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

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

Oral diazepam vs placebo or no intervention

It is very uncertain whether oral diazepam 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 0.62 [-0.28, 1.53]
  1 study · 20 participants
  Very low

Intravenous midazolam vs placebo or no intervention

It is very uncertain whether intravenous midazolam 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 1.21 [0.24, 2.18]
  1 study · 20 participants
  Very low

Oral midazolam vs placebo or no intervention

Oral midazolam probably leads to higher behaviour (Houpt/behavioural score) compared with placebo (including no intervention) (moderate certainty).

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  SMD 1.96 [1.59, 2.33]
  6 studies · 202 participants
  Moderate

Hypnosis vs Inhalation sedation with nitrous oxide and oxygen

• Hypnosis for children undergoing dental treatment 2010 · Cochrane All outcomes
  Hypnosis can control some of the patient's negative responses to dental treatment, such as movement and behaviour, during administration of local anaesthesia. (Braithwaite 2005; single-blind cross-over, 10 patients…
  1 study · 10 participants
  GRADE not reported

Preoperative paracetamol (acetaminophen) vs placebo

Preoperative paracetamol (acetaminophen) showed no clear difference in postoperative pain (dichotomous measure: parent report of presence… compared with placebo (low certainty).

• Preoperative analgesics for additional pain relief in children and adolescents having dental treatment 2016 · Cochrane All outcomes

  Mean 6.5 hours
  RR 0.81 [0.53, 1.22]
  2 studies · 100 participants
  Low