This systematic review aimed to assess the outcomes of dental treatment provided to children aged < 18 years under general anesthesia (GA). An electronic search was conducted of the Medline (via PubMed), Cochrane Library, Web of Science, and Scopus databases (up to December 2021). In addition, the bibliographic references of identified articles were hand-searched for relevant articles. The exclusion criteria were non-English articles, case reports, and review articles. The search yielded 886 articles (after the removal of duplicates). These articles were independently assessed by two reviewers at the title, abstract, and full-text levels. A total of 46 articles were included in the systematic review; 40 studies were retrospective, 3 were prospective, and 3 were case-control. The results revealed that some of the children suffered from relapse after receiving dental treatment under GA; 24–59% developed new caries lesions and 6.5–87% required further restorative dental treatment. The reported rate of repeat GA ranged between 0% and 31.8%, with an average interval between GA episodes of about 2 years. Stainless steel crowns and pulpotomies showed a higher success rate compared to direct restorations. Dental treatment provided under GA was successful in addressing the consequences of dental caries but did not help prevent the development of new carious lesions or the need for a subsequent dental treatment under GA. The focus of dental professionals should shift from the traditional approach of treating the consequences of oral diseases towards more preventative measures.
