Volume 30, Issue 174, August 2026

Types of pharmacological sedation for uncooperative patients in pediatric dentistry - narrative review

Aleksandra Wyciślok^1♦, Katarzyna Waśkowska¹, Zuzanna Małek¹, Olgierd Czapiński¹, Weronika Kubiak¹, Julia Kalsztein¹, Marta Kwiatkowska¹, Piotr Wysocki², Sonia Krzykawska³

¹Institute of Dentistry of the Central Teaching Hospital of the Medical University of Lodz. ul. Pomorska 251, 92-213 Łódź, Poland
²Faculty of Medicine of the Medical University of Lodz. ul. Pomorska 251, 92-213 Łódź, Poland
³University Dental Clinic of the Jagiellonian University Medical College in Krakow. ul. Montelupich 4, 31-155 Krakow, Poland

^♦Corresponding author
Aleksandra Wyciślok, Institute of Dentistry of the Central Teaching Hospital of the Medical University of Lodz. ul. Pomorska 251, 92-213 Łódź, Poland

ABSTRACT

Background: Dental fear is, and has been for centuries, a great problem when it comes to treating patients, especially pediatric patients. When non-pharmacological techniques are insufficient, the use of pharmacological sedation becomes necessary. It allows behavior management, pain minimization, and ensures patient safety. Aim: The aim of this systematic review is to compile scientific evidence on the clinical effectiveness and safety profile of various sedation methods in uncooperative pediatric patients. Material and methods: The present paper searched the literature on electronic databases, including PubMed, using the keywords: “Pediatric dentistry”, “Pharmacological sedation”, “Dental phobia”, “Dental procedures”. Articles included randomized controlled trials, meta-analyses, and systematic reviews from 2015 to the present year. Results: Evidence shows that Midazolam and Nitrous Oxide remain the most commonly used and best-studied drugs. They can effectively improve a child’s behavior during dental procedures. Dexmedetomidine is also playing an increasingly important role. The review emphasizes significant diversity in international guidelines and the absence of a “gold standard” for dosing and monitoring methods. Conclusions: Pharmacological sedation is a safe and effective alternative to general anesthesia in pediatric dentistry; however, its success depends on careful selection of the drug, route of administration, and the operator’s qualifications. There is an urgent need to standardize research and clinical protocols to optimize care for pediatric patients and improve the predictability of treatment outcomes.

Keywords: Pediatric dentistry, Pharmacological sedation, Dental phobia, Dental procedures

Medical Science, 2026, 30, e158ms3955

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Published: 23 August 2026