Nitrous oxide/oxygen inhalation sedation is widely used in paediatric dentistry to reduce anxiety, enhance patient cooperation, and improve comfort during dental procedures. When administered appropriately, it provides anxiolytic and mild analgesic effects while maintaining protective reflexes and communication with the patient.
This technique allows clinicians to safely perform restorative and minor surgical procedures in children who may otherwise experience difficulty cooperating with treatment.
Core principles include:
When used appropriately, nitrous oxide inhalation sedation is considered a safe and effective behaviour guidance technique in paediatric dentistry.
Dentists must comply with national regulations governing sedation, including patient assessment, training, equipment requirements, monitoring, and emergency preparedness.
(Consensus-based statement; Global agreement: 98%)
Nitrous oxide sedation may be indicated for anxious or fearful children requiring restorative or minor surgical procedures.
(Consensus-based statement; Global agreement: 96%)
Nitrous oxide may be contraindicated in patients with respiratory infections, sinusitis, COPD, or other conditions impairing nasal breathing.
(Consensus-based statement; Global agreement: 95%)
Appropriate delivery systems with safety mechanisms, scavenging systems, and adequate ventilation must be used.
(Consensus-based statement; Global agreement: 96%)
Dental personnel administering nitrous oxide must receive appropriate training and be able to manage potential complications.
(Consensus-based statement; Global agreement: 100%)
Continuous monitoring of patient responsiveness, respiratory rate, pulse rate, and oxygen saturation is recommended.
(Consensus-based statement; Global agreement: 95%)
Administration of 100% oxygen for at least five minutes following sedation is recommended to reduce the risk of diffusion hypoxia.
(Consensus-based statement; Global agreement: 98%)
To support clinical implementation and knowledge translation, IAPD has developed complementary educational materials.
The IAPD podcast series explores evidence-based approaches to paediatric dental care and clinical decision-making.
Selected IAPD webinars address pain management strategies and clinical decision-making in paediatric dentistry.
International Association of Paediatric Dentistry (IAPD).
IAPD Foundational Articles and Recommendations on Behaviour Guidance in Paediatric Dental Patients.
Originally published 2019. Global Agreement Validation 2022.
