EMONO National study in pediatric dentistry: effects sought and experienced

Abstract EMONO is an equimolar mixture of oxygen and nitrous oxide and is considered a reference for dental care in children. Completion of dental treatment has usually been used as a criterion to assess EMONO treatment. However, patient-reported outcomes are needed because i) we treat vulnerable subjects, and ii) effects felt can impact dental care prognosis. The aim of this study was to describe the patients’ feelings during EMONO sedation for dental care, especially anxiolytic and analgesic effects. We conducted a national prospective observational multicentric study 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. We assessed i) the prevalence of complete achievement of therapeutic effects (analgesia and anxiolysis) and ii) associated factors using a mixed effects logistic regression. In total, 677 children were analyzed. Anxiolysis and analgesia were experienced by a large majority of patients (86.5% and 79.0%, respectively, and 73% for both effects experienced). Several factors were associated with complete achievement of therapeutic 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 using the VAS and race. Our study characterized the patients who best 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.