Self‐ratings by phobic patients during dental treatment: Greater improvement with nitrous oxide than midazolam

Abstract

AbstractThe efficacy of intravenous midazolam and nitrous oxide inhalation at reducing self‐rated mood and bodily symptoms was compared in patients referred to a dental sedation unit because their dental fears precluded treatment undrugged. Fifty‐eight per cent of our patients could be randomly allocated to drug treatment, the others were assigned on clinical grounds. When they arrived for their first treatment, the clinically allocated patients (n = 40) were significantly more anxious, tense and restless than those randomly allocated (n = 61). Both drugs reduced ratings of anxious, tense, discontented and restlessness, but the improvements were greater with nitrous oxide. Nitrous oxide reduced ratings of irritable and depressed, but patients treated with midazolam only showed reductions when dental treatment was finished. The scores for 70 patients were analysed over two treatment days; their pre‐sedation scores of tense, depressed and discontented were lower on day 2 than on day 1, with the randomly allocated group showing greater reduction. Nitrous oxide remained superior on day 2. Thirty‐eight patients completed 3 days of treatment; there were no further reductions in baseline ratings and the superiority of nitrous oxide was maintained.