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The environmental impact of nitrous oxide inhalation sedation appointments and equipment used in dentistry

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European Archives of Paediatric Dentistry Aims and scope Submit manuscript

Abstract

Purpose

This paper reports a life cycle impact assessment (LCIA) to calculate the environmental footprint of a dental appointment using N2O, comparing single-use equipment with reusable equipment. Nitrous oxide (N2O) is used successfully in dentistry to provide sedation and pain relief to anxious patients, most commonly in children. However, N2O is a powerful climate pollutant 298 times more damaging than carbon dioxide over a 100-year estimate.

Methods

The functional unit chosen for this LCIA was 30 min delivery of N2O to oxygen in a 50:50 ratio at 6 L per minute flow rate as inhalation sedation to one patient. Two types of equipment were compared to deliver the anaesthetic gas: reusable and disposable items.

Results

The use of disposable equipment for N2O sedation produces a significantly larger environmental impact across nearly all of the environmental impact scores, but the overall global warming potential is comparable for both types of equipment due to the vast environmental pollution from N2O itself.

Conclusion

N2O sedation is a reliable treatment adjunct but contributes to climate change. Single-use equipment has a further deleterious effect on the environment, though this is small compared to the overall impact of N2O. Dental priorities should be to deliver safe and effective care to patients that protects staff, minimises waste and mitigates impact on the environment alongside promoting research into alternatives.

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Data availability

The data available in this submission has been described in the methodology and analysed using opensource software.

References

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Funding

This research has been independently funded.

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Authors and Affiliations

Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by AF-W, BD, and EM. The first draft of the manuscript was written by AF-W and BD, and all authors commented on subsequent versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to A. Fennell-Wells.

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Conflict of interest

The authors declare no conflict of interest.

Informed consent

This research did not involve human participants, and therefore informed consent from participants was not applicable.

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Appendices

Appendix 1

See Table 5.

Table 5 Inputs for reusable inhalation sedation equipment

Appendix 2

See Table 6.

Table 6 Inputs for disposable inhalation sedation equipment

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Fennell-Wells, A., Duane, B., Ashley, P. et al. The environmental impact of nitrous oxide inhalation sedation appointments and equipment used in dentistry. Eur Arch Paediatr Dent (2024). https://doi.org/10.1007/s40368-024-00895-6

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  • DOI: https://doi.org/10.1007/s40368-024-00895-6

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