Nitrous Oxide Sedation

May 5, 2020 Update: The CDHBC Interpretation Guidelines are under review. The content of these guidelines remains in place at this time; however, they need to be applied in the context of the new Dental Hygienists Regulation and CDHBC Bylaws. Readers are welcome to contact the CDHBC office if they have questions about the application of these guidelines in the interim time.


To clarify the dental hygiene scope of practice as it relates to nitrous oxide sedation.


The CDHBC Scope of Practice Statement indicates that the dental hygienist may manage client pain, anxiety and fears. Inhalation sedation with nitrous oxide has proven to be an extremely effective and safe technique for the reduction of stress in the apprehensive or medically compromised client.

A dental hygienist may provide dental hygiene care to clients who are sedated by nitrous oxide/oxygen gases. However, appropriate education is required. "Appropriate education" is defined in the Scope of Practice Statement. The preferred "appropriate education" for dental hygienists treating clients who are receiving nitrous oxide sedation is formal theoretical and clinical instruction.

The following definitions have been developed to clarify the policy statement:

  • "Administration" of nitrous oxide/oxygen gases: the act performed by the person who is responsible for making the decision to initiate sedation, determine the appropriate level of sedation and/or adjust the flow of gases;
  • "Delivery" of nitrous oxide/oxygen sedation gases: performed by the person who follows the administration instructions. This not only includes following the administration instructions but also includes monitoring the client and terminating the gas flow.


The "delivery" of nitrous oxide/oxygen sedation gases is within the dental hygiene scope of practice, with appropriate education.

The "administration" of nitrous oxide/oxygen sedation gases is not within the dental hygiene scope of practice.


  • Malamed, SF. Sedation: A Guide of Patient Management. 5th Ed. St. Louis: Mosby; 2009.
  • CDHBC Scope of Practice. Victoria: College of Dental Hygienists Of British Columbia; 2013.
          Added to Handbook: Prior to June 2004
          Updated: September 2013