Comparative Evaluation of Two Different Induction Techniques of Nitrous Oxide Sedation – A Randomized Clinical Trial

Nitrous oxide (N2O) is a recognized method in pediatric dentistry for reducing anxiety and enhancing communication. It can be administered rapidly in uncooperative children or slowly with gradual concentration increases. Anxiety triggers the release of cortisol through the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system. The American Academy of Pediatric Dentistry (AAPD) acknowledges N2O’s efficacy in reducing anxiety levels and facilitating effective patient-doctor communication. This method offers a safe and effective approach to managing anxiety in pediatric patients, allowing for improved cooperation during dental procedures.The aim of this study is to compare and evaluate the variations in physiological, psychomotor parameters and analgesic effects in 4–8-year-old children undergoing pulpal therapy under nitrous oxide sedation using two different induction techniques. The patient will be made to sit on the dental chair and will be examined under a strict sterilization protocol. The patient’s behavior will be assessed according to the Frankl’s behavior rating scale following which the pre-op saliva would be collected – approx. 1ml and physiological, psychomotor parameters and analgesic effects will be recorded . Then the nitrous oxide sedation would be initiated as per the nitrous oxide induction protocol and the induction technique will be based on the randomized block design. Administration of the local anesthetic agent and the pulp therapy procedure will be carried out. After induction, the salivary sample will be recollected and all the other parameters will be re recorded.The samples will be sent for salivary biomarker level analysis to the microbiology lab .