Oral melatonin vs nitrous oxide inhalation for paediatric dental sedation: a randomised controlled ELISA-based study

Area of Science:

• Pediatric Dentistry
• Anesthesiology
• Pharmacology

Background:

• Dental anxiety is a significant concern in pediatric dentistry.
• Effective sedation methods are crucial for managing anxiety and pain during dental procedures in children.
• Nitrous oxide inhalation is a common sedation technique, but alternatives are being explored.

Purpose of the Study:

• To compare the sedative, anxiolytic, and post-operative effects of oral melatonin versus nitrous oxide inhalation sedation.
• To evaluate these effects in children aged 5 to 8 years undergoing dental treatment.
• To assess the efficacy of melatonin as a potential alternative to nitrous oxide.

Main Methods:

• A randomized clinical trial involving 78 children allocated to three groups: Tell-Show-Do (control), nitrous oxide (N₂O) inhalation, and oral melatonin.
• Anxiety assessed using Venham's Anxiety Scale, pulse rate, SpO₂, and salivary cortisol (ELISA).
• Sedation evaluated with Houpt Sedation Rating Scale; post-operative effects and parental satisfaction recorded.

Main Results:

• Both N₂O and melatonin significantly reduced anxiety and pain scores compared to the control group.
• Salivary cortisol levels decreased significantly in both sedation groups.
• No significant difference was observed between N₂O and melatonin in sedation efficacy or post-operative recovery.

Conclusions:

• Oral melatonin and nitrous oxide inhalation sedation are both effective in reducing dental anxiety and pain in children.
• Melatonin presents a viable alternative to nitrous oxide for pediatric dental sedation.
• Further research may explore long-term effects and optimal dosing.