Effectiveness and Safety of Nitrous Oxide as a Sedative Agent at 60% and 70% Compared to 50% Concentration in Pediatric Dentistry Setting

Behavioral Modifications in Children after Repeated Sedation with Nitrous Oxide for Dental Treatment: A Retrospective Study

Sedation with nitrous oxide (N₂O) has been widely used as a viable alternative to general anesthesia to perform dental treatments in uncooperative or anxious children. The purpose of this retrospective study is to assess if repeated sedations with N₂O can improve collaboration of uncooperative children. The medical records of 650 children, aged between 3 and 14 years, who underwent at least two sedations, were consulted. Differences in the Venham score during the first sedation and subsequent sedations were collected. After removal incomplete records, 577 children's records (309 males and 268 females) were analyzed. The Venham score decreased both during each sedation and with repeated sedations (p < 0.01 for both comparisons). In particular, a significant reduction of the Venham score was observed at the first contact with the dentist, with a mean score ranging from 1.56 ± 1.46 to 1.16 ± 1.37, comparing the first and the second sedation, and from 1.65 ± 1.43 to 1.06 ± 1.30, comparing the first with the third sedation (p < 0.01). The reduction in the Venham score was recorded in both healthy and physically impaired patients, and it was significantly greater in older children than in younger children (p < 0.01). In conclusion, uncooperative children with or without physical impairments can be successfully treated with N₂O sedation in order to increase their confidence in dental procedures.

Nitrous Oxide Inhalation Sedation Rapid Analgesia in Dentistry: An Overview of Technique, Objectives, Indications, Advantages, Monitoring, and Safety Profile

Nitrous oxide inhalation sedation (NOIS) has been the backbone of anxiety alleviation in dentistry for a long time. Advantages of nitrous oxide (N2O) include anxiolysis, mild analgesia, and amnesia. It also has the ability to raise the patient pain threshold, providing rapid analgesia (RA), thus enhancing the action of any local anesthesia used. This paper describes the technique of NOIS in detail and highlights its objectives, advantages, indications, monitoring, and safety profile. Other than the specialty of pediatric dentistry, this paper also highlights the applications and merits of NOIS in adult, geriatric, and special healthcare needs dentistry. Away from dentistry, it also brings to light the multidisciplinary applications of NOIS in other medical streams. This review could be a valuable interpretation on the present position of N2O sedation in dentistry and a valuable starting point for future perspectives.

How to cite this article

Khinda V, Rao D, Singh Sodhi SP. Nitrous Oxide Inhalation Sedation Rapid Analgesia in Dentistry: An Overview of Technique, Objectives, Indications, Advantages, Monitoring, and Safety Profile. Int J Clin Pediatr Dent 2023;16(1):131-138.