Sedation in pediatric dentistry: A scoping review

Abstract

Introduction: Pediatric dentists face the daily challenge of treating patients with anxiety, phobias and fears, and it is important to know the drugs for each patient. Objective: To analyze the literature on drugs used for sedation, particularly dexmedetomidine, ketamine, midazolam and nitrous oxide. Methodology: Articles were searched in databases such as PubMed, Google Scholar, using keywords: sedation, drugs, pediatric dentist, pediatric patient. Results: Dexmedetomidine provides sedation, analgesia and sympathicolysis, is safe and acceptable in infants and children without respiratory depression, and adverse events such as hypoxemia and bradycardia may occur. Ketamine is a drug that presents multiple routes of administration and has analgesic, hypnotic, amnesic, anti-inflammatory and sympathomimetic properties, having undesirable side effects such as delirium, psychosis, perception disorders, arterial and intraocular hypertension. Midazolam is a fast-acting and short-acting drug, which can be administered by different routes. It presents adverse reactions such as disinhibition, hallucinations and marked respiratory depression. Oral absorption and action time are prolonged. Nitrous oxide has analgesic and anesthetic effect, as well as its rapid elimination from the body, does not affect respiration, so it is possible to administer it in patients with respiratory ailments, its use is limited to short or non-invasive procedures and can cause side effects such as nausea, vomiting, headache and fatigue. Conclusion: All the drugs reviewed have unacceptable systemic side effects, and if it is necessary to choose one, it would be nitrous oxide as the best drug to use for sedation in pediatric dentistry.