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. 2025 May;18(5):522-526.
doi: 10.5005/jp-journals-10005-3113. Epub 2025 Jul 25.

Evaluating the Success of Rapid Titration on Children with Different Temperament during Nitrous Oxide Inhalation Sedation in a Pediatric Dental Setup

Divya Singh  1 , Nidhi Gupta  1 , Natasha Gambhir  1 , Sonam Yadav  1 , Rishabh Solanki  1 , Vrinda Luthra Pruthi  2
Affiliations

Evaluating the Success of Rapid Titration on Children with Different Temperament during Nitrous Oxide Inhalation Sedation in a Pediatric Dental Setup

Divya Singh et al. Int J Clin Pediatr Dent. 2025 May.

Abstract

Effective management of pediatric dental patients often requires pharmacological intervention when behavioral techniques fail, with nitrous oxide/oxygen (N2O/O2) sedation being a common choice for anxiety and pain relief. The aim is to assess how temperament influences sedation success and compare physiological responses like O2 saturation (SpO2) and pulse rate between the two methods. This research aims to improve personalized sedation strategies in pediatric dentistry. Conventional slow induction gradually increases the N2O concentration, while rapid induction administers a higher concentration initially to calm the child quickly. A total of 54 pediatric patients aged 3-9 years were assessed for temperament using behavioral scales and then randomly assigned to slow induction and if not benefited with slow titration, the second visit was under rapid titration. Sedation success was measured by RASS scale, patient cooperation, oxygen saturation, pulse rate, and adverse events during the procedure. Initial findings indicated that children with temperamental negative affect benefited more from rapid induction, achieving quicker sedation, with no variations in oxygen saturation and pulse rate. Overall temperament had an impact on sedation success though the result showed no significant associations between titration method and gender, age, or temperament scale scores. Child temperament plays a crucial role in sedation outcomes. Personalizing sedation protocols based on temperament could optimize pediatric dental care and improve patient outcomes in the future.

How to cite this article: Singh D, Gupta N, Gambhir N. Evaluating the Success of Rapid Titration on Children with Different Temperament during Nitrous Oxide Inhalation Sedation in a Pediatric Dental Setup. Int J Clin Pediatr Dent 2025;18(5):522-526.

Keywords: Behavior management; Nitrous oxide inhalation sedation; Pharmacological behavior management; Temperament; Titration.

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Conflict of interest statement

Source of support: Nil Conflict of interest: Dr Nidhi Gupta is associated as the National Editorial Board member of this journal and this manuscript was subjected to this journal's standard review procedures, with this peer review handled independently of this editorial board member and his research group.Conflict of interest: Dr Nidhi Gupta is associated as the National Editorial Board member of this journal and this manuscript was subjected to this journal's standard review procedures, with this peer review handled independently of this editorial board member and his research group.

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