Ketamine: Angel Dust in Pediatric Dental Sedation

Child visit to the dentist’s office can elicit fear and anxiety which can cause chaos to both the dentist and the child patient and, which in turn subvert the delivery of quality dental care, thus posing a challenge to oral health care practitioners worldwide. As pedodontists, our motto is to strive to relieve pain and suffering, and pledge to do no harm. Anxiety if not handled with tender love and care can be very devastating which has led to exploring new frontiers in behavior management. Behavior management with aversive methods using forced restraints, is no longer acceptable and may compound the hospital— and needle—phobia throughout life. Non pharmacological behavior management procedures like effective communication, distraction techniques, play therapy, modeling and adequate analgesia coupled with TLC may be sufficient to produce a cooperative, relaxed child. Assuming that the aforementioned non pharmacological behavior management techniques have failed, alternative pharmacological dental sedation methods is usually sought, in spite of moderate sedation with nitrous oxide being the safest mode of sedation, sedation with IV or IM ketamine remains one of the most used sedation technique popularly known as angel dust because of the unique magical experience of both the patient and the anesthesiologist using it. Bearing in mind that the perks of ketamine dissociative sedation are not free off its risks, the purpose of this article is to give the readers, an in depth knowledge of this agent. To deliberate; is ketamine sedation the answer for the inconsolable anxious child requiring a painful procedure in the pediatric dental department?