What do systematic reviews say?

Rectal midazolam vs A different sedative agent

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  Any behavioural score - Rectal midazolam versus (other sedatives): 90 (1); VERY LOW
  1 study · 90 participants
  Very low

Intravenous midazolam vs A different sedative agent

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  Any behavioural score - Intravenous midazolam versus (other sedatives): 70 (2); VERY LOW
  2 studies · 70 participants
  Very low

Hydroxyzine vs Different dosage/timing of hydroxyzine

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  Any behavioural score - Hydroxyzine: 30 (1 study); VERY LOW. Insufficient evidence to determine whether any specific dose of hydroxyzine is effective.
  1 study · 30 participants
  Very low

Ketamine/midazolam vs placebo or no intervention

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  Moreira 2013: 0.5 mg/kg midazolam + 3 mg/kg ketamine produced significantly better behaviour than placebo and oral midazolam (P=0.03); not included in meta-analysis / not GRADE-rated. Narrative.
  1 study
  GRADE not reported

Dexmedetomidine vs A different sedative agent

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  Any behavioural score - Dexmedetomidine versus (other sedatives): 120 (2); VERY LOW
  2 studies · 120 participants
  Very low

Chloral hydrate/promethazine vs A different sedative agent

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  Any behavioural score - Chloral hydrate/promethazine versus (other sedatives): 24 (1); VERY LOW
  1 study · 24 participants
  Very low

Chloral hydrate/hydroxyzine vs A different sedative agent

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  Any behavioural score - Chloral hydrate/hydroxyzine versus (other sedatives): 235 (6); VERY LOW
  6 studies · 235 participants
  Very low

Ketamine vs A different sedative agent

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  Any behavioural score - Ketamine versus (other sedatives): 494 (8); VERY LOW
  8 studies · 494 participants
  Very low

Midazolam (any mode of delivery) vs Different dosage of the same sedative

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  Any behavioural score - Midazolam (any mode of delivery): 394 (10 studies); VERY LOW. Insufficient evidence to determine whether any specific dose of intranasal midazolam is effective; weak evidence oral midazolam…
  10 studies · 394 participants
  Very low

Sevoflurane vs A different sedative agent

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  Any behavioural score - Sevoflurane versus (other sedatives): 1140 (3); VERY LOW
  3 studies · 1140 participants
  Very low

Ketamine/midazolam vs A different sedative agent

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  Any behavioural score - Ketamine/midazolam versus (other sedatives): 27 (1); VERY LOW
  1 study · 27 participants
  Very low

Oral midazolam vs A different sedative agent

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  Any behavioural score - Oral midazolam versus (other sedatives): 654 (7); VERY LOW
  7 studies · 654 participants
  Very low

Chloral hydrate vs placebo or no intervention

It is very uncertain whether chloral hydrate changes good or better behaviour compared with placebo (including no intervention) (very low certainty).

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  RR 1.33 [0.80, 2.22]
  1 study · 60 participants
  Very low

Meperidine (intramuscular) vs placebo or no intervention

Meperidine (intramuscular) may leads to higher good or better behaviour compared with placebo (including no intervention) (low certainty).

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  RR 5.33 [1.45, 19.64]
  1 study · 60 participants
  Low

Clinical examination with risk-based recall vs Clinical examination with 24-month recall

Clinical examination with risk-based recall showed no clear difference in oral health behaviour (1-9 scale) compared with clinical examination with 24-month recall; GRADE not reported.

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  MD 0.01 [-0.02, 0.04]
  1 study · 304 participants
  GRADE not reported

Clinical examination with risk-based recall vs Clinical examination with 6-month recall

Clinical examination with risk-based recall showed no clear difference in oral health behaviour (1-9 scale) compared with clinical examination with 6-month recall; GRADE not reported.

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  MD 0.00 [-0.01, 0.01]
  1 study · 1608 participants
  GRADE not reported

Clinical examination with 24-month recall vs Clinical examination with 6-month recall

Clinical examination with 24-month recall showed no clear difference in oral health behaviour (1-9 scale) compared with clinical examination with 6-month recall; GRADE not reported.

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  MD 0.00 [-0.03, 0.03]
  1 study · 308 participants
  GRADE not reported

Self-management (self-administered/self-monitored OHA) vs Professional OHA

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes
  Baab 1986 (time spent brushing, number of oral hygiene aids), Aljafari 2017 (child's dietary habits, self-reported snacking and toothbrushing), Jonsson 2006 (oral self-care habits); measured, not synthesised or…
  3 studies
  GRADE not reported

Enhanced one-to-one OHA vs Routine one-to-one OHA

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes
  Tedesco 1992 reported self-reported brushing and flossing behaviours and self-efficacy (Oral Health Behavior Expectation Scale); measured, not synthesised or GRADE-rated.
  1 study
  GRADE not reported

Nitrous oxide/oxygen vs placebo or no intervention

It is very uncertain whether nitrous oxide/oxygen changes behaviour (Houpt/behavioural score) compared with placebo (including no intervention) (very low certainty).

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  SMD 0.69 [0.13, 1.26]
  1 study · 52 participants
  Very low