Longitudinal Follow-up Comparing Future Care of Primary Teeth Treated with Silver Diammine Fluoride: A Private Dental Claims Review.

Purpose: The purpose of this study was to longitudinally evaluate follow-up treatment on primary teeth initially treated with silver diammine fluoride (SDF). Methods: This retrospective cohort evaluated private insurance (not Medicaid) claims data from 2018 to 2019 for children no older than 12 years with at least one primary tooth initially treated with SDF. Additional treatment per tooth was recorded over a follow-up of at least 24 months. Results: The mean and standard deviation (±SD) age of 46,884 patients was 5.7±2.3 and for SDF-treated teeth per patient was 2.6±2.1. Forty percent (95 percent confidence interval [95% CI] equals 39 to 40.7 percent) of teeth initially treated with SDF received additional treatment. The odds of SDF-treated teeth receiving future treatment significantly decreased with patient age by 22 percent per year (odds ratio equals 0.78; 95% CI equals 0.077 to 0.79; P<0.001). Pediatric dentists had only slightly lower odds than general dentists for providing additional treatment (0.91, P<0.001). Posterior teeth and teeth expected to exfoliate in two or more years had significantly higher odds of receiving additional treatment (2.47 and 1.27, respectively, P<0.001). Conclusions: Beginning at age four, patient age at placement of silver diammine fluoride was inversely proportional to future treatment provided. Posterior teeth and teeth expected to exfoliate in two or more years were more likely to receive additional treatment.

Evaluation of Claim Reports for Potential Impact of COVID-19 on Pediatric Dental Procedures.

PURPOSE: To evaluate whether the postponement of dental elective procedures at the start of the COVID-19 pandemic was associated with an increased number of simple dental extractions, and/or decreased restorative procedures by analyzing data obtained from state-funded insurance dental claims. METHODS: Paid dental claims collected from March 2019 to December 2019 and from March 2020 to December 2020 for children ages two to 13 years old were analyzed. Dental procedures were selected based on Current Dental Terminology (CDT) codes for simple dental extractions and restorative procedures. Statistical analyses were performed to compare the rates of procedure types between 2019 and 2020. RESULTS: No differences in dental extractions but full-coverage restoration procedure rates per month and child were significantly lower than pre-pandemic (P=0.016). CONCLUSION: Further study required to determine the impact of COVID-19 on pediatric restorative procedures and access to pediatric dental care in the surgical setting.

Pediatric Phantom Dosimetry of a Portable Handheld X-ray Device.

The purpose of this study was to quantify radiation dose from the XTG (Xray2Go) handheld X-ray device for bitewing and maxillary anterior occlusal projections using a pediatric phantom. The aim was to evaluate effects of thyroid shielding on total effective dose (E) and tissue equivalent doses (HT) and assess operator backscatter radiation. Methods:A pediatric phantom head with 24 tissue site dosimeters was exposed to radiation from the x-ray device. Exposures included: (1) right and left bitewing (BW) without thyroid collar on phantom, (2) BW with thyroid collar, (3) maxillary anterior occlusal (AO) without thyroid collar, (4) AO with thyroid collar. With each exposure type, new dosimeter sets were used and 30 exposures completed. The operator wore dosimeters on the forehead and right hand to quantify backscatter radiation. Average values of HT and E were calculated. Conclusions: Thyroid shielding made a statistically significant difference for radiation dose with the Xray2Go for BW projections at specific tissue sites, including the thyroid, lymph nodes, and muscle, and for overall effective dose. Radiation to the operator from the device was very low and indistinguishable from background radiation.

Effect of a Tea Polyphenol on Different Levels of Exposure of Nicotine and Tobacco Extract on Streptococcus mutans Biofilm Formation.

Objective: The purpose of this study was to compare the effects of different levels of nicotine and tobacco extract exposure on Streptococcus mutans biofilm formation and the inhibitory effect of the polyphenol epigallocatechin-3 gallate (EGCG) found in green tea. This study addressed the results of biofilm assays with EGCG and varying relative concentrations of nicotine and tobacco extract consistent with primary, secondary and tertiary levels of smoking exposure. Primary smoking exposure to nicotine has been demonstrated to significantly increase biofilm formation, while EGCG has been demonstrated to reduce S. mutans biofilm formation. Methods: S. mutans was treated with varying levels of nicotine or cigarette smoke condensate (CSC) concentrations (0-32 mg/ml and 0-2 mg/ml, respectively) in Tryptic Soy broth supplemented with 1% sucrose for different lengths of time simulating primary, secondary and tertiary smoking exposure with and without 0.25 mg/ml EGCG. The amount of total growth and biofilm formed was determined using a spectrophotometric crystal violet dye staining assay. Results: For both nicotine and CSC, primary exposure displayed overall significantly less growth compared to secondary exposure. For nicotine, secondary exposure demonstrated significantly greater growth than tertiary exposure levels. Overall, significantly greater total bacterial growth and biofilm formation in the presence of nicotine and CSC was observed in the absence of EGCG than in the presence of EGCG. However, biofilm growth was not significantly different among different concentrations of CSC. Conclusion: The results of this study help illustrate that nicotine-induced S. mutans biofilm formation is reduced by the presence of EGCG. This provides further evidence of the potential beneficial properties of polyphenols.

Pediatric Phantom Dosimetry Evaluation of the Extraoral Bitewing.

Purpose: This study's purpose was to evaluate the effective dose (E) and equivalent dose (HT) of exposing a pediatric phantom to the extraoral bitewing programs of the Planmeca ProMax 2D S3 (ProMax) and Instrumentarium Orthopantomograph OP30 (OP30) and compare these results with dosimetry associated with the intraoral bitewing and panoramic radiograph. Methods: Dosimetry was acquired by placing 24 dosimeters in tissues of interest in a 10-year-old phantom. Manufacturer child settings were used for all scans. Repeat exposures of 20 scans were utilized. The average values of E and HT were calculated. Results: The E for the ProMax and OP30 units, respectively, were 16.84 µSv and 5.82 µSv. The highest E for both units was delivered to the thyroid, remainder tissues, and salivary glands. The highest HT for both units was delivered to the oral mucosa, salivary glands, extrathoracic airway, and thyroid. The mean differences between units were statistically significant (P<0.05). Conclusions: The average effective dose of the ProMax was higher than for the OP30. The effective dose of the pediatric extraoral bitewing is three to 11 times higher than that of the intraoral bitewing and comparable to the traditional panoramic radiograph of a pediatric phantom. Pediatric extraoral bitewing radiation protection guidelines are recommended.

The Effects of Different Levels of Ambient Oxygen in an Oxygen-Enriched Surgical Environment and Production of Surgical Fires.

Surgical fires require an oxygen-enriched environment, a flammable substrate, and an ignition source. We hypothesized ambient oxygen concentration is proportional to the latency time to combustion and the incidence of surgical fires that are detected. We examined latency time and number of events, utilizing the VanCleave et al model of intraoral fire ignition under 60, 80, and 100% oxygen concentration and flow rates of 4 and 10 L/min. Results demonstrated that ambient oxygen concentration and flow rate correlated positively to the initiation of combustion. The number of combustion events with 60% oxygen was significantly lower than with both 80% ( p = .0168) and 100% ( p = .002). Likewise, the number of events with 80% oxygen was significantly lower than with 100% oxygen ( p = .0019). Flow rate has a significant effect on the time to the first event ( p = .0002), time to first audible pop ( p = .0039), and time to first flash or fire ( p < .0001). No combustion occurred at oxygen concentrations less than 60% or flows less than 4 L/min. We conclude that latency time to combustion is directly proportional to ambient oxygen concentration and flow rate. Minimum oxygen concentration and flow rate were identified in our model. Further research is indicated to determine the minimal clinical oxygen concentration and flow rate needed to support combustion of an intraoral fire in a patient.

Silver Diamine Fluoride and Potassium Iodide Disruption of In Vitro Streptococcus mutans Biofilm.

Purpose: The purpose of this study was to investigate the inhibitory in vitro effects of silver diamine fluoride (SDF) with and without a saturated solution of potassium iodide (SSKI) on established Streptococcus mutans biofilm.Methods: Fifty µl of an overnight S. mutans culture (106 CFU per mL) in Tryptic Soy Broth (TSB) and three ml of fresh TSB supplemented with one percent sucrose (TSBS) were incubated for 24 hours to establish an S. mutans biofilm in six-well tissue culture plates. Four treatments (SDF, SSKI, SDF plus SSKI, and untreated control) were used to disrupt the biofilm. The biofilm groups were each treated with reagent and washed; the biofilm was collected, diluted, and spiral-plated onto blood agar plates; and an automated counting machine was used to determine the bacterial colony forming units (CFU).Results: The control had significantly more CFU than the SSKI, SDF, and SDF plus SSKI groups (P<.0001). The SSKI group had significantly more CFU than the SDF and SDF plus SSKI groups (P<.0001). The SDF group had significantly fewer CFU than the SDF plus SSKI group (P=.02). The reduction from the control was more than seven-fold for SDF, four-fold for SDF plus SSKI, and two-fold for SSKI.Conclusions: SDF alone, SDF plus SSKI, and SSKI disrupted an established S. mutans biofilm. SDF alone had the greatest overall disruption.

Office-Based Anesthesia: Safety and Outcomes in Pediatric Dental Patients.

The number of children with caries requiring general anesthesia to achieve comprehensive dental care and the demand for dentist anesthesiologists to provide ambulatory anesthesia for these patients is increasing. No current published studies examine the safety and outcomes of ambulatory anesthesia performed by dentist anesthesiologists for dental procedures in pediatric patients, and there is no national requirement for reporting outcomes of these procedures. In 2010, the Society for Ambulatory Anesthesia Clinical Outcomes Registry was developed. This Web-based database allows providers of ambulatory anesthesia to track patient demographics and various outcomes of procedures. Our study is a secondary analysis of data collected in the registry over a 4-year period, 2010-2014. Of the 7041 cases reviewed, no cases resulted in serious complications, including death, anaphylaxis, aspiration, cardiovascular adverse events, or neurologic adverse events. Of the 7041 cases reviewed, 196 (3.0%) resulted in a predischarge or postdischarge adverse event. The predischarge adverse event occurring with the highest frequency was laryngospasm, occurring in 35 cases (0.50%). The postdischarge adverse event occurring with the highest frequency was nausea, reported by 99 patients (5.0%). This study provides strong clinical outcomes data to support the safety of office-based anesthesia as performed by dentist anesthesiologists in the treatment of pediatric dental patients.

Pediatric Phantom Dosimetry of Kodak 9000 Cone-beam Computed Tomography.

PURPOSE: The purpose of the study was to evaluate the radiation dose of the Kodak 9000 cone-beam computed tomography (CBCT) device for different anatomical areas using a pediatric phantom. METHODS: Absorbed doses resulting from maxillary and mandibular region three by five cm CBCT volumes of an anthropomorphic 10-year-old child phantom were acquired using optical stimulated dosimetry. Equivalent doses were calculated for radiosensitive tissues in the head and neck area, and effective dose for maxillary and mandibular examinations were calculated following the 2007 recommendations of the International Commission on Radiological Protection (ICRP). RESULTS: Of the mandibular scans, the salivary glands had the highest equivalent dose (1,598 microsieverts [µSv]), followed by oral mucosa (1,263 µSv), extrathoracic airway (pharynx, larynx, and trachea; 859 µSv), and thyroid gland (578 µSv). For the maxilla, the salivary glands had the highest equivalent dose (1,847 µSv), followed closely by oral mucosa (1,673 µSv), followed by the extrathoracic airway (pharynx, larynx, and trachea; 1,011 µSv) and lens of the eye (202 µSv). CONCLUSION: Compared to previous research of the Kodak 9000, completed with the adult phantom, a child receives one to three times more radiation for mandibular scans and two to 10 times more radiation for maxillary scans.

The Effect of Fluoride Varnish on Enamel Shear Bond Strength of Pit and Fissure Sealants.

PURPOSE: The purpose of this study was to determine the effects of fluoride varnish on the enamel shear bond strength of pit and fissure sealants. METHODS: Ninety-six teeth were divided into three duplicated test groups: sealant (S)/sealant thermocycle (ST) received Clinpro Sealant only; varnish sealant (VS)/varnish sealant thermocycle (VST) received five percent sodium fluoride (NaF) varnish plus sealant (VPS); and VPS/VPS thermocycle (VPST) received NaF, polish with Clinpro Prophy Paste, plus sealant. One set of each group (ST, VST, VPST) was thermocycled to represent aging, and one set (S, VS, PVS) was not. The shear bond strengths for the thermocycled groups and nonthermocycled groups were determined, and two-way analysis of variance tested the effects of thermocycling and varnish. RESULTS: Thermocycling did not have a significant effect on the peak stresses of the groups (P=0.0552), so sets were combined. The peak stress for S/ST was significantly higher than for VS/VST (P<0.0001). The peak stress for VPS/VPST was significantly higher than for VS/VST (P<0.0001). The peak stress for S/ST was significantly higher than VPS/VPST (P=0.025). CONCLUSION: Fluoride varnish applied immediately before pit and fissure sealant placement negatively affected the shear bond strength of the sealant. Mechanically cleaning a fluoride varnish-coated tooth with prophy paste did not provide pit and fissure sealant enamel shear bond strengths comparable to those of untreated enamel.

Fluoride in the diet of 2-years-old children.

OBJECTIVES: This study aimed to calculate the fluoride concentrations of commonly consumed foods and beverages for 2-years-old children utilizing market basket information for the US Midwest region. METHODS: Total Diet Study food lists were cross-referenced with National Health and Nutrition Examination Survey-What We Eat in America data to determine the foods and beverages to be included. Fluoride concentrations were determined using a modification of the hexamethyldisiloxane microdiffusion technique. Fluoride concentrations were summarized for each of the food categories. Daily dietary fluoride intake was estimated using a simulation analysis. RESULTS: Food and beverage fluoride concentrations varied widely, ranging from nondetectable for some oils and dairy products to more than 3.0 µgF/g food for some processed meats, fish and fruits. The estimated mean (±SD) daily dietary fluoride intake, excluding dentifrice and supplements, was 412±114 µgF/d. The estimated average ingestion for a 2-years-old weighing 12.24 kg was 0.034±0.009 mg/kg/d. A diet based on foods and beverages in the fifth percentile of fluoride intake distribution for an average child would result in 247 µgF/d or 0.020 mg/kg/d, while a diet with foods and beverages in the 95th percentile would result in a total intake of 622 µgF/d or 0.051 mg/kg/d. CONCLUSIONS: The fluoride concentrations of foods and beverages vary widely, and, if items in the 95th percentile of fluoride intake distribution are ingested, children could consume more fluoride than the recommended 0.05 mg/kg/d. Fluoride intake calculated in this study was higher than historically reported dietary levels.

Behavior Assessment in Children Following Hospital-Based General Anesthesia versus Office-Based General Anesthesia.

The purpose of this study was to determine if differences in behavior exist following dental treatment under hospital-based general anesthesia (HBGA) or office-based general anesthesia (OBGA) in the percentage of patients exhibiting positive behavior and in the mean Frankl scores at recall visits. This retrospective study examined records of a pediatric dental office over a 4 year period. Patients presenting before 48 months of age for an initial exam who were diagnosed with early childhood caries were included in the study. Following an initial exam, patients were treated under HBGA or OBGA. Patients were followed to determine their behavior at 6-, 12- and 18-month recall appointments. Fifty-four patients received treatment under HBGA and 26 were treated under OBGA. OBGA patients were significantly more likely to exhibit positive behavior at the 6- and 12-month recall visits p = 0.038 & p = 0.029). Clinicians should consider future behavior when determining general anesthesia treatment modalities in children with early childhood caries presenting to their office.

The effect of intraoral suction on oxygen-enriched surgical environments: a mechanism for reducing the risk of surgical fires.

In this study, a mechanical model was applied in order to replicate potential surgical fire conditions in an oxygen-enriched environment with and without high-volume suction typical for dental surgical applications. During 41 trials, 3 combustion events were measured: an audible pop, a visible flash of light, and full ignition. In at least 11 of 21 trials without suction, all 3 conditions were observed, sometimes with an extent of fire that required early termination of the experimental trial. By contrast, in 18 of 20 with-suction trials, ignition did not occur at all, and in the 2 cases where ignition did occur, the fire was qualitatively a much smaller, candle-like flame. Statistically comparing these 3 combustion events in the no-suction versus with-suction trials, ignition (P = .0005), audible pop (P = .0211), and flash (P = .0092) were all significantly more likely in the no-suction condition. These results suggest a possible significant and new element to be added to existing surgical fire safety protocols toward making surgical fires the "never-events" they should be.

Factors involved in dental surgery fires: a review of the literature.

Surgical fires are well-characterized, readily preventable, potentially devastating operating room catastrophes that continue to occur from 20 to 100 times per year or, by one estimate, up to 600 times per year in US operating rooms, sometimes with fatal results. The most significant risk factors for surgical fires involve (a) the use of an ignition source, such as laser or electrocautery equipment, in or around an oxygen-enriched environment in the head, neck, and upper torso area and (b) the concurrent delivery of supplemental oxygen, especially via nasal cannula. Nonetheless, while these 2 conditions occur very commonly in dental surgery, especially in pediatric dental surgery where sedation and anesthesia are regularly indicated, there is a general absence of documented dental surgical fires in the literature. Barring the possibility of underreporting for fear of litigation, this may suggest that there is another mechanism or mechanisms present in dental or pediatric dental surgery that mitigates this worst-case risk of surgical fires. Some possible explanations for this include: greater fire safety awareness by dental practitioners, incidental ventilation of oxygen-enriched environments in patient oral cavities due to breathing, or suction used by dental practitioners during procedures. This review of the literature provides a background to suggest that the practice of using intraoral suction in conjunction with the use of supplemental oxygen during dental procedures may alter the conditions needed for the initiation of intraoral fires. To date, there appear to be no published studies describing the ability of intraoral suctioning devices to alter the ambient oxygen concentration in an intraoral environment. In vivo models that would allow examination of intraoral suction on the ambient oxygen concentration in a simulated intraoral environment may then provide a valuable foundation for evaluating the safety of current clinical dental surgical practices, particularly in regard to the treatment of children.

Fluoride content of infant foods.

Excessive fluoride consumption during the first 2 years of life is associated with an increased risk of dental fluorosis. Estimates of fluoride intake from various sources may aid in determining a child's risk for developing fluorosis. This study sought to assess the fluoride content of commercially available foods for infants, and to guide dentists who are advising parents of young children about fluoride intake. Three samples each of 20 different foods (including fruits and vegetables, as well as chicken, turkey, beef/ham, and vegetarian dinners) from 3 manufacturers were analyzed (in duplicate) for their fluoride content. Among the 360 samples tested, fluoride concentration ranged from 0.007-4.13 µg fluoride/g food. All foods tested had detectable amounts of fluoride. Chicken products had the highest mean levels of fluoride, followed by turkey products. Consuming >1 serving per day of the high fluoride concentration products in this study would place children over the recommended daily fluoride intake. Fluoride from infant foods should be taken into account when determining total daily fluoride intake.

Pulp therapy in pediatric patients with congenital heart disease: survey of American Academy of Pediatric Dentistry members.

PURPOSE: The purpose of this study was to identify treatment options recommended by American Academy of Pediatric Dentistry (AAPD) members concerning pulp treatment in primary teeth in pediatric patients with congenital heart disease (CHD). METHODS: A web-based survey was sent to all active members of the AAPD. The survey contained radiographs of pulpally involved primary teeth, a description of associated signs/symptoms, and a medical history of the patient who was positive for a type of CHD. Pediatric dentists were requested to report treatment recommendations. RESULTS: Of the 6,590 surveys sent, 1,493 surveys (23%) were completed. Most respondents preferred to extract the tooth with the clinical presentation of irreversible pulpitis followed by distal shoe space maintenance when the patient presented with a negative medical history. By contrast, approximately half of the respondents elected to extract this tooth without space maintenance for all of the cardiac conditions. By contrast, most respondents elected to perform a pulpotomy in the case of reversible pulpitis regardless of the medical history. Indirect or direct pulp therapy were the least chosen options for both presentations. CONCLUSIONS: The presence of CHD affects treatment decisions in teeth exhibiting irreversible pulpitis with symptomatic apical periodontitis but not in teeth displaying reversible pulpitis with a normal periodontal status.

Current trends in pulp therapy: a survey analyzing pulpotomy techniques taught in pediatric dental residency programs.

PURPOSE: The study's purpose was to survey directors of pediatric dental residency programs in order to evaluate the materials currently being taught and used for pulpotomy procedures for primary teeth in educational and clinical settings. METHODS: A web-based survey was emailed to all graduate pediatric dental residency program directors in the United States. RESULTS: Seventy one emails were sent to program directors, 47 responded but only 39 respondents (55%) were included in the study. Results suggested a slight decrease in utilization of formocresol 1:5 dilution (P<.01) and an increase in both ferric sulfate (P<.05) and mineral trioxide aggregate (MTA; P<.02) utilization for primary tooth pulpotomy procedures. The most common reasons for elimination of formocresol (18% of respondents) were systemic health concerns and carcinogenicity, in addition to evidence-based literature. Even though 25% of respondents have begun to use MTA for primary pulpotomy procedures, the most common reason for utilization of other medicaments over MTA was its higher cost. CONCLUSIONS: With 82% of graduate pediatric dental residency programs still utilizing formocresol 1:5 dilution for pulpotomy procedures in primary teeth, there has been no major shift away from its clinical use, in spite of increased usage of newer medicaments over the last 5 years.

Factors influencing behavior guidance: a survey of practicing pediatric dentists.

PURPOSE: The purpose of this study was to identify factors influencing behavior guidance technique utilization among practicing pediatric dentists and explore potential barriers to the incorporation of previously unused techniques. METHODS: The data for this study were obtained from a web-based survey containing 15 multiple choice questions concerning the practitioners' past, current, and anticipated future behavior guidance technique utilization. RESULTS: Most respondents received hands-on training in 10 of the American Academy of Pediatric Dentistry behavior guidance techniques. The type of training was associated with the practitioners' level of comfort using a given technique upon graduation and with the current frequency of technique utilization. Residency type impacted hands-on behavior guidance training, with 39 percent of respondents reporting no intravenous sedation training. The type of practice was associated with the frequency of behavior guidance technique utilization, as was graduation decade. Currently practicing dentists cited legal concerns, parental acceptance to change, and limited resources as perceived obstacles in the incorporation of new techniques. CONCLUSIONS: Behavior guidance technique selection and utilization among practicing pediatric dentists was influenced by multiple factors, including advanced education training, residency type, graduation decade, and practice type. Obstacles to the incorporation of previously unused techniques appear to be multifactorial.

Demand in pediatric dentistry for sedation and general anesthesia by dentist anesthesiologists: a survey of directors of dentist anesthesiologist and pediatric dentistry residencies.

This study describes what training programs in pediatric dentistry and dental anesthesiology are doing to meet future needs for deep sedation/general anesthesia services required for pediatric dentistry. Residency directors from 10 dental anesthesiology training programs in North America and 79 directors from pediatric dentistry training programs in North America were asked to answer an 18-item and 22-item online survey, respectively, through an online survey tool. The response rate for the 10 anesthesiology training program directors was 9 of 10 or 90%. The response rate for the 79 pediatric dentistry training program directors was 46 of 79 or 58%. Thirty-seven percent of pediatric dentistry programs use clinic-based deep sedation/general anesthesia for dental treatment in addition to hospital-based deep sedation/general anesthesia. Eighty-eight percent of those programs use dentist anesthesiologists for administration of deep sedation/general anesthesia in a clinic-based setting. Pediatric dentistry residency directors perceive a future change in the need for deep sedation/general anesthesia services provided by dentist anesthesiologists to pediatric dentists: 64% anticipate an increase in need for dentist anesthesiologist services, while 36% anticipate no change. Dental anesthesiology directors compared to 2, 5, and 10 years ago have seen an increase in the requests for dentist anesthesiologist services by pediatric dentists reported by 56% of respondents (past 2 years), 63% of respondents (past 5 years), and 88% of respondents (past 10 years), respectively. Predicting the future need of dentist anesthesiologists is an uncertain task, but these results show pediatric dentistry directors and dental anesthesiology directors are considering the need, and they recognize a trend of increased need for dentist anesthesiologist services over the past decade.

The use of office-based sedation and general anesthesia by board certified pediatric dentists practicing in the United States.

The purpose of this study is to explore the use of office-based sedation by board-certified pediatric dentists practicing in the United States. Pediatric dentists have traditionally relied upon self-administered sedation techniques to provide office-based sedation. The use of dentist anesthesiologists to provide office-based sedation is an emerging trend. This study examines and compares these two models of office-based sedations. A survey evaluating office-based sedation of diplomates of the American Board of Pediatric Dentistry (ABPD) based on gender, age, years in practice, practice types, regions, and years as a diplomate of the ABPD was completed by 494 active members. The results were summarized using frequencies and percentages. Relationships of dentist age, gender, and number of years in practice with the use of intravenous (IV) sedation was completed using two-way contingency tables and Mantel-Haenszel tests for ordered categorical data. Relationships of office-based sedation use and the type of one's practice were examined using Pearson chi-square tests. Of the 1917 surveys e-mailed, 494 completed the survey for a response rate of 26%. Over 70% of board-certified US pediatric dentists use some form of sedation in their offices. Less than 20% administer IV sedation, 20 to 40% use a dentist anesthesiologist, and 60 to 70% would use dentist anesthesiologists if one were available.