Best Practice Guidelines for Nitrous Oxide/Oxygen Use in Pediatric Dentistry

Abstract

This best practice guideline is designed to equip dental professionals with detailed recommendations for the safe and effective use of nitrous oxide/oxygen (N2O/O2) analgesia and anxiolysis in children. Key recommendations address the goals, general considerations, indications, and contraindications associated with this inhalation sedation technique. Before administering N2O/O2, dental professionals must assess various factors, including the child’s physical and emotional development, medical and dental histories, and the specific procedures planned, as well as any alternative behavior management techniques available.the qualifications and training of the dental team; the adequacy of equipment and facilities; administration methods and monitoring protocols; potential adverse effects; and occupational safety concerns. Additionally, proper documentation of N2O/O2 usage is emphasized. When used judiciously, N2O/O2 can be an effective tool for managing anxiety related to dental care in children, adolescents, and individuals with special health care needs. This document has been developed collaboratively by the American Academy of Pediatric Dentistry Councils on Clinical Affairs and Scientific Affairs, aiming to provide updated information and recommendations to ensure the development of safe practices in pediatric dental sedation.