the outpatient clinic (25.0%) and the GA subgroup (42.9%); a statistically significant association with ASD status was observed against the non-overlapping outpatient-only comparator (18.6% ASD; p = 0.003), while sex (p = 0.432) and age (p = 1.00) did not differ. Dental caries was the most common finding at outpatient assessment (61.0%), followed by root remnants (32.1%). Among GA patients, tooth extraction was performed in 78.6%, composite restoration in 71.4%, and professional dental cleaning in 50.0%. The mean number of procedure types per GA patient was 2.5 ± 1.0 (range 1–5); 81.0% received two or more procedure types in a single session. Conclusions: CSHCN attending this service present advanced oral disease, and those referred for GA had a significantly higher prevalence of ASD than the remaining clinic population, requiring complex, multi-procedure interventions in a single session. The wide geographic pattern of referrals suggests that further evaluation of the distribution of hospital dental services within the public health network may be warranted, and caregiver-targeted preventive programmes may represent a promising strategy to reduce the oral disease burden in this population.