Effectiveness of Oral Midazolam for Paediatric Dental Care: A retrospective study in two Specialist Centres
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Aim: To analyse retrospectively the outcomes for children undergoing oral care under conscious sedation with oral midazolam and local analgesia at Leeds Dental Institute, England and Westmead Dental Hospital, Sydney, Australia. Secondly, the study assessed the suitability of oral midazolam for paediatric dental treatment. Study Design: Retrospective study of clinical outcomes based on dental records. Methods: All children included in the study had been treated between September 2000 to August 2004 and full dental records were available. The dental records were examined using a standard pro forma sheet and data collection for: age, previous behaviour using the Frankl  scale, units of work planned and achieved using the modified index of O’Sullivan and Curzon , midazolam dosage and treatment outcome. Results: The study population consisted of 101 children aged 1–11 years in both Leeds (57 children) and Westmead (44 children). There were significant differences between Leeds and Westmead with respect to age (mean ±SD) in years 5.0±1.9 versus 2.9±1.6; number of treatment visits 1.7 versus 1.1; sedation dose used 0.5–0.7 mg/kg versus 0.2–0.3; type and amount of treatment planned 8.3 versus. 3.3 and achieved 7.5 versus 2.2, for both centres respectively. There was also a difference in overall success rates of rendering the children dentally fit of 65% v. 91 %, respectively. Conclusion: Oral midazolam was found to be a useful drug for the management of young children with behaviour problems. It was found, however, not to be effective in all cases and for the provision of all types of paediatric dentistry. The results indicate that, when using oral midazolam in children, treatment should be restricted to simple restorations and extractions over a maximum of two visits.
Key wordsmidazolam sedation children dental care
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