The challenges of sedating a child for dental procedures are multifactorial as described in a previous edition of this textbook (Wilson et al., Sedation of pediatric patients for dental procedures: the USA, European, and South American experience, in: Pediatric sedation outside of the operating room: a multispecialty international collaboration, Springer, 2021, p. 497–531) and appear in the midst of change. It is possibly that dental practitioners and educators are witnessing a significant shift in philosophy of treating children for dental caries including pharmacologic management. Driving factors for such change may include, among others, cultural flows across and within countries, parental evolution of child-rearing philosophy driven by social media embracement, litigation outcomes, and the recent global pandemic (i.e., coronovirus) affecting health delivery systems (Aziz, SAAD Dig 8:38, 2022; Dziedzic et al. Healthcare 8:419, 2020; Favaretto et al. Int J Environ Res Public Health 17(7):2495, 2020; Fux-Noy et al., Front Public Health 9:637351, 2021; Gao et al., J Med Internet Res 15(2):e2290, 2013; Genish et al., J Calif Dent Assoc 49(10):615–629, 2021; Gupta et al., Int J Paediatr Dent 31(3):433–435, 2021). The latter factor has had a major effect on access to care for dental procedures especially in hospital settings. Since the last edition of this book, there have been few notable and dominant changes in the use of new sedative agents for restorative care in children in private dental practice. There are recent studies on newer sedative agents in the dental literature. These agents and regimens will be reviewed later in this chapter. Nonetheless, there are some trends in the use of classes of sedatives that have been used for years in dental practice worthy of discussion. For example, minimal evidence taken collectively suggests training programs in pediatric dentistry, and private practices are targeting lighter depths of sedation using primarily benzodiazepines. Since dental caries do not appear to be decreasing in some socioeconomic groups of pediatric patients, some potential consequences of this trend of minimal sedation levels are less efficient completion rates of restorative treatment plans, an increased rate of sedation relative to non-sedative appointments, or alternatively, a reduction in sedation practices leading to increased likelihood of more general anesthesia cases. Only time will tell.