3. Discussion
anxiety
Effective behavior management is crucial to pediatric dentistry while providing optimal treatment for anxious children. When nonpharmacological behavior management strategies are unsuccessful in alleviating anxiety, pharmacological approaches are often considered viable alternatives [Various temperament models are available, and the primary models utilized are the Behavior Style Questionnaire (BSQ) and the Emotionality-Activity-Sociability (EAS) scales [The EAS tool divides temperament traits into 4 types: emotionality, activity, sociability, and shyness. Quinonez et al. conducted a study using the EAS Temperament Survey for Children to explore the potential association between temperament and trait anxiety [Children with a difficult and slow-to-warm up temperament initially accepted the nasal mask better than the intranasal MAD. Previously, few studies have focused on evaluating the acceptability of the nasal hood and intranasal drug administration methods in children undergoing dental treatment. Srinivasan et al. observed that children displayed greater acceptance and reduced anxiety when using the nasal hood, which was attributed to its noninvasive and comfortable nature [Based on the current study's findings, children's behavior showed improvement following the administration of intranasal midazolam sedation compared to nitrous oxide during the treatment. However, this difference was not found to be statistically significant. These findings are consistent with the results reported by Panchal et al. [A limitation of the study was the need for more behavioral variability. This may be attributed to the selection of mostly cooperative children for sedation or the automatic scheduling of children perceived as uncooperative during their initial examination for restorative treatment under general anesthesia. The parents classified the temperament of the child. However, it should be understood that parents may not recognise their child correctly or may refrain from defining him/her as difficult, potentially leading to misleading results. In addition, our study exclusively examined the administration of midazolam through the intranasal route, which is known to have a bitter taste that may have influenced the acceptance of this particular method. To address this limitation, further research is warranted to explore the use of other nonbitter sedative agents delivered via the intranasal route.