Dexmedetomidine for Paediatric Dental Sedation: A Literature-based Perspective

Dental anxiety and difficult behaviour need to be managed efficiently to instil a positive attitude and to ensure the provision of quality treatments to the children. Unlike other traditional sedatives such as midazolam and ketamine, dexmedetomidine (DEX), a highly selective α 2 -adrenergic agonist, owing to its anxiolytic and analgesic properties, has emerged as a novel sedative agent. Its increasing use in paediatric sedative procedures has prompted an in-depth investigation of its use in dentistry settings. According to published research, it can be used to provide cooperative sedation with minimal respiratory compromise and stable haemodynamic parameters. The most commonly reported routes are intranasal (IN) and intravenous; IN administration is practical and well accepted by young children. When used alone or in conjunction with other medications, DEX exhibits a better and more seamless recovery as well as less post-operative agitation. Nevertheless, potential bradycardia and delayed onset of action are matters of concern for its use in a dental office setup and for shorter dental procedures. The purpose of this review of the literature was to assess the clinical benefits, safety profile, routes of administration and effectiveness of DEX for paediatric dental sedation. Although encouraging, more randomised trials tailored to the dental procedures in an office setup are required to improve long-term outcome evaluation and ideal dosage schedule. This in turn, will help support clinical judgement and define areas that need more investigation.