Use of nitrous oxide in children with special health care needs
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Use of nitrous oxide in children with special health care needs Priyanshi Ritwik1 · Kunal Gupta2 Received: 26 May 2020 / Accepted: 9 September 2020 © Springer Nature Switzerland AG 2020
Abstract Providing optimal oral health care for children and individuals with special health care needs (SHCN) is an integral professional and ethical responsibility of dentists. Children with special health care needs may have behavioral factors, medical complexities, and/or intellectual disabilities which influence their ability to cooperate for dental treatment. They may have elevated dental fear and anxiety which may not be alleviated with basic behavior guidance strategies alone. The option to offer inhalational nitrous oxide provides an adjunctive method to help reduce a child’s pain and anxiety during dental treatment. Inhalational nitrous oxide can be simply administered via a well-fitting nasal hood. Based on the underlying medical condition of the child, it may be necessary to monitor oxygen saturation with pulse oximetry. Administration of 100% oxygen preoperatively and upon completion of treatment is an essential step applicable to all the patients. Children recover quickly from the effects of nitrous oxide after post-treatment oxygenation and can be discharged to the parent without any residual effects. With appropriate case selection and administration technique, inhalational nitrous oxide is a safe and effective technique to provide dental treatment for children with special health care needs. Keywords Children with special health care needs · Anxiolysis · Nitrous oxide · Sedation
Quick reference/description Delivery of optimal dental treatment for children with special health care needs may be significantly challenging for dentists. Inhalational nitrous oxide is a vital adjunct for dentists to provide safe and effective care for this vulnerable patient population. * Priyanshi Ritwik [email protected] 1
Department of Pediatric Dentistry, University of Texas Health Science Center at Houston School of Dentistry, 7500 Cambridge St, Suite 5301, Houston, TX 77054, USA
2
Children’s Dental Center, Gurugram, India
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Clinical Dentistry Reviewed
(2020) 4:23
Anxiolysis, analgesia, and a wide margin of safety and ease of delivery are some of the key attributes of nitrous oxide which support its utilization. Successful utilization of nitrous oxide sedation can avoid the use of general anesthesia for these children and hence avoid the associated risks.
Overview
Medical conditions in children requiring special health care
Indications for the use of nitrous oxide
Contraindications for the use of nitrous oxide
Asthma
Children with moderate or severe Children with well-controlled persistent asthma with frequent intermittent and mild persistent active episodes asthma without a recent or active episode
Attention Deficit Hyperactivity Disorder (ADHD)
Children with ADHD for tolerat- No absolute contraindications ing lengthy appointments with fewer incidences of disr
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