BACKGROUND Differences in dental treatment under general anesthesia (GA) in healthy and disabled children are rarely reported. This retrospective study evaluated the characteristics and treatment modalities performed under general anesthesia in pediatric dental patients at Taipei Chang Gung Memorial Hospital between 2004 and 2005, and compared the different treatment patterns performed in healthy children and children with special health care needs. METHODS The data were reviewed in pediatric patients from 1 to 18 years old who underwent dental treatment performed under general anesthesia from January 2004 to December 2005. Patients with special health care needs who had at least one type of mental or physical disability were assigned to the disabled group (Group D) and the other healthy patients were assigned to the healthy group (Group H). The treatment modalities of operative restoration, crowns, pulp therapy, sealant and extracted teeth were compared in the two groups. RESULTS A total of 185 patients were assigned to group H and 112 to group D. The patients in group D were significantly older than those in group H. There were no significant differences in the mean number of teeth treated between the two groups. However, there was a significantly greater mean total number of teeth extracted in group D patients (p < 0.001). In addition, there were more stainless steel crown reconstructions (p < 0.05) and pulp therapies (p < 0.001) performed in group H patients. In group D, there were no significant differences in the total number of teeth extracted between the 1-3 year old patients and the 3-6 year-old patients (p = 0.99). CONCLUSIONS For very young children or those with special health care needs, dental treatment performed under general anesthesia is beneficial and efficient. The findings of this study suggest that underlying medical or mental conditions may influence the dental condition and treatment modality provided.