Published March-April 2016
Pediatric Dentistry

Sedation use is rising, especially among dentists working with school-aged children. Meanwhile, restraint use is declining.

These are some of the trends in pediatric dentistry detailed by a 25-year follow-up survey of members of the American Academy of Pediatric Dentistry (AAPD).

Stephen Wilson, DMD, PhD, recently retired director of the Division of Dentistry, and Rutgers University professor emeritus Milton Houpt, DDS, PhD, examined findings from 1,642 responses to a 2010 AAPD survey. They compared the data to surveys conducted in 1985, 1991, 1995 and 2000.

Pediatric dentists still rely primarily on benzodiazepines and nitrous oxide to sedate their young patients. The use of restraints has steadily declined.

The most frequently used benzodiazepine has been diazepam (Valium). Other sedatives, used with or without nitrous oxide, have included midazolam (Versed), hydroxyzine (Vistaril) and choral hydrate.

The authors report an increase in sedation use by dentists in practice less than five years and more than 20 years, as well as regional variations. The highest rates of sedation occurred in the Southeast, with growing rates in the West, declining rates in the Midwest and stable rates in the Northeast.

Over the last two decades, sedation rates have declined for preschool-aged children, but have risen among the school-aged. Dentists indicating a rising use of sedatives say they: a) felt children needed sedation, b) were prepared to provide sedation, or c) found general anesthesia more difficult.

The increase reflects, in part, new sedation-related training requirements. However, other social factors also play a role.

“I think it’s a function of how our society is changing,” Wilson says. “Today’s parents don’t want their children to feel the discomfort of dental procedures.”