Conscious Inhalation Sedation with Nitrous Oxide and Oxygen in Children: A Retrospective Study

Abstract

Dental anxiety is a common problem in younger children, especially those who have had traumatic or perceived traumatic dental treatments. Nitrous oxide (N2O) and oxygen (O2) have been recommended by the American Academy of Pediatric Dentistry as the optimal approach for uncooperative or anxious patients. The study aimed to evaluate the cooperation of children treated on deciduous teeth without local anesthesia and with rubber dam. A retrospective study was conducted from January 2019 to December 2020 in a private dental practice on children aged 4–10 years who had previously reported cases of dental anxiety during dental procedures or refused to undergo them. After an initial cognitive examination, the children underwent conservative treatment lasting a maximum of 30 min. Initially, 100% O2 was administered, then N2O dose was gradually increased to 35%. At the end of the treatment, 100% pure O2 was administered for 5 min. Children’s cooperation was assessed by Venham score before treatment (T0), at the end of induction (T1), and during the treatment (T2). A total of 371 children (age: 6.3 ± 1.7 years) were included in the study. Cooperation increased significantly from baseline at T1 (p < 0.001) and T2 (p < 0.001). Younger children (4–6 years) showed lower levels of cooperation at baseline (p < 0.001) but achieved optimal levels of cooperation at T1 (p = 0.022). Only 2.7% of children reported side effects. N2O/O2 proved to be an effective and safe method in achieving a good level of cooperation in younger children.