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Original Research

Open Access

Effectiveness and Safety of Nitrous Oxide as a Sedative Agent at 60% and 70% Compared to 50% Concentration in Pediatric Dentistry Setting

  • Johny Kharouba1
  • Mostafa Somri2,*,
  • Christopher Hadjittofi3
  • Jomana Hasan4
  • Sigalit Blumer5

1Department of Pediatric Dentistry, Tel Aviv University, Tel Aviv, Israel

2,Department of Anesthesia, Bnai Zion Medical Center, Haifa, Israel

3Faculty of Medicine, Technion Institute of Technology, Haifa, Israel

4Department of General Surgery,Epsom and St. Helier University Hospitals, Wrythe Lane, Carshalton SM5 1AA, United Kingdom, United Kingdom

5Department of the Pediatric Dental Unit,Barzilai University Medical Center, Ashkelon, Israel

DOI: 10.17796/1053-4625-44.1.11 Vol.44,Issue 1,January 2020 pp.60-65

Published: 01 January 2020

*Corresponding Author(s): Mostafa Somri E-mail:


Objective: Sedation using 50% nitrous oxide (N2O) concentration is common in pediatric dentistry.The aim to assess sedation and cooperation levels following sedation with 60% and 70% N2O concentrations in children whose dental treatment failed using 50% N2O concentration.Study design: Children (n=51) aged 5–10 years were included. Sedation started with N2O concentration of 50%; when appropriate cooperation and sedation were not achieved, N2O concentration was increased to 60%, and subsequently to 70% during the same session. Sedation and cooperation levels were the primary outcomes. Adverse events were defined as secondary outcomes.Results: At 50% N2O concentration, five children reached adequate sedation and cooperation and completed their dental treatment, where 32 children completed the treatment at 60% N2O concentration. Fourteen children required a concentration of 70% to complete treatment. For ten of the latter, treatment was successfully completed, while for four, treatment failed, despite the achievement of adequate sedation. Adverse events were observed in 9%, 22%, of the children who received 60%, 70% N2O concentrations, respectively. Conclusions: When sedation with 50% N2O concentration does not achieve satisfactory cooperation to complete pediatric dental treatment, 60% N2O concentration appears to be more effective than 50% and safer than 70%.


Cooperation; Nitrous oxide; Pediatric dentistry; Sedative agent

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Johny Kharouba,Mostafa Somri,Christopher Hadjittofi,Jomana Hasan,Sigalit Blumer. Effectiveness and Safety of Nitrous Oxide as a Sedative Agent at 60% and 70% Compared to 50% Concentration in Pediatric Dentistry Setting. Journal of Clinical Pediatric Dentistry. 2020. 44(1);60-65.


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