Effectiveness of Children Experiencing Nitrous Oxide/Oxygen Inhalation Sedation at an Assessment Visit Before Having Treatment.
Condition: Dental Anxiety
MeSH terms: Respiratory Aspiration
Study type: Interventional

Summary: 
      The purpose of this study is to find out the effect of experience of dental sedation at
      assessment on children's anxiety before the actual treatment session.
    

Detailed description: 
      Title: Effectiveness of children experiencing nitrous oxide/oxygen inhalation sedation at an
      assessment visit before having treatment.

      Background: Dental anxiety is a common problem, affecting people of all ages, but
      predominantly children and adolescents. Inhalation sedation (IHS) using nitrous oxide/oxygen
      (N2O/O2) mixture is a pharmacological behaviour management technique that is widely used to
      manage dental anxiety in children. It is suggested that the use of an acclimatisation would
      increase the acceptability and the efficacy of N2O/O2 success. Even though the introductory
      appointment has been widely proposed, there have not been any studies conducted to measure
      the effectiveness of this appointment in improving the success of N2O/O2 sedation in
      children.

      Aims: This study aimed to investigate the effect of experience of nitrous oxide/oxygen
      sedation at assessment prior to dental inhalation sedation on children's anxiety.

      Methods: The study was a parallel randomised non blinded control clinical trial. Children
      aged five to fifteen years who were seen at the Leeds Dental Institute for dental treatment
      under inhalation sedation were recruited on the assessment appointment (1st visit). Both two
      groups received an assessment appointment, however participants of the study group tried on
      the mask and the nitrous oxide/oxygen sedation while the ones of the control group tried on
      the mask without the nitrous oxide/oxygen sedation. Following the assessment appointment,
      both groups received a second appointment for treatment. Dental anxiety was measured through
      two different methods. Primarily through the MCDASf questionnaire, which was completed once
      at the beginning of the assessment visit and twice at the beginning and end of the treatment
      visit. Secondarily anxiety was measured though the E4 wristband which participants of both
      groups wore throughout both appointments and recorded their Heart Rate (HR) and Skin
      Temperature (ST). At the end of the treatment visit, participants and their parents/legal
      guardians were asked to complete a feedback questionnaire related to the E4 wristband and the
      experience of N2O/O2 sedation at the assessment visit.

      - 6 -
    

Intervention name(s): Experience of nitrous oxide sedation at assessment
Intervention type(s): Behavioral
Intervention description(s): Apart from the Lead researcher, a dental nurse assisted with the dental treatment on every appointment. A specially trained sedation nurse was responsible for the monitoring during sedation. The Porter Brown inhalation sedation machine (RA Services, Keighly, W. Yorkshire, UK) was used. Once the appropriate nasal hood was selected, 100% O2 was introduced for 1-2 minutes. Following that, the level of N2O was increased in 10% increments until signs of sedation were observed. The endpoint was between 30-40% nitrous oxide.
Intervention MeSH terms: Nitrous Oxide
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment