Use of midazolam for behavioral management in dental care of a child with attention deficit hyperactivity disorder: a case report

  • Isabela Ribeiro Madalena
  • Mariana Vieira Paskakulis
  • Carolina Paes Torres
  • Alexandra Mussolino de Queiroz
  • Francisco Wanderley Garcia Paula-Silva
Palavras-chave: attention deficit disorder with hyperactivity; behavior control; nitrous oxide; midazolam.


Attention deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental condition characterized by variations in levels of inattention, hyperactivity, and impulsivity. Such symptoms may be even more exacerbated when the patient is exposed to dental care. Objective: To present a case report of behavioral management in a patient with ADHD, emphasizing the use of sedation techniques such as oral sedation drugs and inhalation conscious sedation. Case report: A 10-year-old patient was referred to the basic health unit due to the difficulty of behavioral management during dental treatment. It was reported by the guardian that the patient presents ADHD and is under continuous medication. The dental examination revealed that the patient needed an endodontic treatment on tooth 46, an extraction of residual root of tooth 36, and oral health education strategies. Preventive strategies were successfully carried out through detailed verbal communication, but, in a subsequent session, the patient presented acute symptoms on tooth 46. The dental team chose to proceed to a tooth extraction under inhalation conscious sedation with nitrous oxide/oxygen for care optimization. Even though the procedure was performed, the sedation strategy did not show satisfactory results. Due to this circumstance, the extraction of the residual root (36) was performed by oral drug sedation without any intercurrence. Conclusion: Behavioral management in a patient with ADHD was optimized by verbal communication and the use of oral drug sedation.

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