Cochrane Library Cochrane Database of Systematic Reviews Sedation of children undergoing dental treatment (Review) Ashley PF, Chaudhary M, Lourenço-Matharu L Ashley PF, Chaudhary M, Lourenço-Matharu L. Sedation of children undergoing dental treatment. Cochrane Database of Systematic Reviews 2018, Issue 12. Art. No.: CD003877. DOI: 10.1002/14651858.CD003877.pub5. www.cochranelibrary.com Sedation of children undergoing dental treatment (Review) Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Cochrane Trusted evidence. Informed decisions. Library Better health. Cochrane Database of Systematic Reviews T A B L E O F C O N T E N T S HEADER......................................................................................................................................................................................................... 1 ABSTRACT..................................................................................................................................................................................................... 1 PLAIN LANGUAGE SUMMARY....................................................................................................................................................................... 2 SUMMARY OF FINDINGS.............................................................................................................................................................................. 3 BACKGROUND.............................................................................................................................................................................................. 7 OBJECTIVES.................................................................................................................................................................................................. 7 METHODS..................................................................................................................................................................................................... 7 RESULTS........................................................................................................................................................................................................ 10 Figure 1.................................................................................................................................................................................................. 11 Figure 2.................................................................................................................................................................................................. 18 DISCUSSION.................................................................................................................................................................................................. 24 AUTHORS' CONCLUSIONS........................................................................................................................................................................... 25 ACKNOWLEDGEMENTS................................................................................................................................................................................ 26 REFERENCES................................................................................................................................................................................................ 27 CHARACTERISTICS OF STUDIES.................................................................................................................................................................. 36 DATA AND ANALYSES.................................................................................................................................................................................... 87 Analysis 1.1. Comparison 1 Sedatives versus placebo, Outcome 1 Mean Houpt/other behavioural score...................................... 87 Analysis 1.2. Comparison 1 Sedatives versus placebo, Outcome 2 Good or better behaviour......................................................... 88 Analysis 2.1. Comparison 2 Chloral hydrate (CH), Outcome 1 Overall behaviour (ordinal scale, Houpt or similar)........................ 89 Analysis 2.2. Comparison 2 Chloral hydrate (CH), Outcome 2 Good or better behaviour................................................................. 89 Analysis 3.1. Comparison 3 Ketamine, Outcome 1 Overall behaviour (ordinal scale, Houpt or similar).......................................... 90 Analysis 3.2. Comparison 3 Ketamine, Outcome 2 Good or better behaviour.................................................................................. 91 Analysis 4.1. Comparison 4 Midazolam (versus other), Outcome 1 Overall behaviour (ordinal scale, Houpt or similar)................ 92 Analysis 4.2. Comparison 4 Midazolam (versus other), Outcome 2 Good or better sedation........................................................... 93 Analysis 5.1. Comparison 5 Nitrous oxide, Outcome 1 Overall behaviour (ordinal scale, Houpt or similar).................................... 93 ADDITIONAL TABLES.................................................................................................................................................................................... 93 APPENDICES................................................................................................................................................................................................. 118 WHAT'S NEW................................................................................................................................................................................................. 121 HISTORY........................................................................................................................................................................................................ 121 CONTRIBUTIONS OF AUTHORS................................................................................................................................................................... 121 DECLARATIONS OF INTEREST..................................................................................................................................................................... 121 SOURCES OF SUPPORT............................................................................................................................................................................... 122 DIFFERENCES BETWEEN PROTOCOL AND REVIEW.................................................................................................................................... 122 INDEX TERMS............................................................................................................................................................................................... 122 Sedation of children undergoing dental treatment (Review) i Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Cochrane Trusted evidence. Informed decisions. Library Better health. Cochrane Database of Systematic Reviews [Intervention Review] Sedation of children undergoing dental treatment Paul F Ashley1, Mohsin Chaudhary2, Liege Lourenço-Matharu3 1Unit of Paediatric Dentistry, Department of Craniofacial Growth and Development, UCL Eastman Dental Institute, London, UK. 2Paediatrics, University College London Hospital, London, UK. 3London, UK Contact address: Paul F Ashley, Unit of Paediatric Dentistry, Department of Craniofacial Growth and Development, UCL Eastman Dental Institute, 256 Grays Inn Road, London, WC1X 8LD, UK. [email protected]. Editorial group: Cochrane Oral Health Group. Publication status and date: New search for studies and content updated (conclusions changed), published in Issue 12, 2018. Citation: Ashley PF, Chaudhary M, Lourenço-Matharu L. Sedation of children undergoing dental treatment. Cochrane Database of Systematic Reviews 2018, Issue 12. Art. No.: CD003877. DOI: 10.1002/14651858.CD003877.pub5. Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. A B S T R A C T Background Children's fear about dental treatment may lead to behaviour management problems for the dentist, which can be a barrier to the successful dental treatment of children. Sedation can be used to relieve anxiety and manage behaviour in children undergoing dental treatment. There is a need to determine from published research which agents, dosages and regimens are eHective. This is the second update of the Cochrane Review first published in 2005 and previously updated in 2012. Objectives To evaluate the eHicacy and relative eHicacy of conscious sedation agents and dosages for behaviour management in paediatric dentistry. Search methods Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 22 February 2018); the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 1) in the Cochrane Library (searched 22 February 2018); MEDLINE Ovid (1946 to 22 February 2018); and Embase Ovid (1980 to 22 February 2018). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Selection