Nitrous Oxide Administration and Monitoring for the Dental Hygienist

hands on continuing educaitonSaturday, September 8, 2018; January 26, 2019 and May 4, 2019 from 8 a.m. until 3 p.m. at the University of Maryland School of Dentistry

Presented by: Deborah Cartee, RDH, MS

Speaker Biography:

New PhotoMs. Deborah L. Cartee, RDH, MS, Clinical Associate Professor, Division Chief, Admissions Director, and Junior Clinical Coordinator in the Dental Hygiene Program at the University of Maryland School of Dentistry (UMSOD). She is also the Chair of the UMSOD Faculty Assembly, and member of the University of Maryland Faculty Senate, and UMSOD Judicial Committee.  She earned her M.S. in Management (Health Care Administration Track) at the University of Maryland, University College (UMUC), B.S. degree in dental hygiene at UMSOD, and an A. A. degree in dental hygiene at Baltimore City Community College (BCCC). Ms. Cartee has nearly 40 years of clinical experience, and has been teaching full-time for the last 16 years. She has been the course coordinator for numerous didactic courses including: Prevention and Control of Oral Disease I, II, Fundamentals of General Pathology, Oral Radiology, Dental Materials, Oral Histology & Embryology, Head and Neck Anatomy, Ethics, Introduction to Oral Health Research and Co-Director of Dental Pain Management and Sedation. She was awarded Teacher of The Year by the Junior Class: 2010, 2011, 2012, 2014 2015, and 2018.

Ms. Cartee is the course director for Nitrous Oxide Administration and Monitoring by the Dental Hygienist, and she teaches the laboratory component of the Local Anesthesia for Dental Hygienists CEU.

Along with entry-level teaching, she also mentors degree completion students at UMSOD, resulting in publications in the Journal of Dental Hygiene, Dimensions of Dental Hygiene and Access. In addition, her scholarly work includes presenting scientific posters at the American Dental Hygienists’ Association (ADHA) and the American Dental Educators Association (ADEA) annual sessions; and the following grant supported research projects:

2009-2010 Dental Sealant Demonstration Project

2010-2011 Oral Health Survey of Maryland

2013-2014 A multi-centered clinical trial, single blind, split mouth study concerning the efficacy of numerous periodontal treatments including laser therapy

2015-16 Oral Health Survey of Maryland

Ms. Cartee is an active member of the American Dental Hygienists' Association (ADHA). On the national level, she has served as the Maryland State Educators' Network Representative, Teller for ADHA, Continuing Education Peer Review Panel, Maryland Delegate, District III Reference Committee Chair and national graduate poster judge for ADHA. Her past state and local leadership roles have included: component and State President, legislative chair, and Student American Dental Hygienists' Association (SADHA) advisor. She was awarded the Maryland Dental Hygienists' Association "Symbol of Excellence" award in 2012. Additional memberships include ADEA, Sigma Phi Alpha and Phi Kappa Phi Honor Societies.

As MDHA legislative chair, Ms. Cartee constructed bills, lobbied, and provided written and verbal testimony in Annapolis leading to successful passage of legislation influencing the dental hygiene scope of practice in Maryland; including, allowing dental hygienists to administer local anesthesia and nitrous oxide, providing dental health screenings at health fairs without dental supervision and providing direct access to patients in long term care facilities. Ms. Cartee was appointed by Governor Larry Hogan in 2012 to serve on the Maryland Commission for Women.  Her career goal has been empowering women to be independent future leaders.


  • Teacher of the Year, University of Maryland, Junior Dental Hygiene Class of 2011, 2012, 2014, 2015, 2016, and 2019
  • 2012 MDHA Symbol of Excellence Award
  • Commissioner; Maryland Commission for Women
  • Senator, University of Maryland, Baltimore
  • Chair, UMSOD Faculty Assembly
  • Division Chief, UMSOD Dental Hygiene Division
  • Dental Hygiene Admissions Director, UMSOD
  • Dental Hygiene Junior Clinic Coordinator, UMSOD
  • UMSOD Judicial Committee
  • ADHA Maryland State Educators Network Representative
  • SADHA and Faculty Advisor, UMSOD Chapter
  • Treasurer, UMSOD Faculty Assembly
  • Chair, UMSOD Faculty Affairs Committee
  • UMSOD Faculty Council
  • UMSOD Dental Hygiene Progression Committee
  • UMSOD Scholarship Committee
  • Co-Chair UMB Outreach Council
  • Delegate Chair, ADHA
  • Judge, Graduate Posters, ADHA
  • Delegate, MDHA
  • Past President, MDHA (2010-2011)
  • Legislative Chair, MDHA
  • Past President, Western Shore Dental Hygienists' Association
  • Expert Witness, Nitrous Oxide Legislation
  • Course Director: CEU Nitrous Oxide Administration for the RDH
  • Laboratory Instructor: CEU Local Anesthesia for the RDH
  • Mission of Mercy Project Volunteer 2011 Western MD, 2012 Southern MD, 2013 Eastern Shore, 2016 Baltimore, 2017 Eastern Shore
  • Remote Area Medical Project Volunteer 2017 Baltimore
  • International Dental Mission for the 20th Anniversary Operation Smile Vietnam, 2009 Volunteer
  • Membership: Quill and Scroll Society, Sigma Phi Alpha, Phi Theta Kappa, American Dental Education Association (ADEA), American Dental Hygienists' Association (ADHA)


DHYG 311: Prevention and Control I

DHYG 321: Prevention and Control II

DHYG 312H: Oral Histology and Embryology

DHYG 324: Methods and Materials in Dentistry

DHYG 316: Oral Radiology I

DHYG 425: Issues in Healthcare Delivery

DHYG 416: Introduction to Oral Health Research

CEU: Nitrous Oxide Administration and Monitoring for the Dental Hygienist-Director

Local Anesthesia Administration for the Dental Hygienist-Laboratory

DHYG 411 & DHYF 421 Clinical Instructor

Course Description:

The Maryland State Board of Dental Examiners (MSBDE) adopted rules and regulations which allow properly-trained registered dental hygienists to monitor and administer nitrous oxide sedation during dental related procedures. This course fulfills MSBDE educational requirements for registered dental hygienists.

The first portion of this course will consist of four hours of lecture, followed by a written examination. The course will include the history, physiological and pharmacologic effects of nitrous oxide sedation; definitions and descriptions of the physiological and psychological aspects of pain and anxiety;  concepts and management of pain and anxiety; indications and contraindications; anatomy and physiology of respiration; medical assessment of a patient prior to administration of nitrous oxide; armamentarium and equipment; moderate sedation, deep sedation and general anesthesia versus nitrous oxide at anxiolytic levels pharmacological and physiological effects of nitrous oxide, including drug interactions; a description of the distinction between consious and unconscious state; monitoring and evaluating a patient to whom nitrous oxide has been administered; chart documentation; occupations exposure and toxicity; preventing, recognizing and managing possible complications and medical emergcncies of inhalation sedation.

Attendees will also participate in a two-hour practical demonstration and proficiency testing where they will administer and monitor nitrous oxide. Course work includes readings and a homework assignment. Course participants must pass the written and proficiency examination with a 75 or greater. THis course prepares the participant to successfully pass the CDCA written nitrous oxide examination for certification by the Maryland State Board of Dental Examiners.

Course Objectives:

Upon completion of this course, the participants should be able to:

  • Recognize patient indications for nitrous oxide sedation 
  • Describe the basic physiology of the human respiratory system 
  • Describe the pharmacological effects of oxygen and nitrous oxide, including drug interactions
  • Assess and manage pain and anxiety
  • Assess a patient prior to administration of nitrous oxide
  • Describe the stages of anesthesia, and the planes of analgesia, including signs and symptoms of each
  • Identify specific clinical symptoms associated with each of the planes of analgesia while administering and monitoring nitrous oxide
  • List the steps in administering nitrous oxide sedation
  • Calculate the total liters of flow per minute
  • Recognize and manage complications and medical emergencies
  • Properly record chart entries including administration of nitrous oxide sedation
  • List health hazards associated with nitrous oxide toxicity


  • Dental Hygienist: $425

CDE Credits:

  • 6 CDE credit hours - lecture / hands-on

Required Texts:
Clark, Morris S.; Brunick, Ann L.; "Handbook of Nitrous Oxide and Oxygen Sedation" fourth edition


  • Dental Hygienists
Register here

Participants will be obligated to participate as a clinical patient. If you are pregnant, medically compromised or are otherwise unable or unwilling to be a patient, you must contact UMSOD prior to the course to discuss accommodations. If you are unable or unwilling to participate as a patient, you will be asked to provide a patient for the clinical portion of this course.

Failure to successfully complete all course requirements and competencies voids certification and course refund. There is no credit for partial completion of this course. The full course fee and updated documents will be required upon registration for a future course. UMSOD reserves the right to cancel the course up to one week before the course date. Upon receipt of registration fee and submitted documentation, the participant will be emailed specific course information.