Effect of Continuous versus Interrupted Administration of Nitrous Oxide-Oxygen Inhalation on Behavior of Anxious Pediatric Dental Patients: A Pilot Study

Abstract

The purpose of this study was to determine the effect of interrupted administration of nitrous oxide (N2O) inhalation, after obtaining profound local anesthesia, on the behavior of mild to moderately anxious pediatric patients during routine restorative dentistry. Healthy children, 5 to 8 years old, requiring nitrous oxide/oxygen inhalation sedation and bilateral mandibular restorative treatment performed in two sequential appointments under local anesthesia were recruited for this study. After profoundness of the local anesthesia was confirmed, the subject was randomly assigned to either Protocol A (50% N2O/50% O2) or Protocol B (100% O2) and restorative dental care was completed. On the second appointment, the subject was assigned to the alternate protocol. Hemoglobin oxygen saturation remained constant with no episodes of oxygen desaturation recorded. There were no statistically significant differences (P > .05) in pulse rate or behavior change noted between the two protocols. The implication of this pilot study was significant in consideration of the desire to minimize chronic exposure to ambient nitrous oxide and its potential health hazards to the dental team. These findings challenge the traditional practice of N2O maintenance throughout the dental appointment.