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Observational Study
. 2025 Feb;26(1):149-158.
doi: 10.1007/s40368-024-00950-2. Epub 2024 Nov 15.

Equimolar oxygen-nitrous oxide (EMONO) in dental pediatric care: which patients achieve therapeutic effects? A French national exploratory prospective observational multicenter study

T Prud'homme  1 , M Rousselet  2   3 , M Istvan  2   3 , M Cheraud-Carpentier  4 , S Dajean-Trutaud  4 , S Lopez  4   5 , M Muller-Bolla  6 , M Marty  7 ; French Pediatric Dentistry Network (FPDN); F Feuillet  3   8 , C Victorri-Vigneau  2   3
Affiliations
Observational Study

Equimolar oxygen-nitrous oxide (EMONO) in dental pediatric care: which patients achieve therapeutic effects? A French national exploratory prospective observational multicenter study

T Prud'homme et al. Eur Arch Paediatr Dent. 2025 Feb.

Abstract

Purpose: Equimolar oxygen-nitrous oxide mixture (EMONO) is considered as a reference for dental care in children. Completion of dental treatment has usually been used as a criterion to assess EMONO treatment. However, other patient-reported outcomes are needed. We sought to assess the prevalence of complete therapeutic effects (analgesia and anxiolysis) experienced by children during dental care under EMONO and identifying associated factors.

Methods: A national prospective observational multicentric study was conducted between September 2018 and June 2020 in 13 French university hospitals. Participants were children between 3 and 15 years of age requiring dental care under EMONO.

Results: 677 children were analyzed. Anxiolysis and analgesia were experienced by a large majority of patients (86.5% and 79.0%, respectively, and 73% experienced both effects). Several factors were associated with both analgesia and anxiolysis effects: the presence of expected effects (no loss of judgment and slight decrease in level of consciousness), the absence of agitation and distress, a positive perception of EMONO and ethnicity.

Conclusion: Most patients benefit from the therapeutic effects (anxiolysis and analgesia) expected by EMONO during dental treatment. It is reassuring to observe that most sociodemographic characteristics and medical history do not seem to influence the effectiveness of care. The study was registered at www.

Clinicaltrials: gov under the reference number NCT03453411.

Keywords: Analgesia; Anxiolysis; Nitrous oxide; Pediatric dentistry; Therapeutic effects.

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Conflict of interest statement

Declarations. Conflict of interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Ethical approval: Informed oral consent and study conditions have been approved by the French Research Ethics Committee (CPP) on April 4th, 2018, and the study was conducted in accordance with the National Commission of Information Technology and Liberties (Commission Nationale de l’Informatique et des Libertés—CNIL) rules regarding data management and analysis. Patient consent: Written information was adapted to the age of the children, and all of them and their legal representative provided informed oral consent to participate in accordance with the Declaration of Helsinki.

References

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