Title |
Pharmacological Dental Anxiety Management with Ketamine and Midazolam in Uncooperative Children |
Clinical Question |
In young uncooperative children, will ketamine be more effective than midazolam in reducing dental anxiety? |
Clinical Bottom Line |
The benzodiazepine midazolam was more effective than ketamine in reducing dental anxiety in young uncooperative children. (See Comments on the CAT below) |
Best Evidence |
|
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
18923220 | Damle/2008 | Uncooperative children 2-6 years of age. | Randomized Controlled Trial | Key results | Dental anxiety was lower with the use of ketamine than with midazolam. Heart rate and respiratory rate were marginally higher with ketamine and parents reported a less traumatic experience for their children administered midazolam. Both medications were deemed successful at reducing dental anxiety during treatment. | |
Evidence Search |
Limits: Systematic Reviews Randomized Controlled Trial, Systematic Reviews Meta-Analysis\"Midazolam"Ketamine"[Mesh] \"Benzodiazepines"[Mesh] Dental Anxiety" |
Comments on
The Evidence |
The study was double blind and randomized with adequate follow-up and compliance. The weaknesses are that it was a small study (10 subjects per group) with a lack of a placebo group. |
Applicability |
Oral sedation will be more accepted by parents and patients. The fact that there will be fewer side effects with the use of midazolam is an added benefit that pediatric dentists can use to their advantage in gaining informed consent from a child patient’s parents. Children and thus parents will be less traumatized by procedures performed at the pediatric dentists' office. |
Specialty |
(Pediatric Dentistry) (Behavioral Science) |
Keywords |
Dental anxiety; Midazolam; Ketamine
|
ID# |
447 |
Date of submission |
12/08/2009 |
E-mail |
aworinde@livemail.uthscsa.edu |
Author |
Adepeju Aworinde |
Co-author(s) |
Steven Hogan |
Co-author(s) e-mail |
hoganS@uthscsa.edu |
Faculty mentor |
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Faculty mentor e-mail |
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Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
by Austin McIntyre (San Antonio, TX) on 04/12/2012 A PubMed search on this topic was completed March 2012. The publications listed in the CAT are the most recent and the highest level of evidence related to this clinical question. | |