Pharmacologic patient management in pediatric dentistry: an update

This paper reviews the issue of sedation in pediatric dentistry in the light of recent controversies and rapidly increasing legal, professional and governmental regulations. Consideration is given to "Guidelines for safe administration of pharmacologic agents in dental practice". The various avenues of drug administration are reviewed with specific comment on recent approaches. Many of the older pharmacologic agents used for pediatric sedation are falling into disfavor. Chloral hydrate, in particular, would seem to be heading toward its demise. The benzodiazepines appear to have a very promising future as sedative agents. When administered and monitored appropriately, they have a wide margin of safety. Consideration is given to research and development into agents that reverse the action of sedative drugs. It is emphasized that contemporary electronic monitoring equipment in no way diminishes the necessity for sound and expert clinical judgment, supplemented by such simple devices as the precordial stethoscope and observation and communication in the form of simple commands.