Report of project USAP: the use of sedative agents in pediatric dentistry

Project USAP was performed to examine the use of sedation in pedodontics; part one studied the use of sedative agents by pediatric dentists, and part two examined the use of sedation in postgraduate teaching programs. In part I all 2,040 members of the American Academy of Pediatric Dentistry were sent questionnaires in 1985 concerning their use of sedation, and 1,105 responded. In regard to their use of nitrous oxide alone, 55 percent of practitioners responded that they used nitrous oxide less than 10 percent of the time. In regard to other types of sedative agents, most practitioners used little, if any sedation; 88 percent of practitioners used sedation for less than 10 percent of their patients. In a typical three-month period, the 1,105 respondents performed 33,465 sedations. Of that number, almost half (14,802) were administered by only 64 practitioners. Compared with other geographic areas, there appeared to be greater use of sedation in the south/southeast and west regions of the United States. The heavier use of sedation by some practitioners was not related to the percentage of their handicapped patients who received sedation. In part II, all 59 postgraduate programs in pediatric dentistry were surveyed during 1985 to examine the use of sedation by postgraduate students. There were wide differences in frequency and type of experience of students with different drugs. It is concluded that when a healthy child receives a sedative agent for dental treatment, the type of drug and drug dosage depend more on the biases of the individual practitioner, than on the requirements of the patient.