The Use of Nitrous Oxide for Routine Dental Treatment in Pediatric Patients with Sickle Cell Anemia

Purpose To identify differences in mean oxygenation levels between healthy pediatric patients and pediatric patients with sickle cell disease (SCD) receiving nitrous oxide (N2O) for dental procedures and to determine if N2O decreases oxygen saturation levels for SCD patients. Methods Patients aged 2-17 years with SCD and healthy age matched controls were recruited at their preventive or restorative visits from 2019-2023. N2O up to 50% oxygen and 50% nitrous was administered during routine restorative treatment. Oxygen saturation was measured via a pulse oximeter before starting nitrous, at 10-minute intervals throughout treatment, and after nitrous oxide termination. Statistical analysis was completed using SPSS. Results There was a significant difference in average O2 saturation at baseline between cases and controls; however, there was no significant difference at 10 mins, 20 mins, or 30 mins. There was no significant difference in O2 saturation between cases and controls after terminating N2O. Conclusion Use of N2O for dental treatment up to 50% nitrous/50% oxygen mixture is safe in SCD patients. The oxygen saturation of healthy patients and patients with SCD increases with the use of N2O. In addition, N2O use in patients with SCD can alleviate anxiety and increase the pain threshold, decreasing the risk for vaso-occlusive crisis.