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Adverse outcomes associated with pediatric dental sedation: Claims data analysis, 2014-2019
Kawtar Zouaidi1, Colin C Hubbard2, Matthew R Cooke3
1Texas Center for Oral Healthcare Quality and Safety, School of Dentistry, UTHealth Houston, Houston, TX.
Journal of the American Dental Association (1939)
|June 13, 2026
Summary
One in 27 pediatric dental sedation visits results in an adverse outcome, particularly for older children and those with chronic conditions. Risk mitigation strategies are crucial for improving patient safety in dental sedation.
Area of Science:
- Pediatric Dentistry
- Dental Sedation Safety
- Health Services Research
Background:
- High-risk medications are frequently used in pediatric dentistry.
- Existing medication safety evidence primarily focuses on medical settings, with limited data from dental environments.
- This study assesses adverse outcomes linked to pediatric dental sedation.
Purpose of the Study:
- To evaluate the incidence and risk factors associated with adverse outcomes following dental sedation in children.
- To identify patient and setting characteristics that increase the likelihood of adverse events.
- To inform targeted safety improvements in pediatric dental sedation practices.
Main Methods:
- Analysis of MarketScan data for pediatric patients (under 18) undergoing dental sedation between 2014-2019.
- Composite outcomes included emergency visits or hospitalization within 7 days; attributable outcomes focused on sedation-related adverse events.
- Multivariable generalized estimating equations were used to model associations between patient/setting characteristics and outcomes.
Main Results:
- Four percent of all sedations were linked to a composite adverse outcome.
- Increased odds of composite outcomes were observed in older children (12-17 years), those with chronic conditions, Medicaid coverage, and prior medical visits.
- Sedation-related adverse outcomes occurred in 0.18% of cases, with higher likelihood in children with complex chronic conditions, Medicaid coverage, and in hospital/ambulatory surgery settings compared to outpatient clinics.
Conclusions:
- Approximately 1 in 27 pediatric dental sedation visits is associated with an adverse outcome.
- Targeted risk-mitigation strategies are essential for high-risk pediatric populations undergoing dental sedation.
- Enhancing safety necessitates comprehensive presedation assessments, vigilant monitoring, provider training, and adherence to clinical guidelines.
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