Comparison of Behavior and Dental Anxiety During Intranasal and Sublingual Midazolam Sedation - A Randomized Trial

Objectives: The objective of the study was to assess the behavioral effects and the changes in the anxiety level of children after intranasal and sublingual midazolam sedation using Venham's clinical anxiety scale and salivary cortisol level. Study Design: Twenty children aged 3 to 7 years were randomly assigned to Group A (n=10) intranasal or Group B (n=10) sublingual midazolam (0.2mg/kg) sedation. The anxiety levels at various time periods were assessed using Venham clinical anxiety scale and corresponding changes in salivary cortisol levels were assessed before and after the drug administration. The anxiety levels were assessed independently by two pediatric dentists from recorded videos. Wilcoxon signed rank test and Mann Whitney U test were used for statistical analysis using SPSS version 19.0.Results: There was a significant decrease in anxiety level from baseline to 20 minutes after drug administration in group A (p=0.004) and group B (p=0.003). There was no significant change in salivary cortisol levels before and after the drug administration in group A (p=0.07) and group B (p=0.38). Conclusions: Both intranasal and sublingual administration of midazolam was equally effective in reducing the child's anxiety. However, there was no significant difference in the salivary cortisol levels in both groups.