ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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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 (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 18923220Damle/2008Uncooperative children 2-6 years of age.Randomized Controlled Trial
Key resultsDental 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/Discipline (Pediatric Dentistry)
Keywords Dental anxiety; Midazolam; Ketamine
ID# 447
Date of submission: 12/08/2009spacer
E-mail aworinde@livemail.uthscsa.edu
Author Adepeju Aworinde
Co-author(s) Steven Hogan
Co-author(s) e-mail hoganS@uthscsa.edu
Faculty mentor/Co-author
Faculty mentor/Co-author e-mail
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?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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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.
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