Perception of dentists regarding the use of Nitrous Oxide-Oxygen Inhalation Sedation and General Anaesthesia in dental treatment

Abstract

Introduction: Dental fear and anxiety remain significant barriers to oral health care affecting patients across all age groups. These psychological barriers often result in avoidance or delay of necessary dental treatments ultimately exacerbating oral diseases and complicating treatment needs. The use of pharmacological behavioral management techniques such as Nitrous Oxide-Oxygen Inhalation Sedation (NOIS) and General Anaesthesia (GA) is essential in managing uncooperative, apprehensive and anxious dental patients. This study aims to assess the knowledge, attitudes, preferences and practices of dentists regarding the use of NOIS and GA in dental treatment. Materials and Methods: A cross-sectional Google questionnaire-based survey was conducted among practicing dental professionals to evaluate their knowledge, attitudes, experiences and perceived advantages and disadvantages regarding the use of NOIS and GA. The questionnaire was circulated through online social media platform and 223 responses were obtained which were analyzed statistically. Results: A total of 223 dentists participated in the survey. 164 (73%) respondents were familiar with NOIS and reported using it in clinical practice. 202 (90%) respondents used NOIS or GA for children upto 12 years age. In contrast, 50% respondents referred patients for GA-based procedures, typically for extensive dental needs or uncooperative patients. NOIS was preferred for managing anxious but cooperative patients while GA was avoided for patients with complex medical conditions. Conclusion: The study highlights variability in the perception and utilization of NOIS and GA among dental professionals. Dentists acknowledge the clinical value of both NOIS and GA in behavior management but face barriers in their implementation, particularly related to training and infrastructure. Increasing access to continuing education and clinical training programs may enhance the adoption of sedation techniques, thereby improving patient care and outcomes.