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

: Sedation using 50% nitrous oxide (NO) concentration is common in pediatric dentistry. The aim to assess sedation and cooperation levels following sedation with 60% and 70% NO concentrations in children whose dental treatment failed using 50% NO concentration. : Children (n=51) aged 5-10 years were included. Sedation started with NO concentration of 50%; when appropriate cooperation and sedation were not achieved, NO 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. At 50% NO concentration, five children reached adequate sedation and cooperation and completed their dental treatment, where 32 children completed the treatment at 60% NO 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% NO concentrations, respectively. When sedation with 50% NO concentration does not achieve satisfactory cooperation to complete pediatric dental treatment, 60% NO concentration appears to be more effective than 50% and safer than 70%.