Investigation of inhalational conscious sedation as a tool for reducing anxiety in adults undergoing exodontia

Br Dent J. 2012 Sep;213(6):E9. doi: 10.1038/sj.bdj.2012.839.


Aim: To determine whether adult patients' dental anxiety levels decrease following exodontia carried out under inhalational conscious sedation with nitrous oxide and oxygen (IHS) and local anaesthetic (LA).

Design: Retrospective analysis of pre- and post-operative modified dental anxiety score (MDAS) questionnaires completed by patients treated in a primary care oral surgery service between 21 July 2010 and 17 December 2010.

Methodology: 138 patients who had undergone exodontia were divided into three groups: moderate to severe anxiety (MDAS scores 11-25) treated under IHS and LA (n = 60), mild anxiety (MDAS scores 5-10) treated under IHS and LA (n = 43) and mixed anxiety (MDAS scores 5-15) treated under LA only (n = 35). The mean pre- and post-operative MDAS scores were analysed by means of one-tailed, paired t-tests.

Results: The moderate to severely anxious group treated under IHS and LA showed a statistically significant decrease of 3.68 between the mean pre- and post-operative MDAS scores (p = 0.000). The IHS mildly anxious group showed a decrease of 0.07 (p = 0.392) and the LA group showed a decrease of 0.23 (p = 0.227). Neither of these results were statistically significant.

Conclusion: These results support the use of IHS, to reduce anxiety of exodontia, in moderate to severely anxious adults undergoing minor oral surgery (MOS) procedures under LA in primary care oral surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anesthesia, Dental / methods*
  • Anesthesia, Local / methods*
  • Conscious Sedation / methods*
  • Dental Anxiety / diagnosis
  • Dental Anxiety / prevention & control
  • Dental Anxiety / therapy*
  • Female
  • Humans
  • Lidocaine / administration & dosage
  • Male
  • Middle Aged
  • Nitrous Oxide / administration & dosage*
  • Retrospective Studies
  • Surveys and Questionnaires
  • Tooth Extraction / methods*


  • Lidocaine
  • Nitrous Oxide