Special Health Care Needs
The Use of Nitrous Oxide for Routine Dental Treatment in Pediatric Patients with Sickle Cell Disease
Diamond Grady-Williams, DMD, MS (she/her/hers)
Resident
University of Illinois at Chicago, Chicago IL
University of Illinois at Chicago
Midlothian, Illinois, United States
Brittaney J. Hill, DDS, MS, MPH
Program Director
University of Illinois Chicago College of Dentistry
University of Illinois at Chicago
Chicago, Illinois, United States
Lewis Hsu, MD, PhD
University of Illinois at Chicago
Patrick D. Smith, DMD, MPH
University of Illinois at Chicago
Brittaney J. Hill, DDS, MS, MPH
Program Director
University of Illinois Chicago College of Dentistry
University of Illinois at Chicago
Chicago, Illinois, United States
Purpose: To identify differences in mean oxygenation levels between healthy pediatric patients and pediatric patients with Sickle Cell Disease (SCD) receiving nitrous oxide sedation for dental procedures, and to determine if nitrous oxide sedation decreases oxygen saturation for patients with SCD.
Methods: Twenty-six patients requiring restorative treatment aged 2-16 years with SCD, and 23 healthy, age-matched controls were recruited. Subjects presented for routine dental treatment with up to 50% nitrous/50% oxygen mixture. Oxygen saturation levels were recorded at baseline, during, and after the procedure using a pulse oximeter. Repeated measures ANOVA was applied. Data were analyzed with SPSS version 28, (IBM Statistics, Armonk, NY).
Results: Twenty-six cases, aged 2-16, were age-matched with 23 controls. The mean age of subjects was 8.7 years (SD 3.6). There were changes in oxygen saturation for both groups over time (P=.005); however, there were no differences in the patterns of change between groups (P=.653). Controls had a slightly higher mean baseline oxygen level (98.43, SD 0.728) than SCD cases (97.69, SD 1.379), but no difference was detected between groups over the course of the procedures (P=.197).
Conclusion: There are no differences in patterns of change in oxygen saturation upon administering nitrous oxide to healthy patients and patients with SCD. Patients with SCD can safely receive up to 50% nitrous oxide, when administered according to recommended guidelines and upon consultation with their hematologist. When used appropriately, nitrous oxide does not increase complications, in fact, it increases oxygen saturation which can be beneficial for patients with SCD.