Treatment outcomes in adult patients experiencing dental anxiety: A comparative retrospective study.

Aims: To assess and compare the effectiveness of pharmacological and cognitive-behavioral modalities-behavioral methods (BM), nitrous oxide inhalation sedation (NOIS), and premedication with Diazepam-for alleviating anxiety during dental treatment, using completed treatment sessions and adverse outcomes as indicators.

Methods and results: For 239 patients (515 dental records), 18-53 y/o, who underwent dental treatments under anxiety reduction measures, sessions under NOIS were categorized as "nitrous group" (456 sessions) versus premedication with Diazepam or behavioral strategies (control, 59 sessions). Outcomes were completed treatment sessions considering demographic and clinical parameters, and adverse outcomes during and between sessions. Adjusted logistic regression showed significantly higher odds of completing treatment sessions after NOIS (p = 0.014) as compared to controls. Univariate analyses demonstrated failure of anesthesia was higher in the control versus the nitrous group (p < 0.001). Adverse outcomes were more frequent in controls (p = 0.005). No significant effects of age, gender, and general health condition on completion rates of treatment plans were demonstrated. The complexity of the treatment plan had a significant effect on its completion (p = 0.03).

Conclusions: NOIS modality yielded significantly superior outcomes as compared to BM and premedication with Diazepam, with no significant effects of age or gender on the completion of treatment plans.