The two most common benzodiazepine used in dentistry are midazolam (Versed) and diazepam (Valium). Midazolam is used most commonly in pediatric dentistry as a sedative/anxiolytic agent. It provides anxiolysis, sedation, hypnosis, skeletal muscle relaxation, anterograde amnesia, respiratory depression and an anticonvulsant effect but has no analgesic properties. It has a wide margin of safety between the therapeutic and toxic doses and has a rapid onset of action. Its administration is usually combined with nitrous oxide/oxygen to enhance the above effects and provide analgesia. It is usually given orally, as syrup, at a dosage of 0.25 mg/kg-1.0mg mg/kg, depending on age and anxiety level of the patient, with an onset of sedation in 20-30 minutes. The intranasal dosage is 0.25mg/kg with an onset of sedation in 10 to 15 minutes. The time available for treatment will vary from 20 minutes to 40 minutes.
The signs and symptoms of benzodiazepine overdose are:
The treatment for benzodiazepine overdose is: