68 - Impact of Body Mass Index on Pediatric Dentistry Sedation Outcomes

Abstract: Title: Impact of Body Mass Index on Pediatric Dentistry Sedation Outcomes
Authors: Abigail L. Roederer, DMD | LaQuia A. Vinson, DDS, MPH, FAAPD | Allison Scully, DDS, MS, FAAPD | Brian J. Sanders, DDS, MS | Aline Castilho, DDS, MSc, PhD | George Eckert, MAS

Introduction: Mild to moderate sedation with oral medication is a routine treatment modality in pediatric dentistry and is essential for managing patients with limited cooperation. Medical history and health status are carefully evaluated to determine a patient's candidacy for sedation. Anatomic variations in tonsils and airway can be limiting factors in determining patient selection. Lack of universally accepted dosing standards and clear contraindications based on a patient's body mass index (BMI) present significant challenges. Understanding how BMI influences sedation outcomes is essential to optimize treatment efficacy and ensure patient safety. Little is known about how one's physical stature and resulting BMI impacts the outcome of a sedation.

Purpose:   The purpose of this study is to evaluate if body mass index impacts the outcome of a procedural oral sedation in pediatric dentistry by performing a retrospective chart review.

Methods: Data was obtained from an urban pediatric dentistry clinic located in Indianapolis, IN from January 1, 2014 to December 31, 2024.  A convenience sample included children who were ages one-year-old to eighteen-years-old with an ASA I, ASA II, or ASA III physical status that underwent a mild to moderate procedural sedation using oral Midazolam with or without nitrous oxide / oxygen analgesia. BMI was calculated from collected data.

Results: A total of 903 charts were reviewed with 339 subjects meeting inclusion criteria (170 females and 196 males). According to the CDC standards, 29 patients were considered to be underweight (7.9%), 212 were considered to be of normal weight (57.9%), 61 were considered to be overweight (16.7%), and 64 were considered to be obese (17.5%). The results of the stepwise ordinal logistic regression showed no evidence of BMI being associated with the sedation outcome, either alone or in conjunction with behavior prior to sedation and patient age. The only statistically significant predictor of sedation outcome was behavior prior to sedation (p-value = 0.0307).

Conclusion: The results obtained in this study further verify that preoperative behavior is one of the strongest predictors of sedation success.

Identify Supporting Agency and Grant Number: Research supported by Indiana University School of Dentistry.