The Effectiveness of Nitrous Oxide Sedation Combined with Behavior Management in a Private Dental Practice in Saudi Arabia

Volume 4 - Issue 3

Najwa Mansour Joharji*

Received: July 01, 2020;   Published: July 14, 2020

DOI: 10.32474/IPDOAJ.2020.04.000186

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Abstract

Purpose: To show the different dental treatment responses and outcomes of different pediatric age groups under nitrous oxide (N₂O), based on the experiences of a private practice, to show that N₂O inhalation is an effective tool for all young patients if used in conjunction with behavior management techniques, and to show that N₂O is an outstanding tool for decreasing the dentist risk and stress when using pre-medication or general anesthesia.

Methods: A total of 826 middle- and upper-class children 394 males and 432 females, ranging in age from < 2 to 13 years old, participated in this study using the rapid induction method. All patients were treated over a total of 1,924 appointments (average, 2-3 visits per patient). The PDCC (Pediatric Dental Consulting Center) created criteria for each child’s evaluation at the first visit prior to categorization, according to which behavioral rating scale he or she belonged. Moreover, these categorizations were based on McDonald and Frankel’s Behavior Rating Scale with Wright’s Modification, in conjunction with the PDCC criteria. During the first visit, we enhanced the parents-child-dentist relationship. The child was familiarized with the dental environment by a skillful dental team, while the parents were educated about several behavior management techniques and the use of N₂O sedation.

Results: N₂O worked effectively when combined with basic behavior management techniques. The child’s first visit to the dental clinic should only include familiarization, acclimatization and enhancement of the parent-child-dentist relationship, as well as education. It was observed that, patients 4-6 years old responded best including children with bad experience and different personalities.

Conclusion: Behavior management and N₂O constitute an excellent combination. If both applied and used properly, pediatric patients can be treated successfully. The pediatric dentist should master his or her communication skills with children and parents. Based on this study, children with moderate to severe anxiety can be managed with proper application of behavior management and with the use of N₂O sedation (with a high success rate of 91%).

Keywords: Nitrous oxide; behavior management; N₂O sedation

Abbreviations: BBG: Basic Behavior Guidance; BG: Behavior Guidance; CNS: Central Nervous System; DFA: Dental Fear and Anxiety; DBP: Dental Behavioral Problem; CDA: Child Dental Anxiety

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