Predictors of Behavioral Response to Nitrous Oxide Sedation in Pediatric Dental Patients: A Retrospective Study

Abstract Background: Nitrous oxide (N 2 O) is a widely used anxiolytic agent in pediatric dentistry, shown to improve cooperation and reduce dental anxiety. However, predictors of behavioral response and sedation success remain unclear. The aim of this study was to evaluate demographic, clinical, and tablepsychological predictors of behavioral response and sedation success among pediatric dental patients undergoing N 2 O sedation. Materials and Methods: This retrospective cohort study included 159 children aged 3–12 years who received dental treatment under N 2 O sedation. Data extracted from patient records included age, sex, accompanying guardian, temperament, previous dental experience, visit number when N 2 O was used, and type of treatment. Behavioral responses were assessed using the Frankl scale before and during sedation. Ordinal and binary logistic regression analyses were conducted to identify predictors. Results: N 2 O significantly improved behavior, with 74.8% showing positive responses during sedation compared to predominantly negative behavior before. Overall, sedation success was 91.2%. None of the tested predictors – including age, sex, guardian, temperament, prior dental experience, or visit number – was statistically significant. Fearful temperament trended toward lower odds of positive response, while negative prior experience trended toward increased success. Conclusions: N 2 O sedation is highly effective in improving behavior and facilitating treatment in pediatric patients. Its benefits appear broadly applicable, independent of demographic or psychological predictors.