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DOI: 10.48087/BJMS.2026.130409
Authors: Fouzia Kawter BAROUDI, Nawel ALLAL, Fouad OUDGHIRI, Amina KEDDAR, Chahinez ABDELAOUI
Affiliations: Department of Dental Medicine, CHU Tlemcen, Algeria
Abstract
Background: The equimolar mixture of oxygen and nitrous oxide (MEOPA) is widely used for conscious sedation in dentistry. It facilitates the management of anxious or uncooperative patients and represents an alternative to general anesthesia. Objective: To evaluate the effectiveness, safety, and clinical indications of MEOPA in improving the management of difficult patients and optimizing treatment outcomes. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. An electronic search was performed in the PubMed and Lissa databases, covering English- and French-language publications from 2004 to 2024. Studies were selected based on predefined inclusion and exclusion criteria following the screening of titles, abstracts, and full texts. Results: The search identified 31 articles, of which 9 were included in the final analysis. Findings indicate that MEOPA significantly improves patient cooperation, reduces anxiety, and facilitates dental care delivery. Its combination with midazolam further enhances its effectiveness. MEOPA is particularly beneficial for patients with intellectual disabilities and during tooth extractions. Adverse effects, such as vomiting, are rare (< 1%) and are generally associated with the duration or depth of sedation. The use of the Porter/Brown mask additionally reduces nitrous oxide emissions, promoting a more environmentally responsible practice. Conclusions: MEOPA is an effective and safe sedation technique in dentistry, optimizing the management of difficult patients and enhancing the overall dental care experience. However, the heterogeneity across the included studies underscores the need for further standardized research.
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Keywords: MEOPA, Nitrous Oxide, Conscious Sedation, Dental Care, Dental Anxiety, Pediatric Dentistry.