385 - Comparing the Efficacy of Oral Hydroxyzine, Midazolam and Diazepam when Administered to Pediatric Patients Undergoing Dental Sedation

Purpose: To compare the efficacy of oral Hydroxyzine, Midazolam and Diazepam, when administered to pediatric patients undergoing dental sedation.


Methods: A retrospective chart review of patients aged 3-11 years old, ASA I and II, treated under dental sedation from November 1, 2018 to May 1, 2022 was conducted. Patients received either oral Hydroxyzine, Midazolam or Diazepam in combination with nitrous oxide. Charts were reviewed and allocated evenly into 3 groups at 1:1:1 ratio. Effectiveness of sedation was determined using Frankl’s Behavior Rating Scale (The Handbook of Pediatric Dentistry, 5th Edition - 2018).


Results: A total of 180 charts were reviewed; the average age of the subjects was 6 years, 2 months old and 51.1% of them (N=92) were females and 48.9% (N=88) were males. The percent of patients who exhibited the behavior pattern for each drug was as follows: (Frankl 1) – Hydroxyzine (12%), Midazolam (28%), Diazepam (33%); (Frankl 2) – Hydroxyzine (80%), Midazolam (53%), Diazepam (38%); (Frankl 3) – Hydroxyzine (1%), Midazolam (10%), Diazepam (15%); (Frankl 4) – Hydroxyzine (7%), Midazolam (8%), Diazepam (13%). The most common behavior pattern shown for all 3 medications was (Frankl 2), which occurred 57% of the time. These results were considered statistically significant with a (P < 001).


Conclusion: There was a difference in patient behavior between Hydroxyzine, Midazolam and Diazepam when administered for dental sedation. Diazepam produced the most (Frankl 4) and (Frankl 1) behavior patterns of all 3 medications. Most often, all 3 medications elicited a negative, reluctant, timid and/or uncooperative behavior throughout the course of the respective dental treatment.