Dentists have expertise in providing anxiety and pain control for their patients. While anxiety and pain can be modified by psychological techniques, in many instances pharmacological approaches are required. The outcome of pharmacological approaches is variable and depends upon each patient's response to various drugs. The clinical effect of nitrous oxide/oxygen inhalation, however, is more predictable among the majority of the population. When used for analgesia/anxiolysis, nitrous oxide/oxygen inhalation allows for diminution or elimination of pain and anxiety in a conscious patient, while entailing minimum risk.
The practitioner who utilizes nitrous oxide/oxygen analgesia/ anxiolysis for a pediatric dental patient shall possess appropriate training and skills and have available the proper facilities, personnel, and equipment to manage any reasonably foreseeable emergency. The practitioner is responsible for managing the potential complications associated with the intended level of sedation and the next deeper level. Therefore, because moderate sedation may occur, practitioners should have the appropriate training and emergency equipment to manage this. Training and certification in basic life support are required for all clinical personnel. These individuals should participate in periodic reviews of the office's emergency protocol, the emergency drug cart, and simulated exercises to assure proper emergency management response.