Factors Associated with Repeated Dental Sedation in Pediatric Patients: A Retrospective Study

This study aimed to identify the factors associated with repeated sedation in pediatric patients undergoing dental treatment via a retrospective review of clinical records from 2020 to 2024. A total of 132 children who underwent at least one sedation session were followed for up to 4 years. Our results showed that repeated sedation occurred in 48 patients (36.36%). Recurrent event survival analysis using the Andersen-Gill Cox model revealed that mental disability (hazard ratio (HR) = 2.59, p = 0.022), use of midazolam-based sedation (HR = 3.31 for midazolam + hydroxyzine, p = 0.004; HR = 2.44 for chloral hydrate + midazolam + hydroxyzine, p = 0.029), and a higher number of planned teeth for treatment (HR = 1.34, p = 0.020) were significantly associated with repeated sedation. Other demographic, medical, dental, and behavioral factors were not significantly related to repeated sedation. These findings highlight the importance of medical and treatment-related factors in predicting repeated sedation and supporting personalized sedation planning in pediatric dentistry.