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. 2020 Oct 22;8(4):419. doi: 10.3390/healthcare8040419

Table 1.

Comparison of the main advantages and disadvantages of various dental conscious sedation (DCS) techniques used in dental care services.

Conscious Sedation Method Advantages Disadvantages
Oral sedation (OS) Simple method, does not require specific training/equipment, side effects are rare if any, can be combined with other DCS methods Age restricted, unpredictable pharmacokinetics and patients’ response, limited efficiency of anxiolysis, risk of oversedation or undersedation, unpredictable sedative effect, sometimes prolonged recovery, may require a chaperone person
Inhalation sedation (IHS) No age restrictions, although it requires good cooperation, wide safety margin, can be enhanced by additional techniques, such as music and tranquilizing verbal descriptions, quick recovery, does not require chaperone person Limited efficiency, requires special, expensive equipment; anxiolysis less effective in adults; special facilities requirements (scavenging); operator sensitive; technique sensitive
Intravenous sedation with single-drug titration (midazolam IVS) Effective in situations where OS or IHS failed or for patients with severe dental phobia who cannot be sedated with IHS, well-controlled patient’s response due to drug titration, allows a profound anxiolysis, post-operative amnesia effect, may substitute dental general anaesthesia in selected cases, reversal agent in case of intraoperative complications or abnormal reaction associated with the use of benzodiazepine agent Age limited, usually not used in children below 12 y.o.a., risk of systemic complications, age-restricted, requires advanced training and cannulation skills, requires training in advanced life support, chaperone person required, comprehensive pre- and postoperative instructions for patient
Intranasal, transmucosal sedation with a short-acting benzodiazepine (midazolam) Non-invasive, often used as an adjunct to IV sedation prior to cannulation, allowing a better patient’s co-operation during cannulation; does not require specific facilities or equipment; reversal agent in case of complications Unpredictable sedative effect, unpleasant sensations during administration, usually not used alone, requires advanced training and cannulation skills (in case of adverse effects)