To describe triazolam in pediatric dental mild to moderate sedation and report changes to overall visit behavior for permanent first molar extraction. This retrospective chart review from 2018 to 2022 analyzed demographic, procedural, and behavioral data for children eight years and older receiving triazolam for a permanent first molar extraction. The outcomes included adverse events measured by deviations in heart rate and oxygen saturation and changes to overall visit-level Frankl scores from the referral to sedation visit. Descriptive statistics and non-parametric statistical analyses were conducted. The study population (n equals 82) was predominantly female (61 percent), English-speaking (85 percent), and White (41 percent) or Black (39 percent). The most common indication for mild to moderate sedation was dental anxiety (28 percent). There were zero instances of adverse events requiring emergency intervention or the use of reversal medication. The change in visit-level Frankl scores was significantly positive (P<0.001). Triazolam is likely a safe choice for mild to moderate sedation, leading to improved overall visit behavior in children undergoing a permanent first molar extraction.