How safe is oral midazolam sedation in pediatric dentistry?
This summary is based on the article published in the International Journal of Pediatric Dentistry: Safety of oral midazolam sedation use in pediatric dentistry: a review (January 2014)
Young children needing multiple procedures often cannot be managed using local anesthesia alone. General anesthesia (GA) is an alternative, but is associated with significant morbidity and expense. Sedation is a possible alternative to GA for behaviour management but evidence in support of its use is weak.
A recent systematic review noted that oral midazolam is one of the few agents available whose efficacy in dental procedures for children is supported by evidence. Midazolam is potentially an ideal sedative agent for pediatric dentistry because it can be administered orally, has anxiolytic and anterograde amnesic effects, and is short acting.
Purpose of the Study
Little information is available as to the safety of this drug when used as an oral sedative in children needing dental treatment. Therefore, it is important to evaluate the side effects and any other adverse outcomes following use of oral midazolam for behaviour management in pediatric dentistry.
- There appear to be rare significant side effects associated with oral midazolam use for behaviour management in children and adolescents requiring dental treatment.
- Minor side effects are more common, but determining precise figures is complicated by poor reporting.
- There is currently little information available as to the safety of midazolam when used as an oral sedative in children needing dental treatment.
- This study revealed that significant side effects are uncommon. Minor side effects are more common, with paradoxical reactions, nausea and vomiting being the chief complaints.
- The frequency of transient desaturations emphasizes the importance of adequate monitoring during sedation.
- The study highlights the need for more consistent reporting of adverse effects.
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