Economic Impact of Nitrous Oxide Sedation in Pediatric Dental Care: A Cross-Sectional Survey in Baghdad

Background: Dental anxiety and uncooperative behavior among pediatric patients can reduce the delivery of preventive dental care. Nitrous oxide (N₂O) sedation is recognized as an effective behavior management tool; however, its unavailability in public healthcare centers in Iraq makes families seeking the service in private clinics, increasing the overall treatment cost. Objective: To assess the economic impact of nitrous oxide sedation on dental treatment costs. Methods: A cross‐sectional survey conducted between January and February 2025 among private dental clinics in Baghdad specified via social media. Out of 45 clinics contacted, 38 participated. Clinics provided self- reported data on the base costs for (fissure sealant, tooth extraction, filling, and pulpotomy) and the additional fee for administering N₂O sedation. The economic burden of sedation was calculated as the cost increase ratio using the formula: (Cost Increase Ratio=N₂O Sedation Cost/Base Procedure Cost). Descriptive statistics (mean, SD), inferential statistics (One Way ANOVA) were used for analysis with SPSS. Results: Mean base procedure costs varied significantly, with tooth extractions averaging 32,370 Iraqi Dinar (ID) and pulpotomies 59,870 ID. The mean cost of N₂O sedation was 101,973 ID. The tooth extraction has the highest (3.4 x), while pulpotomy has the lowest (1.7 x) cost increase ratios.Conclusions:Nitrous oxide sedation markedly inflates the costs of dental treatment in private clinics in Baghdad, potentially restricts families from seeking necessary dental care. These findings highlight the need for policy interventions to integrate sedation services into public healthcare, ensuring more equitable access to pediatric dental care.