Conscious and deep sedation drugs in pediatric dentistry: a systematic review of randomized controlled trials (2019–2024)

Background: Dental anxiety in children is a common issue that hinders dental treatment, generates negative experiences, and perpetuates fear. This highlights the importance of finding effective solutions. Conscious and/or deep sedation techniques are key tools to improve the pediatric patient’s experience and facilitate complex procedures. However, their application requires careful analysis due to the wide variety of available protocols, recommendations and administration routs. Methods: A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The electronic search for this review was conducted from October to January (2024–2025). Articles were selected from three databases: PubMed, Scopus, and Web of Science. Specific filters were applied for each database. Eight terms were used for the search strategy and selection criteria was followed. Studies that performed any dental treatment on pediatric patients aged 2 to 12 years who underwent conscious or deep sedation to reduce their anxiety. The risk of biased of the selected articles was assessed. Results: The initial electronic search generated 1697 titles from the MEDLINE/PubMed database, 1563 from Web of Science, and 1437 from Scopus, which were lateter filtered and duplicates eliminated. After analyzing the titles and abstracts of 196 articles, 14 Randomized Controlled Trials (RCTs) that were published during the last 5 years were selected for this review. Conclusions: The fastest onset of action is determined by the route of administration. Reported adverse effects were not statistically significant. Nitrous oxide shows the fastest recovery, but drug selection should always be based on the type of dental procedure, its duration, and the child’s specific needs. Further research is needed to evaluate parents’ level of satisfaction. The PROSPERO Registration: The review was registered into PROSPERO (registration number: CRD420250637249).

Pediatric dentistry; Anti-anxiety agents; In-office sedation

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