Environmental monitoring of nitrous oxide during dental anaesthesia

Henderson, K.; Matthews, Ian

doi:10.1038/sj.bdj.4800556

Cited by 22 publications

(8 citation statements)

References 14 publications

(1 reference statement)

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“…In both dental and other medical procedures, the environmental concentrations are lower in the presence of a double mask system compared to the single mask system. Some studies have shown that the introduction of scavenging systems can reduce anesthetic gas pollution by over 90% [5, 42–44], as demonstrated also by the present study. More rarely, urinary concentrations in the exposed personnel were detected by other studies [39].…”

Section: Discussionsupporting

confidence: 86%

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Nitrous oxide occupational exposure in conscious sedation procedures in dental ambulatories: a pilot retrospective observational study in an Italian pediatric hospital

et al. 2019

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Background Nitrous oxide has a proven clinical efficacy in conscious sedation. At certain environmental concentrations it may pose a health risk to chronically exposed healthcare workers. The present pilot study aims at evaluating the exposure to nitrous oxide of dental ambulatory personnel of a pediatric hospital. Methods A descriptive study design was conducted in two phases: a bibliographic analysis on the environmental safety policies and a gas concentration analysis in the dental ambulatories of a pediatric hospital, detected every 6 months from December 2013 to February 2017 according to law provisions. The surveys were carried out using for gas analysis a photoacoustic spectrometer Innova-B&K “Multi-gas monitor model 1312” and Innova-B&K “Multi-sampler model 1309”. The biological analysis and monitoring have been carried out on staff urine. Results The analyses were performed during 11 dental outpatient sessions on pediatric patients. All the patients were submitted to the same dental procedures, conservative care and dental extractions. The pediatric patients were 47 (23 males, 24 females; age range 3–17 years; mean age 6,63, SD ± 2,69) for a mean of 4,27 (SD ± 1,49) per session., The mean environmental concentration of nitrous oxide during the sessions was 24.7 ppm (SD ±16,16). A correlation was found between urinary nitrous oxide concentration of dentists (Pearson’s correlation 0.786; p = 0.007) and dental assistants urines (Pearson’s correlation 0.918; p < 0.001) and environmental concentrations of nitrous oxide. Weak negative correlations were found between age and sex of patients and environmental concentrations of nitrous oxide. The mean values of the biological monitoring data referring to all the outpatient sessions are lower than the reference values foreseen in accordance to the regulations in force on nitrous oxide concentration. Conclusions The mean environmental concentration values recorded in our study are below the limit of 50 ppm considered as a reference point, a value lower than those reported in other similar surveys. The results of the present study provide a contribution to the need to implement technical standards, criteria and system requirements for the dental ambulatories, to date not yet completely defined, and cannot be assimilated to the ones established for the surgical rooms.

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Section: Discussionsupporting

confidence: 86%

“…Other previous surveys reported some similar methods of measurement of environmental nitrous oxide concentrations [2, 4, 5, 7], while others indicated different ones [4, 8–10, 41].…”

Section: Discussionmentioning

confidence: 96%

Nitrous oxide occupational exposure in conscious sedation procedures in dental ambulatories: a pilot retrospective observational study in an Italian pediatric hospital

et al. 2019

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“…Nitrous oxide has the disadvantage that it may give rise to haematological and reproductive difficulties in dental surgery staff [16,17]. Effective scavenging systems are essential and staff should not be exposed to nitrous oxide for prolonged periods [18].…”

Section: Pharmacological Agents Usedmentioning

confidence: 99%

A review of the pharmacological approach to the management of dental anxiety in children

Folayan

Faponle²,

Lamikanra

2002

Int J Paed Dentistry

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This paper aims to review the existing literature on the pharmacology of a number of sedative drugs used in the management of dental anxiety in the conscious child patient. Pharmacological agents may be used as a complement to behavioural techniques to assist in the management of anxiety in some paediatric dental patients. Their use may also be especially indicated in children with disabilities. These agents are usually sedative in action and do not, in themselves, eliminate anxiety but merely enhance patient acceptance by reducing arousal and modifying anticipation of danger. The agents used are varied and diverse and include nitrous oxide, benzodiazepines and narcotics. Nitrous oxide has proved to be of particular value but carries a degree of risk for the operating staff. Amongst the benzodiazepines, Midazolam has been used more frequently in recent years. It may be given by a variety of routes, including intra-nasally. Dentists who employ sedative agents and techniques should be familiar with the pharmacology of the agents selected, be cognisant of the risks and benefits of the technique employed and be able to manage any adverse events that may arise through their use.

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“…Oral healthcare professionals who use nitrous oxide gas on a regular basis over an extended period of time face problems. 33,34…”

Section: Anesthetic Gases In the Dental Officementioning

confidence: 99%

Occupational Hazards in Oral Healthcare Professionals

Kshirsagar¹,

Bafna²,

Vathar³

et al. 2018

Journal of Oral Health and Community Dentistry

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Introduction: Occupational hazards are disorders which are induced due to work-related conditions. Oral healthcare providers are continuously getting exposed to a number occupation-related disorders. This may cause various occupation-related disorders which then develop and increase with years. Unawareness or ignorance makes oral healthcare professionals more vulnerable to occupationrelated disorders. So health of oral healthcare professionals, especially effect of dental activities on it, is important in the present day, and as a matter of fact, not a well-documented subject also. Aim:To summarize the important side of occupation-related disorders influencing oral healthcare professionals and to present its preventive measures.Results: Previous literature suggests evidence of high vulnerability of oral healthcare professionals to certain work-related disorders. Conclusion:It is therefore, important that all the oral healthcare professionals remain constantly informed regarding occupational hazards and implementation of preventive strategies to provide a safe working environment. Continuous education and appropriate interventions are needed to reduce the complications of these hazards.

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Environmental monitoring of nitrous oxide during dental anaesthesia

Cited by 22 publications

References 14 publications

Nitrous oxide occupational exposure in conscious sedation procedures in dental ambulatories: a pilot retrospective observational study in an Italian pediatric hospital

Nitrous oxide occupational exposure in conscious sedation procedures in dental ambulatories: a pilot retrospective observational study in an Italian pediatric hospital

A review of the pharmacological approach to the management of dental anxiety in children

Occupational Hazards in Oral Healthcare Professionals

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