Background: The use of antihistamines for sedation in dental practice has gained attention as an alternative to traditional sedatives like benzodiazepines. This study aims to explore the prevalence, reasons for use, dosage adjustments, and dentists' perceptions regarding antihistamines in dental sedation.

Methods: A cross-sectional survey was conducted among 150 dentists. Participants were asked about their usage of antihistamines for sedation, the most commonly used medications, reasons for their use, and any adjustments made to dosages based on patient factors. Additionally, the study explored their opinions on whether antihistamines could replace benzodiazepines in certain cases.

Results: Of the respondents, 46.7% reported using antihistamines, with Diphenhydramine (71.4%) being the most common, followed by Hydroxyzine (50.0%) and Promethazine (40.0%). The primary reasons for use were preoperative anxiety control (78.6%), salivation reduction (54.3%), and adjunct sedation (42.9%). Regarding dosage adjustments, 44.7% of dentists modified doses based on patient factors. A significant difference in dosage adjustments was observed between private and hospital-based dentists (p = 0.03). When asked about replacing benzodiazepines, 40.0% agreed, 26.7% were unsure, and 33.3% disagreed.

Conclusions: Antihistamines, particularly Diphenhydramine, are commonly used in dental sedation for anxiety control and salivation reduction. However, there is variability in clinical practices, with some dentists modifying dosages based on patient factors. The possibility of replacing benzodiazepines with antihistamines remains a topic of debate among practitioners. Further research is needed to establish clearer guidelines on the safety and efficacy of antihistamines as sedatives in dental practice.