A Caregivers’ Perception of Dental Care Under Nitrous Oxide Sedation in Patients with Autism Spectrum Disorder

Authors

  • Maria Mariana Santos Residência Uniprofissional em Clínica Integrada em Odontologia, Odontologia para pacientes com necessidades especiais, Escola de Saúde Pública da Paraíba, João Pessoa, Paraíba, Brasil. https://orcid.org/0009-0001-6577-0466
  • Andreia Medeiros Rodrigues Cardoso Residência Uniprofissional em Clínica Integrada em Odontologia, Odontologia para pacientes com necessidades especiais, Escola de Saúde Pública da Paraíba, João Pessoa, Paraíba, Brasil. https://orcid.org/0000-0002-2682-1048
  • Jordana Medeiros Lira Decker Residência Uniprofissional em Clínica Integrada em Odontologia, Odontologia para pacientes com necessidades especiais, Escola de Saúde Pública da Paraíba, João Pessoa, Paraíba, Brasil. https://orcid.org/0000-0002-0420-4313
  • Eduarda Gomes Onofre Araújo Programa de Pós-graduação em Odontologia, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brasil. https://orcid.org/0000-0001-7107-6107

Keywords:

Autism Spectrum Disorder, Nitrous Oxide, Unified Health System

Abstract

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that may make dental care more challenging. An effective technique to assist in the clinical management of these patients is conscious sedation with nitrous oxide, making it important to understand caregivers’ perceptions of this approach. This study aimed to describe the perception of caregivers of patients with ASD regarding dental care performed under conscious sedation with nitrous oxide. Method: This is a quantitative, observational, and cross-sectional study conducted with 23 caregivers of patients with ASD treated at the Dental Specialties Center of Cruz das Armas, in João Pessoa, Paraíba, Brazil, between July and December 2025. Data collection was carried out through an online form applied after the dental appointment. Data were analyzed using descriptive statistics in SPSS software, version 22. Mothers accounted for 87% of the caregivers, most aged between 30 and 40 years (60.9%), and with family income predominantly between one and two minimum wages (56.5%). There was a predominance of male patients with ASD (73.9%), aged between 7 and 10 years (52.2%), with frequent comorbidities associated with ASD (60.9%). Improvement in behavior was observed in 91.3% of cases, and good acceptance of the mask was reported in 87.0%. Comfort was classified as comfortable in 86.9% of cases, with absence of adverse effects in 78.3%, high perception of safety (95.6%), and recognition of effectiveness (100%). The technique was recommended by 95.7% of caregivers, desired for future appointments by 91.3%, and evaluated as better than previous experiences by 69.6%, while for 26.1% it was the first dental experience. Despite caregivers’ lack of prior knowledge about nitrous oxide sedation, according to them the technique promoted improved behavior, greater comfort during treatment, low occurrence of adverse effects, and a high perception of safety, being recommended and desired for future dental care.

Downloads

Download data is not yet available.

References

World Health Organization. Autism spectrum disorders [Internet]. Geneva: World Health Organization; 2025 [citado 2026 Fev. 8]. Disponível em: https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders.

Batista AA, Gutierrez GM, Santos RF. Sinais clínicos do transtorno do espectro autista para auxiliar o odontopediatra no diagnóstico precoce. Rev Fac Odontol Porto Alegre. 2022; 63(2):83-9. DOI: 10.22456/2177-0018.121942.

Centers for Disease Control and Prevention (CDC). Data and Statistics on Autism Spectrum Disorder [Internet]. Atlanta: CDC; 2025 [citado 2026 Fev. 8]. Disponível em: https://www.cdc.gov/autism/data-research/.

Muniz FSM, Marques LS, Jorge MLR. Limitações e dificuldades relacionadas à saúde bucal de crianças com transtorno do espectro autista: revisão integrativa da literatura. Rev CROMG. 2024; 22(Suppl 4). DOI: 10.61217/rcromg.v22.480.

Clark MS, Brunick AL. Handbook of Nitrous Oxide and Oxygen Sedation. 5th ed. Elsevier Health Sciences; 2019.

Garret-Bernardin A, Festa P, Matarazzo G, Vinereanu A, Aristei F, Gentile T, et al. Behavioral Modifications in Children after Repeated Sedation with Nitrous Oxide for Dental Treatment: A Retrospective Study. International Journal of Environmental Research and Public Health. 2023 Feb 24;20(5):4037. DOI: 10.3390/ijerph20054037.

Singh D, Anand P, Malik M, Sachdev V. Parents and children perception towards nitrous oxide inhalation sedation as behavioural management technique during pediatric dental care. Int J Curr Res. 2021; 13(12):19774-78. DOI: 10.24941/ijcr.42764.12.2021.

Gomes PTM, Lima LHL, Bueno MKG, Araújo LA, Souza NM. Autism in Brazil: a systematic review of family challenges and coping strategies. J Pediatr (Rio J). 2015; 91(2):111–21. DOI: 10.1016/j.jped.2014.08.009.

Carvalho Filha FSS, Castro RP, Vilanova JM, Silva MVRS, Moraes Filho IM, Sousa TVS. Características sociodemográficas de mães/pais de crianças com autismo, cuidados e tratamento realizado: uma análise exploratória. Rev Bras Pesq Saúde. 2024; 26(1):40751. DOI:10.47456/rbps.v26i1.40751.

Fagundes MLB, Bastos LF, Amaral Júnior OL do, Menegazzo GR, Cunha AR da, Stein C, et al. Socioeconomic inequalities in the use of dental services in Brazil: an analysis of the 2019 National Health Survey. Revista Brasileira de Epidemiologia. 2021; 24(suppl 2). DOI: 10.1590/1980-549720210004.supl.2.

Angelova S, Konstantinova D, Nenova-Nogalcheva A, Pancheva R. Significance of Oral Care for Children with Autism Spectrum Disorder—A Narrative Literature Review. Children. 2025; 12(6):750. DOI: 10.3390/children12060750.

Jones J, Roberts E, Cockrell D, Higgins D, Sharma D. Barriers to Oral Health Care for Autistic Individuals—A Scoping Review. Healthcare. 2024; 12(1):103–3. DOI: 10.3390/healthcare12010103.

Ministério da Saúde (BR). Linha de cuidado para pessoas com Transtorno do Espectro Autista (TEA) na Rede de Atenção à Saúde [Internet]. Brasília: Ministério da Saúde; 2025 [citado 2026 maio 11]. Disponível em: bvsms.saude.gov.br/bvs/publicacoes/linha_cuidado_pessoas_tea.pdf.

Alyahyawi A, Barry M, Helal NM. Dental Conscious Sedation for the Treatment of Children With Autism Spectrum Disorder: A Narrative Review. Cureus. 2024 ; DOI: 10.7759/cureus.64834.

Silva TAP, Silva IAPS, Andrade RS de. Sedação inalatória com óxido nitroso na prática clínica odontológica : revisão integrativa. Brazilian Journal of Implantology and Health Sciences. 2023; 5(5):2740–64. DOI: 0.36557/2674-8169.2023v5n5p2740-2764.

Muller TM, Alessandretti R, Bacchi A, Tretto PHW. Eficácia e segurança da sedação consciente com óxido nitroso no tratamento pediátrico odontológico: revisão de estudos clínicos. J Oral Investig. 2018; 7(1):88. DOI: 10.18256/2238-510X.2018.v7i1.2497.

Silva JVL, Mendonça JP, Almeida PKGN. Sedação consciente com óxido nitroso em pacientes fóbicos na odontologia. Braz J Implantol Health Sci. 2024; 6(10):866-75. DOI: 10.36557/2674-8169.2024v6n10p866-875.

Ritwik P, Gupta K. Use of nitrous oxide in children with special health care needs. Clin Dent Rev. 2020; 4(1):23. DOI:10.1007/s41894-020-00085-9.

Malamed SF. Sedação na Odontologia. São Paulo: Elsevier; 2012.

Benevides BFR, Moreira PMMC. Atendimento humanizado ao paciente com transtorno do espectro autista na odontologia: estratégias e boas práticas [Internet]. Rev Ciênc Odontol. 2026; 10(1):95-103 [citado 2026 maio 11]. Disponível em: https://revistas.icesp.br/index.php/RCO/article/view/5991/4197

Downloads

Published

2026-07-27

How to Cite

1.
Santos MM, Cardoso AMR, Decker JML, Araújo EGO. A Caregivers’ Perception of Dental Care Under Nitrous Oxide Sedation in Patients with Autism Spectrum Disorder. HU Rev [Internet]. 2026Jul.27 [cited 2026Aug.13];51:1-8. Available from: https://periodicos.ufjf.br/index.php/hurevista/article/view/52213

Issue

Vol. 51 (2025)

Section

Artigos Originais

License

Copyright (c) 2026 Maria Mariana Santos, Andreia Medeiros Rodrigues Cardoso, Jordana Medeiros Lira Decker, Eduarda Gomes Onofre Araújo

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Cessão de Primeira Publicação à HU Revista

Os autores mantém todos os direitos autorais sobre a publicação, sem restrições, e concedem à HU Revista o direito de primeira publicação, com o trabalho licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento irrestrito do trabalho, com reconhecimento da autoria e crédito pela citação de publicação inicial nesta revista, referenciando inclusive seu DOI.