497 - Prospective Assessment of a Behavior Score during Pediatric Dental Sedation

Purpose: This prospective observational study used a modified version of the Pediatric Sedation Behavior Score previously reported to the AAPD in 2021. Several categories were updated, and a structured answer matrix to improve inter-rater reliability was added. While the Richmond Agitation-Sedation Score evaluates depth of sedation and patient movement, our rubric provides a structured assessment plan, incorporating degree of procedural completion, patient crying/movement, use of restraint(s), variations in sedative use, and oversedation criteria.

Methods: This research was approved by University at Buffalo Institutional Review Board. A total of 500 patients between the ages of 3 and 17 will be recruited. Pediatric Sedation Behavior Scoring was assessed by the sedation resident/nurse and the operating dentist, with raters blinded to one another’s assessment. Data was gathered for all types of sedation over a wide scope of dental procedures. Demographics, procedural details and scores were collected, and comparative data analysis will be used.

Results: Data collection has occurred for 34 patients to date;17 deep sedation oral surgery patients, 11 deep sedation pediatric dental procedure patients, and 6 patients were seen for oral conscious sedation patients. Behavior scores ranged between 9 - 10. Assessor 1 and Assessor 2 Behavior Scores ranged between 6 - 10 and 7 - 10, respectively. 

Conclusion: Interrelater reliability will be reassessed after an additional 100 patients are evaluated. We expect to improve upon the Spearman Rank R of 0.81 and Weighted Cohen Kappa of 0.74 originally achieved.