Benzodiazepines for conscious sedation in the dental office: literature review

Abstract

Conventional behavioral conditioning techniques are usually sufficient for management of patients with fear and anxiety during dental treatment. When such techniques do not produce the expected results, dental anxiety can be managed using drug-based treatments known as conscious sedation. Anxiety can complicate dental procedures because of effects such as increased blood pressure, hyperventilation, and fainting. Medications such as benzodiazepines can be used to avoid these complications. When used properly, dental procedures are safer and there are fewer difficulties for both patient and clinician. These drugs’ mechanisms of action are exerted on the central nervous system and ultimately result in depression of excitatory cells. Effects vary, depending on the dose administered and the drug used, and can include sedation, hypnosis, muscle relaxation, anticonvulsant effects, coronary dilation, and neuromuscular blockade. With wide safety margins and few contraindications, the benzodiazepines most commonly used by dentists are diazepam, as a mild sedation-inducing anxiolytic, midazolam, to induce sleep and amnesia, and alprazolam, lorazepam, and triazolam, each with their appropriate properties and preferred dosages. This literature review allows us to conclude that benzodiazepines are an effective therapeutic option for management of patients with anxiety during dental treatment and are available for use in both inpatient and outpatient settings.