{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:35:40Z","timestamp":1790778940069,"version":"4.1.0"},"reference-count":31,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,1,24]],"date-time":"2021-01-24T00:00:00Z","timestamp":1611446400000},"content-version":"unspecified","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,12,31]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>It can be challenging to manage patients who are anxious during dental procedures. There is a lack of evidence regarding the effectiveness and safety of oral sedation in adults. This study evaluated the effectiveness and safety of oral sedation in patients undergoing dental procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Randomised clinical trials (RCTs) compared the oral use of benzodiazepines and other medications with a placebo or other oral agents in adult patients. A search of the Cochrane (CENTRAL), MEDLINE (via Ovid), EMBASE (via Ovid) and Cumulative Index to Nursing and Allied Health Literature (via Ovid) databases was conducted, without any restrictions on language or date of publication. The primary outcomes included the adverse effects and anxiety level. The secondary outcomes included sedation, satisfaction with the treatment, heart rate, respiratory rate, blood pressure and oxygen saturation. Reviewers, independently and in pairs, assessed each citation for eligibility, performed the data extraction and assessed the risk of bias. A narrative synthesis of the data was provided.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A number of RCTs (n=327 patients) assessed the use of benzodiazepines (n=9) and herbal medicines (n=3). We found good satisfaction with treatment after the use of midazolam 7.5 mg or clonidine 150 \u00b5g and reduced anxiety with alprazolam (0.5 and 0.75 mg). Midazolam 15 mg promoted greater anxiety reduction than\n                      <jats:italic>Passiflora incarnata<\/jats:italic>\n                      L. 260 mg, while\n                      <jats:italic>Valeriana officinalis<\/jats:italic>\n                      100 mg and\n                      <jats:italic>Erythrina mulungu<\/jats:italic>\n                      500 mg were more effective than a placebo. More patients reported adverse effects with midazolam 15 mg. Diazepam 15 mg and\n                      <jats:italic>V. officinalis<\/jats:italic>\n                      100 mg promoted less change in the heart rate and blood pressure than a placebo.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Given the limitations of the findings due to the quality of the included studies and the different comparisons made between interventions, further RCTs are required to confirm the effectiveness and safety of oral sedation in dentistry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42017057142.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-043363","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T10:33:38Z","timestamp":1611570818000},"page":"e043363","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Effectiveness and safety of oral sedation in adult patients undergoing dental procedures: a systematic review"],"prefix":"10.1136","volume":"11","author":[{"given":"Jimmy de Oliveira","family":"Ara\u00fajo","sequence":"first","affiliation":[{"name":"Division of Pharmacology, Anesthesiology and Therapeutics, Faculdade S\u00e3o Leopoldo Mandic, Instituto de Pesquisas S\u00e3o Leopoldo Mandic, Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6608-1806","authenticated-orcid":false,"given":"Cristiane de C\u00e1ssia","family":"Bergamaschi","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Universidade da Sorocaba, Sorocaba, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3684-3275","authenticated-orcid":false,"given":"Luciane Cruz","family":"Lopes","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Universidade da Sorocaba, Sorocaba, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1672-528X","authenticated-orcid":false,"given":"Caio Chaves","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Anesthesiology and Therapeutics, Faculdade S\u00e3o Leopoldo Mandic, Instituto de Pesquisas S\u00e3o Leopoldo Mandic, Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia Karol","family":"de Andrade","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Anesthesiology and Therapeutics, Faculdade S\u00e3o Leopoldo Mandic, Instituto de Pesquisas S\u00e3o Leopoldo Mandic, Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Cama","family":"Ramacciato","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Anesthesiology and Therapeutics, Faculdade S\u00e3o Leopoldo Mandic, Instituto de Pesquisas S\u00e3o Leopoldo Mandic, Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6983-7883","authenticated-orcid":false,"given":"Rog\u00e9rio Hel\u00e1dio Lopes","family":"Motta","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Anesthesiology and Therapeutics, Faculdade S\u00e3o Leopoldo Mandic, Instituto de Pesquisas S\u00e3o Leopoldo Mandic, Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"key":"2025121421574921000_11.1.e043363.1","doi-asserted-by":"crossref","first-page":"320","DOI":"10.4103\/ams.ams_191_18","article-title":"Conscious sedation in dentistry","volume":"8","author":"Kapur","year":"2018","journal-title":"Ann Maxillofac Surg"},{"key":"2025121421574921000_11.1.e043363.2","doi-asserted-by":"crossref","DOI":"10.3390\/medicina55120778","article-title":"Conscious sedation in dentistry","volume":"55","author":"Fiorillo","year":"2019","journal-title":"Medicina"},{"key":"2025121421574921000_11.1.e043363.3","unstructured":"Dundee Dental Education Centre . Scottish dental clinical effectiveness programme: conscious sedation in dentistry. Frankland Building, 2012: 1\u201337."},{"key":"2025121421574921000_11.1.e043363.4","unstructured":"Academy of Medical Royal Colleges . Safe sedation practice for health care procedures. London, 2013."},{"key":"2025121421574921000_11.1.e043363.5","unstructured":"The Dental Faculties of the Royal Colleges of Surgeons and the Royal College of Anaesthetists . Standards for conscious sedation in the provision of dental care, 2015."},{"key":"2025121421574921000_11.1.e043363.6","unstructured":"National Dental Advisory Committee . Scottish government. emergency drugs and equipment in primary dental care, 2015."},{"key":"2025121421574921000_11.1.e043363.7","doi-asserted-by":"crossref","DOI":"10.1038\/sj.bdj.2011.725","article-title":"Estimating the need for dental sedation. 1. 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