When midazolam meets hyperactivity: tailoring dental sedation for patients with attention deficit hyperactivity disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition which has the potential to significantly impact upon multiple aspects of daily life, including oral health and access to dental care. Many of those with ADHD can experience behavioural challenges such as inattention, impulsivity and hyperactivity, which can make dental treatment difficult and stressful. In response, dentists can utilise conscious sedation to reduce anxiety, improve co-operation and enable effective and safe dental treatment. However, there is evidence that individuals with ADHD may react differently to sedation, particularly to agents like intravenous midazolam, presenting unique challenges for dental professionals responsible for their care. This paper explores the relationship between ADHD and dental sedation, suggesting reasons why sedation may be indicated for this population and how patients with ADHD may respond differently to sedative agents like midazolam. It concludes by investigating ways in which dental care could potentially be improved for this patient demographic.