Effect of intranasal midazolam with/without inhalation sedation (N2O/O2) in 3‒6-year-old uncooperative dental patients

Introduction: Due to incomplete development of coping skills in children, they usually cannot cope with stressful situations like dental appointments. The present study aims to evaluate the effect of intranasal midazolam with/without inhalation sedation (N2O/O2) in children with high levels of dental anxiety. Materials and Methods: This crossover double-blinded clinical trial was conducted on 14 uncooperative children aged 3‒6, who required at least two similar dental treatment visits. Children were randomly sedated by the combination of intranasal midazolam (0.5 mg/kg) and nasal drops of lidocaine hydrochloride (2%) with or without inhalation sedation (N2O/O2) during each visit. Houpt’s scale for sedation was used to evaluate the patient`s behavior and efficacy of the sedation by an independent pediatric dentist. Results: The combination of midazolam and inhalation sedation was significantly more effective in overall behavior after 15 minutes and at the end of the treatment (P<0.05), but not at the time of onset and discharge (P>0.05). Conclusion: To manage the behavior of the children with high levels of dental anxiety, the combination of inhalation sedation with intranasal midazolam can be efficiently used.