Comparing Acceptance of Nasal Spray in Children Receiving Intranasal Sedation During Dental Treatment: Parent-administered versus Dentist-administered - A Randomised Clinical Trial

Introduction: In pediatric dentistry, behavior management is crucial. When non-pharmacological methods are inadequate, pharmacological therapies, like intranasal conscious sedation, are routinely used. The nasal spray is used for the delivery of sedative medications through the nose. To improve behavior control tactics in pediatric dentistry, this study evaluates the acceptance of nasal spray in pediatric patients. Aim: The primary outcome of the study is to compare the acceptance of nasal spray in children receiving sedation by the parent or the dentist during dental treatment. The secondary outcome is to assess the anxiety level of children in each group. Materials and methods: 40 children aged 4-10 years were included in each group. Group A received intranasal drug delivery via a nasal spray administered by parents, whereas Group B received the same treatment administered by dentists. The anxiety levels of the children were recorded before treatment and after delivering the intranasal sedation using the Facial Image Scale. Additionally, the acceptance of the nasal spray was evaluated using the Mask Acceptance Scale. Results: Mann Whitney U test was performed to assess intergroup comparison and Wilcoxon signed rank test was used for intragroup comparison. The statistical level of significance was set at p<0.05. The number of children being calm in Group A (13.9%) is lesser than in Group B(22.2%). More children remained calmer in group A (95%) when compared to group B. Conclusion: Children sedated with intranasal drugs delivered by parents and dentists exhibited no significant difference in acceptance rates. Thus, intranasal drug delivery by both parents and dentists is a viable option, given that the correct dosages and titration are established by an anesthetist and administered under their supervision. Parental presence during administration of intranasal sedation may reduce anxiety in children. Children tend to have an increased level of acceptance of nasal spray in the presence of parents.