The State of Pediatric Dental Sedation Literature and Research: A Paucity of Evidence Based Support
Journal Title: Journal of Dental Health and Oral Research - Year 2021, Vol 2, Issue 3
Abstract
Among the most controversial areas within the field of pediatric dentistry since the latter part of the 20th century has been the utilization of sedative techniques for management of apprehensive and resistive child behaviors when conventional non-pharmacological approaches prove inadequate. Despite a plethora of studies, the vast majority of reports can best be characterized as clinical impression, and retrospective analyses, with a profound paucity of prospective trials representing well-controlled events yielding evidence-based conclusions. Textbook recommendations presented have suggested agent and dosage guidelines, but even more rarely have such been supported by sound research methodologies. Critical analysis of most clinical trials, with few exceptions, are replete with significant shortcomings and design flaws. Some studies including those employing repetitiously flawed methodologies, several in the latter 1980’s and early 1990’s claim findings which carry little or no validity because of the extent of inherent design deficiencies that confound the ability to draw legitimate conclusions. Despite such, it is not uncommon for techniques and drug dosing recommendations of these works to be in current use. This paper will identify several such studies, concatenated authority which discusses their limited contribution to the literature, and a lack of evidence based support for safety and efficacy. The nature of behavioral clinical research carries numerous and often insurmountable obstacles in the form of difficult to control variables which will become apparent in the manuscript. A specific aim of this manuscript will be to place in perspective what has been learned from a constructive perspective, where research direction needs to occur, and how to secure evidence based data to permit favorable clinical decisions to be derived regarding agent and dosage selection based on relevant cues to enhance sedation efficacy and patient safety.
Authors and Affiliations
John E Nathan
Keywords
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- EP ID EP699024
- DOI http://dx.doi.org/10.46889/JDHOR.2021.2304
- Views 85
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