Original Title: Inhalationssedierung mit Lachgas (N2O) in der Zahnmedizin – Organisatorische und berufsrechtliche Aspekte sowie ein systematischer Review zu Wirksamkeit und Sicherheit

Authors' objectives: Among other aspects, this report deals with questions of organisational and professional issues regarding the administration of inhalation sedation with nitrous oxide (N2O).

Authors' results and conclusions: With regard to the underlying research questions on the organisational and professional aspects, it has been shown that inhalation sedation with N2O should be used only by dental personnel, who are appropriately trained in the use of sedation and emergency procedures. When inhalation sedation with N2O is performed by qualified dental personnel, with carefully selected patients, and with appropriate equipment, it is considered to be a safe and effective procedure in primary care to support anxiety and behavioural management according to the Council of European Dentists (CED). The respective national framework conditions must be adapted to the guidelines of the CED. Regarding the clinical efficacy and safety analysis, ten studies (three randomised controlled trials and seven randomised controlled crossover trials) were identified. The strength of evidence for the endpoints of clinical efficacy and safety was rated as "low" to "very low". None of the included studies for the clinical effectiveness and safety clearly demonstrated that inhalation sedation with N2O is more effective than placebo (O2/room air) or midazolam. However, the data on adverse events suggest that inhalation sedation with N2O is safe in the administration per se and therefore a useful method in dentistry. In conclusion, inhalation sedation with N2O appears to be a useful and safe procedure in dentistry for the anxiety and behavioural management of children, adolescents, and adults with fears of dental treatment.

Authors' methods: A systematic analysis of the efficacy and safety of inhalation sedation with N2O in dentistry was performed. In order to answer the research questions, a systematic literature search, an additional literature search with Scopus (citation tracking) and targeted manual searches for relevant (professional) guidelines and guiding principles of dentistry on the websites of institutions and professional societies of selected European countries (Germany, Switzerland, Austria, Sweden and the Netherlands) were carried out.

Project Status: Completed

URL for project: https://aihta.at/page/inhalationssedierung-mit-lachgas-in-der-zahnmedizin/en

Year Published: 2018

URL for published report: http://eprints.aihta.at/1182/1/HTA-Projektbericht_Nr.105.pdf

URL for additional information: http://eprints.aihta.at/1182/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Austria

Organisation Name: Ludwig Boltzmann Institute for Health Technology Assessment

Contact Address: Ludwig Boltzmann Institute for fuer Health Technology Assessment (LBI-HTA), Garnisongasse 7/rechte Stiege Mezzanin (Top 20), 1090 Vienna, Austria. Tel: +43 1 236 8119 - 0 Fax: +43 1 236 8119 - 99

Contact Name: tarquin.mittermayr@aihta.at

Contact Email: office@aihta.at