For every 27 pediatric dental sedation visits, one was linked to an adverse outcome, including visiting the emergency room, according to a study recently published in the Journal of the American Dental Association.
Age, having a chronic medical condition, and other factors were attributed to developing complications, the authors wrote.
“Improving the safety of pediatric dental sedation requires thorough presedation assessment, vigilant patient monitoring, ongoing provider training, and adherence to clinical guidelines,” wrote the authors, led by Dr. Katie Suda, PharmD, MS, director of the Center for Healthcare Evaluation, Research, and Promotion with the Veterans Affairs Pittsburgh Healthcare System (JADA, June 12, 2026).
To assess complications linked to pediatric dental sedation, MarketScan data for patients younger than age 18 who underwent dental sedation from 2014 through 2019 were analyzed. Emergency or urgent care visits and hospitalization within one week of sedation were considered an adverse outcome. Multivariable generalized estimating equations were used to model the correlation between characteristics and outcomes.
Of the more than 37.2 million pediatric dental visits, more than 2.8 million, or 8%, involved dental sedation for approximately 1.4 million patients. The median age was 8, and most sedations involved patients who had no chronic conditions. Medicaid covered 84% of the sedations, while commercial insurance covered the remaining 16%. The majority -- 90% -- were classified as mild sedations, according to the study.
Of the approximately 2.8 million sedations, 107,285 -- or 4% -- were linked to a subsequent adverse outcome, the authors wrote.
Age increased a child’s risk of developing a complication. Pediatric patients ages 12 to 17 (odds ratio [OR], 2.42; 95% confidence interval [CI], 1.66 to 3.53; p < 0.001) had the greatest odds of experiencing a composite outcome compared with children ages 0 to 1.
Additionally, boys (OR, 1.16; 95% CI, 1.14 to 1.18; p < 0.001), children with noncomplex chronic conditions (OR, 2.28; 95% CI, 2.23 to 2.32; p < 0.001), complex chronic conditions (OR, 1.87; 95% CI, 1.80 to 1.94; p < 0.001), neurologic impairment (OR, 1.26; 95% CI, 1.23 to 1.30; p < 0.001), or craniofacial abnormality (OR, 1.06; 95% CI, 1.02 to 1.11; p = 0.01) had the greatest odds of experiencing an adverse outcome, the authors wrote.
Of all sedations, 103,314 (3.6%) were correlated with emergency room or urgent care visits. Of these visits, 23% occurred within 24 hours of sedation, 14% within 48 hours, and 63% more than 48 hours later, they wrote.
However, the study had limitations, including that the results are not representative of patients who do not have dental insurance.
To more accurately evaluate sedation-related complications, researchers should conduct future studies that include those without insurance and incorporate patients who did not receive sedation, the authors wrote.
“Targeted risk-mitigation strategies are needed to enhance patient safety among high-risk groups,” Suda and colleagues wrote.
