• Robert Yanko, Valeri Klitinich, Yaron Haviv, David Gozal, Doron J Aframian, and Andra Ratman.
• Department of Oral Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
• Isr Med Assoc J. 2020 Oct 1; 22 (10): 599-601.

BackgroundSevere acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the pathogen that causes coronavirus disease-2019 (COVID-19), is thought to be transmitted via droplets and aerosols, and was detected in saliva of infected individuals. These droplets from the upper airway may infect the inhalation sedation mask and tubing. The authors determined the adequate measures needed to prevent the transmission of COVID-19 by nitrous-oxide (N2O) system during inhalation sedation in dentistry and provided evidence on mask and tubing sterilization. Additional measures to protect patients and healthcare workers from COVID-19 that may be transmitted by the inhalation sedation system are discussed. The authors recommend minimal use of a N2O system during inhalation sedation in dentistry. In case of need, the practitioners should have more than one scavenger kit and nasal masks for each N2O/O2 mixer. Biologic barriers should be mounted between the scavenger's tubing and the central evacuation system. Strict cleansing and sterilization should be performed for all parts of the N2O system. The use a disposable scavenger system and nasal mask should be considered as a viable option.

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