Evaluation of safe and effective administration of nitrous oxide after a postgraduate training course

45 practitioners were trained between 2002 and 2004. They carried out 826 sessions of inhalation sedation in 662 patients. The clinical competency of this group was compared with an expert group.There was no difference between trainees and experts in ability to complete the planned dental treatment under sedation (89.6% vs 93.2%). Trainees were less successful than experts for patients with intellectual disability (87.4% vs 94.2%, p < 0.01). For both groups, the degree of cooperation improved between initial induction and each perioperative step (Wilcoxon test, p < 0.01). However, for trainees, Venham behaviour scores varied with the type of patient (Kruskal Wallis test, p < 0.001). No major adverse effects were recorded. Trainees reported more minor adverse effects than experts (13% vs. 5.3% respectively, Fisher exact test, p < 0.001)The trainee practitioners provided effective and safe inhalation sedation. This challenges the current French restriction of the 50% nitrous oxide in oxygen premix to the hospital setting. Further emphasis is required on the teaching of behaviour management skills for patients with intellectual disability.In September 2002, four French dental faculties (Clermont-Ferrand, Marseille, Nancy and Strasbourg) set up the first one-year collaborative training course in conscious sedation for dental care. The course objectives were the acquisition of the knowledge, skills and attitudes necessary for the practice of all techniques of conscious sedation relevant to dentistry. This course was evaluated over the first two years in order to validate a minimum training requirement for dentists to ensure safe and effective conscious sedation. Reservations expressed by non-dental professionals, including anaesthetists, could then be addressed [1]. Harmonisation of practices and dental training between European countries could also be improved, as conscious sedation techniques (in particular inhalation and intravenous sedation) have been declared to be