Victor Gil Manich
Minimal inhalation sedation with nitrous oxide and oxygen | Patients requiring special care in dentistry
- 2024 – Current: Coordinator, Oral Health Project UIC – Universitat Internacional de Catalunya, Barcelona-Dentaid.
- 2024 – Current: Member of the Specific Committee for Continuing Education, Dentistry – UIC.
- 2023 – Current: International Director of Geriatric Dentistry, Special Patients and Oral Medicine – UIC.
- 2022 – Current: Director, Online Master’s Degree in Geriatric Dentistry, Special Patients and Oral Medicine – UIC.
- 2019 – Current: Director, in-person Master’s Degree in Geriatric Dentistry, Special Patients and Oral Medicine – UIC.
- 2015 – Current: Coordinator and instructor, Continuing Education in “Updates in Oral Pathology” – UIC.
- 2014 – Current: Opinion leader on “Conscious Sedation with Nitrous Oxide”.
- 2013 – Current: Coordinator and instructor, Continuing Education in “Conscious Sedation with Nitrous Oxide and Basic Support with AED” – UIC.
- 2011 – Current: Associate Professor of Oral Medicine, Geriatric Dentistry and Special Patients – UIC.
- 2010 – Current: Private Dental Clinic.
- Member of several national and international scientific societies.
Nationality: Spain
Scientific areas: Pediatric Dentistry
8 of november, from 09h00 until 12h15
Auditorium C
Conference summary
Minimal inhalation sedation with nitrous oxide and oxygen
9:00–10:30
This lecture covers the fundamentals, clinical indications, and a practical application of minimal sedation using a mixture of nitrous oxide (N₂O) and oxygen (O₂) – a widely used technique in dentistry to manage patient anxiety and improve treatment compliance, especially in anxious or sensitive patients.
Key points covered:
- pharmacokinetics and pharmacodynamics: N₂O has a rapid onset of action (2–3 minutes), low blood solubility, and is eliminated unchanged, enabling precise control of sedation levels (Clark & Brunick, 2021);
- clinical indications: suitable for patients with dental anxiety, a strong gag reflex, or when performing short or minimally invasive procedures (American Dental Association, 2016);
- safe administration protocol: involves proper titration of N₂O concentrations, continuous patient monitoring, and oxygen administration before and after the procedure (Cohen et al., 2020);
- contraindications: contraindicated in cases of pneumothorax, upper respiratory tract infections, first-trimester pregnancy, and untreated vitamin B12 deficiency (Clark & Brunick, 2021);
- advantages: Provides rapid recovery, minimal side effects, and preserves consciousness and protective airway reflexes (AAPD Guidelines, 2021).
Patients requiring special care in dentistry
11:30–12:15
This session focuses on dental care approaches for individuals with physical, intellectual, or sensory disabilities, as well as those with complex medical conditions. Emphasis is placed on a patient-centred approach, clinical adaptations, and behavioural management strategies, including sedation.
Key points covered:
- definition and classification: the need for special care is understood from a biopsychosocial perspective (WHO, 2001).
- barriers to treatment: includes physical access challenges, communication difficulties, fear, and severe anxiety (Anders & Davis, 2010);
- clinical adaptations: may involve improved communication strategies, extended appointment times, use of multidisciplinary teams, and adjustments to equipment or patient positioning (Dougall & Fiske, 2008);
- nitrous oxide checklist: a helpful tool for managing anxiety and sensory sensitivity, especially in patients with autism, cerebral palsy, or developmental delays (Nelson et al., 2017 – PubMed);
- importance of team training: specific training in behaviour management, bioethics, and communication with carers (Dao et al., 2020 – Cochrane Review).