Sedation and beyond: Pharmacological strategies in pediatric dental practices

ABSTRACT Dental fear and anxiety in children present major challenges in the delivery of oral health care. While nonpharmacological techniques remain foundational, pharmacological strategies – including minimal, moderate, and deep sedation as well as general anaesthesia – are indispensable for certain patients. This review synthesizes the current evidence on pharmacological behavior management in pediatric dentistry, emphasizing sedation methods, drug classes, patient selection, parental communication, monitoring, controversies, and future perspectives. Drawing on contemporary reviews and expert guidelines, we highlight best practices for ensuring safety, efficacy, and parental acceptance, while acknowledging ongoing debates regarding indications, consent, and risks. A structured, stepwise algorithm is proposed to guide the clinical decision-making.