High-Flow Nasal Oxygen Supports Safe Deep Sedation in Pediatric Dental Care: Study

A new study published in the journal of the BMC Oral Health showed that for preschool-aged children receiving dental treatment under severe sedation, high-flow nasal oxygen (HFNO) seems to offer dependable and efficient oxygenation with no clinically noted side effects or problems.

Intravenous heavy sedation is frequently necessary while giving dental treatment to young kids in order to control anxiety, guarantee cooperation, and make complicated operations easier. However, there are a lot of airway management issues with this strategy. Because the surgical field and the airway are linked, deep sedation increases the risk of hypoxia by blunting respiratory drive and upper airway muscle tone. During dental procedures, conventional oxygen supply techniques may be insufficient or restrictive.

HFNO, which uses nasal cannulas to provide heated and humidified oxygen at high flow rates, has become a viable substitute. This method extends safe apnea time, enhances oxygenation, and produces mild positive airway pressure without obstructing dental access. Establishing safer methods that reduce perioperative respiratory problems for young children requires examining the clinical viability of HFNO in this particular group. Thus, this study investigated the clinical viability of deep intravenous sedation for longer and more complicated dental operations in preschool-aged children.

In this study, twenty children under severe sedation were scheduled for elective dental procedures that were expected to last 60 to 120 minutes. Qualified anesthesiologists administered sedatives and anesthetics, managed oxygenation, and monitored patients during surgery. The youngster was either under general anesthesia with mask inhalation of sevoflurane or relaxed with intranasal dexmedetomidine before the IV was inserted.

During dental treatment, oxygen administration was provided with the HFNO device with a 2.0 L/kg/min gas flow rate and an FiO2 of 1.0. Propofol was used with a target-controlled infusion device to maintain the depth of drowsiness. Adverse effects, corrective measures, respiratory status, and perioperative pulse oximetry were all meticulously documented.

Under severe sedation, all of the youngsters that were involved successfully finished their dental care. 74 minutes was the average operating time. During this study’s observation and 24-hour follow-up, none of the subjects reported experiencing desaturation or any associated problems.

Overall, the initial results suggest that HFNO might offer optimal oxygenation during deep sedation for preschool-aged children receiving dental care without any side events or clinically noticeable problems. On the other hand, it is important to stress the provider's qualifications, rigorous HFNO device training, appropriate usage, and careful observation.

Source:

Cheng, T., Wu, X.-R., Liu, Y., Li, B.-H., & Yang, X.-D. (2026). Clinical feasibility of high-flow nasal oxygenation during dental procedures in pediatric patients under intravenous deep sedation: initial experience. BMC Oral Health. https://doi.org/10.1186/s12903-026-08710-y