EFFICACY, SAFETY, AND CLINICAL IMPLICATIONS OF NITROUS OXIDE IN PEDIATRIC DENTAL CARE

Abstract

Anxiety and cooperation difficulties can limit pediatric dental care. This study analyzed evidence on the effectiveness, safety, and clinical implications of nitrous oxide and oxygen (N₂O/O₂), distinguishing anxiety, behavior, and treatment completion. A narrative review used a structured PubMed search on October 22, 2026, and complementary searches for reviews and supporting sources. The synthesis comprised 14 publications: eight primary studies and six reviews. Reduced anxiety and improved cooperation were identified in selected settings, with variation in measurement instruments and success definitions. Three clinical series reported completion of 86.3% to 92.7% of sessions in different populations; these percentages indicate neither absence of anxiety nor a pooled effectiveness estimate. Nausea, vomiting, and oversedation were reported, with differences in frequency, denominators, and follow-up. Reporting inconsistencies in some publications restricted the interpretation of numerical findings. N₂O/O₂ may support dental care for selected children when combined with behavior guidance, individual assessment, and appropriate safety measures. Differences in populations, protocols, and outcome measures require individual interpretation of the benefits and risks of the technique.