Conscious sedation in paediatric dentistry: current philosophies and techniques

Abstract

For years paediatric dentists have searched for the ideal sedative, that is, a drug that allows the safe control of a child's behaviour, provides adequate time to complete a procedure, and also has a quick recovery so that the patient may be discharged. Many drugs have been tried either alone or in combination, and unfortunately none has yet produced reliable results. This paper will review current philosophies in the use of conscious sedation in children. Currently, much interest has been focused on the use of midazolam, a short acting benzodiazepine. The safety of midazolam will be addressed, either when given alone or in combination with nitrous oxide. Midazolam appears to be a safe and effective drug when given in the appropriate doses. Its use in combination with nitrous oxide also appears to be effective, but certain precautions should be kept in mind. Careful patient selection, adequate informed consent, and specific clinical criteria appear to be vital for success. In general, the use of sedation in paediatric dentistry should be carried out by experienced operators in a well controlled environment.