Position Summary
Nitrous Oxide sedation is a commonly used and safe technique administered by dentists for treating anxious patients utilising nitrous oxide and oxygen for the relief of dental patients’ anxiety and pain. Dentists should remain the only dental practitioner who can independently administer nitrous oxide sedation. Other dental practitioners (who have undergone suitable training) may provide treatment utilising nitrous oxide sedation under a dentist’s supervision.
1. Background
1.1. Nitrous Oxide sedation is one of the most common pharmacological behaviour management techniques used for dental patients.
1.2. The use of Nitrous Oxide in dentistry has been safely practised in Australia for many years under various levels of regulation dependent upon jurisdiction.
1.3. Until 2010, the ADA had recognised the ANZCA and RACDS document PS21 published in 2003. This was superseded by PS9 in 2009, followed by PG09(G) in 2023.
1.4. Dentists are the only dental practitioner who can independently administer nitrous oxide in a dental
practice. However, other dental practitioners (who have undergone suitable training) may provide
treatment utilising nitrous oxide under supervision, once relative analgesia has been initiated by a
dentist.of a dentist.
Definitions
1.5. MINIMAL SEDATION is a drug induced state of diminished anxiety, during which patients are conscious and respond purposefully to verbal commands or light tactile stimulation.
1.6. NITROUS OXIDE SEDATION is a minimal sedation technique (also known as anxiolysis) in which a combination of nitrous oxide and oxygen is inhaled.
1.7. DENTAL PRACTITIONER is a person registered by the Australian Health Practitioner Regulation Agency via the Board to provide dental care.
1.8. DENTIST is an appropriately qualified dental practitioner, registered by the Board to practise all areas of dentistry.
1.9. MINIMAL SEDATION is a drug-induced state of diminished anxiety, during which patients are
conscious and respond purposefully to verbal commands or light tactile stimulation. It includes the
use of a single low dose oral medication or inhalation of gases for treating anxious patients, but not
inducing a state of moderate sedation or deeper.
2. Position
2.1. Patient safety should be the prime consideration in forming guidelines for minimal sedation techniques for dental practice.
2.2. Regulation of nitrous oxide sedation in dental practice should be evidence-based.
2.3. Dentists practising nitrous oxide sedation must comply with the standards set out in PG09(G) Guideline on Procedural Sedation 2023 (ANZCA) as it relates to minimal sedation techniques.
2.4. Only dentists who have adequate training and experience should administer nitrous oxide.
2.5. Dentists should remain the only dental practitioner who can independently administer nitrous oxide sedation in a dental practice.
2.6. Other dental practitioners (who have undergone suitable training) may provide treatment utilising nitrous oxide sedation under a dentist’s supervision.
2.7. Dentists administering nitrous oxide should follow the ADA Guidelines for the Administration of Nitrous Oxide and Oxygen Relative Analgesia in Dentistry.
