Is dental treatment under general anaesthesia safe? Risks, side effects and a child's brain development

Is general anaesthesia at the dentist safe?

General anaesthesia at the dentist is safe when three conditions are met: the patient has been through qualification, the anaesthetic is given by an anaesthesiologist, and the room has the people and the equipment to manage complications. A systematic review of research on general anaesthesia in paediatric dentistry rates the risk of serious complications as very low (Velasco et al., 2023).

Safe does not mean free of effects. General anaesthesia is a controlled sleep in which the patient does not respond even to pain, and breathing often needs support. That is why a procedure that is routine for a healthy six-year-old needs a different plan for a child with heart disease. The honest answer is therefore: yes, under conditions that can be checked before the procedure.

What makes general anaesthesia at the dentist safe?

The safety of general anaesthesia depends more on preparation than on the drug itself. The first element is qualification: the anaesthesiologist takes a medical history, reviews test results and assesses the patient's general condition on the ASA scale, from class I (a healthy patient) through class II (mild systemic disease) to the classes that describe severe disease.

The second element is people and equipment. Polish regulations for dental treatment under general anaesthesia funded by the NFZ (Poland's National Health Fund) require a doctor specialising in anaesthesiology and intensive care, an anaesthesia nurse, an anaesthesia workstation and a recovery station (Annex 3 to the regulation, Dz.U. 2025 poz. 615). That is a sound reference point for private treatment too.

The third element is a break from eating and drinking. The 2023 guidelines of the American Society of Anesthesiologists (ASA) estimate aspiration of stomach contents at about 1.1 cases per 10,000 anaesthetics in adults and 1.3 per 10,000 in children. Fasting rules exist to keep that risk low.

What are the side effects of general anaesthesia at the dentist?

The most common side effects of general anaesthesia at the dentist are drowsiness, pain where teeth were treated, a sore throat, nausea and agitation on waking. In most children they pass within 3 days, and they are a predictable consequence of the procedure, not a complication.

In a study of 90 children treated under general anaesthesia, 99% of parents reported at least one complaint on the first day: difficulty eating (86%), drowsiness (71%), pain (48%), bleeding (40%), sore throat (34%) and vomiting (26%). By the third day only 33% of children had any complaint at all (Farsi et al., 2009).

Nausea and vomiting after the procedure occurred in 14.6% of 589 children who had surgery on the teeth and mouth (Sasazaki et al., 2025). Crying, agitation and disorientation just after waking are common and short-lived, and how often they occur depends on the anaesthetic technique, which is why studies report very different figures.

How often do serious complications of general anaesthesia happen?

Serious complications of general anaesthesia are rare, and death caused by the anaesthetic itself is very rare. A British hospital information leaflet for parents gives frequency ranges for children, collected in the table below (University Hospitals Birmingham, 2026).

The most common critical events involve breathing. In the European APRICOT study, which covered 31,127 anaesthetics in children for all kinds of procedure, not only dental ones, severe critical events occurred in 5.2% of cases: respiratory in 3.1%, cardiovascular in 1.9% (Habre et al., 2017). The term covers any situation that needs immediate intervention, so it should not be confused with lasting harm.

The practical conclusion from these data: equipment for keeping the airway open and for ventilation must be ready for every anaesthetic, including a short one, and someone whose only job is to watch the patient must be at their side the whole time.

Does general anaesthesia affect a child's brain development?

A single, short general anaesthetic in a young child did not change IQ in large comparative studies. Caution applies to repeated or long anaesthetics in children under 3, and that is where the rule comes from that all dental treatment should be planned for a single anaesthetic.

In December 2016 the US Food and Drug Administration (FDA) warned that repeated use, or use lasting longer than 3 hours, of anaesthetic and sedation drugs in children under 3 and in women in the third trimester of pregnancy may affect brain development. In April 2017 the FDA added that a needed procedure should not be put off for this reason.

The GAS trial randomly assigned 722 infants to general anaesthesia (median 54 minutes) or to regional anaesthesia while awake. At the age of 5 their IQ was 98.97 and 99.08 points, meaning the groups were equivalent (McCann et al., 2019). In the PANDA study, 105 sibling pairs in which one child had a single general anaesthetic before 36 months of age (median 80 minutes) scored 111 points each (Sun et al., 2016).

The MASK study (997 children) also found no difference in IQ, but after multiple anaesthetics it recorded weaker processing speed and fine motor skills, and more behavioural and reading difficulties reported by parents (Warner et al., 2018). In a study of 595 children having dental treatment under general anaesthesia, the procedure lasted 64.7 minutes on average (Ibrahim et al., 2022), which is within the range in which GAS and PANDA found no differences.

When is treatment under general anaesthesia not carried out, or postponed?

Planned treatment under general anaesthesia is most often postponed because of an acute respiratory infection, a fasting break that was not kept, or an illness that first needs to be brought under control. The decision is made by the anaesthesiologist at the qualification visit or on the day of the procedure.

British hospital guidance for parents asks them to report a cough or cold within 2 weeks before the procedure, and diarrhoea or vomiting within a few days before it (King's College Hospital, 2025). Moving the date for such a reason is a safety decision, not a formality.

A separate question is who general anaesthesia is the right path for at all. An adult's fear of the dentist on its own does not give the right to NFZ-funded treatment under general anaesthesia, and in many cases a conversation, local anaesthesia that works and inhalation sedation are enough. General anaesthesia is a medical decision made after qualification, not a more convenient version of a visit.

What questions should you ask before dental treatment under general anaesthesia?

Before dental treatment under general anaesthesia it is worth asking a few specific questions, wherever you are being treated. The answers will show whether the team and the organisation meet the requirements of the regulations and of common sense.

• Who gives the anaesthetic, and is it a doctor specialising in anaesthesiology and intensive care?
• Is an anaesthesia nurse with the patient throughout the procedure and the wake-up?
• Where does the patient wake up, and who observes them until discharge?
• Which vital signs are monitored, and is the airway equipment checked before every procedure?
• Will there be a consultation with the anaesthesiologist before the date is set, and which tests will be needed?
• How many procedures are planned for one anaesthetic, and how long will the sleep last?
• Who do I call after getting home if something worries me?

How it works at DentalBlue

DentalBlue in Białystok has its own anaesthesiology department: 2 anaesthesiologists and 4 anaesthesia nurses in the clinic building. Every treatment under general anaesthesia starts with a joint dental and anaesthesiology consultation with a panoramic X-ray, a full medical history, a list of medicines and test results; the date is set only after it. During the procedure the dental and anaesthesiology teams work in the room at the same time, and an anaesthesia nurse is present from induction to full wake-up. Intubation and ventilation equipment is checked before every procedure, the oxygen source and a separate high-power suction unit work independently of the dental unit, and vital signs are monitored during the procedure and the wake-up.