Oral Propranolol for Reducing Pediatric Dental Patients Anxiety

Evaluating of Oral Propranolol Effect on Managing Anxiety of Dental Extractions in Children: A Randomized Controlled Clinical Trial

Evaluating anxiety, heart rate and behavior during dental extractions after oral dose of either Propranolol, Midazolam or a combination of both in uncooperative pediatric patients.

Use of 0.5 mg/kg of Propranolol or a combination of Propranolol and Midazolam for the first time to manage uncooperative pediatric dental patients anxiety, comparing with Midazolam by evaluating anxiety, heart rate and behavior during administration of local anesthesia and extraction.

Inclusion Criteria:

• High to extreme fear of tooth or molar anesthesia and removal (Frankl: Definitely negative).
• Scoring more than 19 points on MCDAS(f).
• Healthy pediatric patients (ASA I) aging 8-10 years.
• Indication for primary tooth or molar extraction.
• Fasting if indicated (severe gag reflex).
• Airway assessment (Mallampati and tonsillar hypertrophy).

Exclusion Criteria:

• Asthma or any other obstructive pulmonary disease.
• Cardiac failure.
• Cardiac arrhythmia.
• Renal failure.
• Diabetes.
• Current use of another ß-adrenoreceptor antagonist.
• Current use of anxiolytic or antidepressant medication.
• Currently in psychotherapy for dental anxiety.
• Systolic blood pressure <100 mmHg.
• Diastolic blood pressure <60 mmHg.
• Active Upper respiratory infection.