Purpose: A 25-year follow-up survey was conducted among members of the American Academy of Pediatric Dentistry (AAPD) to explore changes in the use of sedative agents. Methods: The survey was conducted in the winter of 2010 via an email LISTSERV of active mem- bers of the AAPD in the United States. The survey targeted demographics of participants and issues related to their use of sedation. Results: A total of 1,642 responded, representing a response rate of 44 percent. The majority was board certified (58 percent) and indicated that nitrous oxide was used for over 50 percent of patients. Restraint (protective stabilization) was used by 72 percent of respondents but had declined compared to previous surveys. The dominant route of sedative administration was oral (93 percent). Benzodiazepines and nitrous oxide repre- sented the most frequently used sedatives. Conclusions: Respondents and their patient pool characteristics are changing (e.g., there are pro- portionately more diplomates), benzodiazepines are the most frequently used sedative besides nitrous oxide (the use of which appears to be increasing), and protective stabilization among users is declining.