Effectiveness and Safety of Elevated Dosages of Nitrous Oxide on Behavior Management in Pediatric Dentistry.

OBJECTIVE: To determine if administering a higher dosage of nitrous oxide (>50%), with a nasal hood in pediatric dental restorative procedures, can allow for a safe and more cooperative experience for the pediatric patient as measured by observable adverse reactions and the Frankl Behavior Rating Scale. STUDY DESIGN: A retrospective chart review was completed of 200 patients total, 100 for each nitrous oxide (N2O) dosage group (≤50% vs >50%). Adverse reactions and The Frankl Behavior Rating Scale during pediatric restorative procedures with N2O were compared between the two dosage groups. RESULTS: There were few adverse reactions for both nitrous oxide groups (≤50% vs >50%) and there was no statistical difference in the Frankl Behavior Rating Scale for each group. CONCLUSIONS: Patients given more than 50% of nitrous oxide were not found to have an increase in adverse events. Higher concentrations of nitrous oxide (>50%) were not found to be associated with a better behavior score when completing pediatric restorative procedures.

Primary care physicians and hospitalists: two branches of the same tree.

The success of the evolving filed of pediatric hospitalist medicine should be judged on the health outcomes achieved for the more than 6 million children who are hospitalized annually. The focused approach hospitalists bring to defining the best knowledge that their role is important but is limited in the overall health of most children. In order to achieve the best health outcomes, hospitalists must fully partner with the child's primary care provider. By consistently communicating well during pre-admission, hospitalization, and discharge intervals, hospitalists and primary care pediatricians can enhance learning, as well as maximize outcomes for shared patients.