Document Type : Review article
Department of Pediatric Dentistry, Razavi Hospital, Mashhad, IR Iran
Context: Behaviour management and carrying out dental procedures for very young pre-cooperative, highly anxious or medically disabled children could be a challenging task. Various drugs and methods have been introduced to render treatment for this group of child patients. Midazolam is a benzodiazepine used as an adjunct to behaviour management techniques in the dental treatment of child patients. Evidence Acquisition: To conduct this review of the literature, Pub-Med and Scopus were searched using the following terms: midazolam, oral, transmucosal, intravenous, intramuscular, rectal, premedication, paediatric dentistry, general anaesthesia. Fourty-five published papers relating to the use of midazolam in paediatric dentistry were shortlisted out of an initial 124 publications and assessed according to the “critical appraisal skills programme” criteria. Randomized controlled trials, non- randomized studies, clinical trials and case reports were reviewed with regard to midazolam's indications, contraindications, drug interactions and various administration routes when used as a single sedative agents. Research and reviews based on the single-drug use of midazolam in children with adequate sample size as well as clinical guidelines were included. However, those conducted on adult populations, using poly-pharmacy for sedation and clinical investigations with flaws or non-significant results were excluded. Conclusions: Midazolam could be used as a safe and effective drug for conscious sedation, general anaesthetic premedication and the treatment of seizures during dental treatment. However, further research on paediatric patients would be beneficial.