Nitrous oxide (aka laughing gas) increases the success rates of pediatric dental procedures, a Thai study published in the current issue of Anesthesia Progress has found.
Anaesthesia is an ongoing challenge in dentistry, especially when working to correct severe disease of the tooth pulp in adult teeth.
The difficulty tends to be compounded when dentists work with pediatric patients who have irreversible pulpitis from dental caries of their permanent teeth. Young, permanent teeth in children have a larger pulp, which increases the blood and nerve supply in young teeth, thereby also increasing sensitivity.
To try and determine the correct method of anaesthesia to assist dentists in fixing these young diseased teeth, a team from Chiang Mai University compared the success rates of pulpal anaesthesia in children pre-medicated with ibuprofen when local anaesthesia was combined with inhalation of nitrous oxide with oxygen or with inhalation of oxygen alone.
The researchers performed a single-blind study in which 33 children with pulpitis of a permanent molar were included. The children were evaluated preoperatively for fear and anxiety in case this affected their intraoperative pain perception, and again during the procedure.
Each child was given ibuprofen with a meal about one hour before the procedure. Seventeen children were then randomly assigned to the nitrous oxide group and 16 to the oxygen group. Once the gas was administered, the children were given nerve blocks to numb the area, and once numb, the procedure commenced.
Overall, the results showed a success rate of 71 per cent in the nitrous oxide group; this was 52 per cent higher than the success rate of the oxygen group.
Compared with previous local anaesthesia studies using nitrous oxide but without preoperative ibuprofen, these results showed an increased success rate in the combination of ibuprofen before the procedure and nitrous oxide during the procedure.
Given these results, the researchers concluded that local anaesthesia with nitrous oxide inhalation sedation combined with preoperative ibuprofen could have an increased success rate of pulpal anaesthesia in cases of severe pulpitis in pediatric patients.