Acclimatisation with Inhalation Sedation in Paediatric Dentistry: A Scoping Review

Background: Acclimatisation with inhalation sedation may involve providing minimally invasive dental treatment alongside a graduated introduction to inhalation sedation, its equipment, and the wider sensory experience. These preparatory visits may help assess a child's suitability for subsequent treatment under inhalation sedation while supporting behavioural familiarisation with the sedation environment. However, the extent to which acclimatisation has been clearly characterised or formally evaluated remains uncertain. Aim: To explore and map the literature relating to acclimatisation with inhalation sedation in paediatric dentistry. Methods: A scoping review was conducted in accordance with Joanna Briggs Institute guidance and reported in line with PRISMA-ScR recommendations. MEDLINE, Embase, Cochrane Library, Scopus and Web of Science were searched alongside grey literature sources and citation searching. Reports involving staged or introductory exposure to inhalation sedation prior to definitive paediatric dental treatment and available in English were eligible for inclusion. Data were extracted and checked by both reviewers, and the findings synthesised narratively. Results: Four reports representing three distinct studies met the inclusion criteria, comprising two protocols describing the same planned trial and two completed studies involving 56 and 20 children. Terminology, interventions and outcome measures varied considerably. One study reported increased initial familiarisation time without fewer visits or shorter overall treatment, while the other found no significant between-group difference in dental anxiety. The protocol reports provided no outcome data. Conclusions: Acclimatisation with inhalation sedation has been described in clinical guidance and a limited number of reports, but remains inconsistently defined and insufficiently evaluated. Current evidence does not establish its clinical effectiveness. Clearer definitions, standardised outcome measures and adequately powered prospective studies are required.