Anxiolytic and Analgesic Effects of Melatonin in Paediatric Dentistry

Aim: Fear and anxiety are the principal obstacles for dental treatment in children and can turn into dental phobia, leading to patients avoiding dental treatment. Melatonin, an endogenous indolamines produced and secreted by the pineal gland, is involved in many physiological functions such as regulation of circadian rhythm as well as possessing antioxidant, oncostatic, anti-inflammatory and anticonvulsant activity; it may be administered orally or sublingually, without any evidence of substantial side effects. After oral administration, melatonin undergoes first-pass effect, reaches the plasma peak after about 60 min and blood levels decrease in about 4 h. Study Design: This is a retrospective case-control age and sex matched study. We collected data about first visit and treatment of 50 patients admitted to the Dental Clinic and to the Private Center of the investigators. Methods: According to literature, 25 children received 0.5 mg/ kg Melatonin 60’ before being subjected to first visit and pedodontic treatment. No preventive treatment was given to 25 children. We compared the success of treatment and the pain experienced by the child assessed by FLACC behavioural pain scale. Results: Both groups included 25 patients (15 male), mean age 7.6 yrs in Group A, 7.1 yrs in Group B. Melatonin treatment was well tolerated by 100% of children. According to FLACC scale categories, 42% of all children presented relaxed and comfortable or mild discomfort (FLACC scale 0-3), 42% moderate pain (FLACC scale 4-6), and 16% severe discomfort or pain or both (FLACC scale 7-10). Statistics: Operators found greater compliance by children receiving melatonin with 96 % successful treatment versus 68% (p 0.012). We found 60% of children receiving melatonin experienced relaxed and comfortable o mild discomfort versus 40% in Group B (p 0.001). Conclusions: Although a larger population study is needed, the anxiolytic and analgesic properties of melatonin seem to offer new therapeutic opportunity in the pedodontic field.