Purpose The American Academy of Pediatric Dentistry (AAPD) recog-

nizes nitrous oxide/oxygen inhalation as a safe and effective technique to reduce anxiety, produce analgesia, and enhance effective communication between a patient and health care provider. The need to diagnose and treat, as well as the safety of the patient and practitioner, should be considered before using nitrous oxide. By producing this guideline, the AAPD intends to assist the dental profession in developing appro-priate practices in the use of nitrous oxide/oxygen analgesia/ anxiolysis for pediatric patients. Methods This document is an update of the previous guideline revised in 2009. The revision is based on a review of the current dental and medical literature related to nitrous oxide use. An elec-tronic search was conducted using PubMed ® with the follow-ing parameters: Terms “nitrous oxide”, “analgesia”, “anxiolysis”