Effectiveness of Nitrous Oxide Sedation on Child’s Anxiety and Parent Perception During Inferior Alveolar Nerve Block: A Randomized Controlled Trial

Abstract

Introduction Dental anxiety is a common phenomenon among children and can have significant implications for their overall oral health and well-being. Among the various dental procedures that induce anxiety in pediatric patients, the Inferior Alveolar Nerve Block (IANB) stands out as one of the most feared due to its perceived pain and discomfort. Dental anxiety not only affects the child's cooperation during the procedure but can also lead to long-lasting negative perceptions of dental care, resulting in the avoidance of necessary treatments in the future. Nitrous oxide (N 2 O) sedation is a well-established sedation technique in dentistry, widely used to manage anxiety and discomfort during dental procedures. However, its efficacy in reducing anxiety during the administration of IANB to pediatric patients remains the subject of ongoing research. The administration of N 2 O sedation during IANB may not only alleviate the child's anxiety but also influence the parent's perception of the procedure, which can have additional effects on the child's dental experience and future adherence to dental care. The aim of this study was to evaluate the effectiveness of N 2 O sedation on pain and anxiety in children before and after IANB administration and the parent's perceptions of sedation following the procedure. Methods The current study was a single-centered, double-blinded, randomized controlled trial. The participants were assigned randomly to two groups, with each group consisting of 20 participants. Group 1 (n = 20) was given only oxygen, and Group 2 (n = 20) was given N 2 O for sedation. Pain perception for local anesthesia was evaluated using the Face, Legs, Activity, Cry, Consolability scale. The anxiety of children was evaluated using the Facial Image scale. Parent satisfaction was analyzed using the Likert scale. Data were extracted before and after the procedure using the Mann-Whitney U test. Results Pain perception evaluated with the FLACC scale showed statistically low pain perception in Group 2 after the procedure with a p-value of 0.001, and anxiety levels assessed with FIS showed a significant difference in Group 2 after the procedure with a p-value of 0.003. Parent satisfaction was analyzed using the Likert scale, and Group 2 showed a statistically significant difference with a p-value of 0.001 after the procedure. Conclusion The administration of the N 2 O sedation results in a notable reduction in anxiety levels and pain perception, as well as better parental satisfaction. This method allows for a practically pain-free and anxiety-free environment.