Nitrous Oxide Administration and Monitoring for the Dental Hygienist

Date: Saturday, August 10, 2024
Time: 8 a.m. to 3 p.m.
Location: University of Maryland School of Dentistry, at 650 W. Baltimore Street, Baltimore, MD 21201
Tuition: Dental Hygienist: $445.00

4 CDE credit hours - lecture
2 CDE credit hours - hands-on

The University of Maryland School of Dentistry designated this activity for 6 Continuing Dental Education hours.

Target Audience:  Dental Hygienists
Presented by: Deborah L. Cartee, RDH, MS
Conflict of Interest: Ms. Cartee has nothing to disclose. 



Register Here

Speaker Biography

Dr. Deb CarteeDeborah L. Cartee, RDH, MS, is a clinical associate professor, Dean’s Faculty at the University of Maryland School of Dentistry (UMSOD). She earned her MS in management (Health Care Administration Track) at the University of Maryland, University College, BS degree in dental hygiene at UMSOD, and AA degree in dental hygiene at Baltimore City Community College. She has extensive clinical experience and has been teaching full-time for the last 29 years.

Ms. Cartee was the course coordinator at the UMSOD for numerous entry-level didactic courses.

Ms. Cartee has also mentored degree-completion students at UMSOD, resulting in publications in the Journal of Dental Hygiene, Dimensions of Dental Hygiene, and Access magazine. Her scholarly effort includes presenting scientific posters at the American Dental Hygienists’ Association (ADHA) and the American Dental Educators Association (ADEA) annual sessions and has been a Principal Investigator and Co-Investigator on numerous grant-supported research projects. She was awarded Teacher of the Year by the Dental Hygiene Program’s junior class in 2010, 2011, 2012, 2014, 2015, and 2018.

She is a current member of the Maryland State Board of Dental Examiners. She is a past president and legislative chair of the Maryland Dental Hygienists’ Association (MDHA). As Legislative Chair, she has constructed bills, lobbied, and provided expert testimony leading to the successful passage of legislation changing the dental hygiene scope of practice to include the administration of local anesthesia and nitrous oxide by dental hygienists in Maryland, and allowing dental hygienists to provide direct access of dental assessments and treatment to special needs patients.

In 2012, she was awarded the MDHA Symbol of Excellence Award.  She is an examiner on the Commission of Dental Competency. Ms. Cartee was appointed by Governor Larry Hogan to serve on the Maryland Commission for Women, where she chaired the Achievement and Recognition (ARC) Committee.

Her career goal has been mentoring and empowering students to be independent future leaders in dentistry and healthcare.

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 conscious 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 emergencies of inhalation sedation.

Attendees will also participate in a two-hour practical demonstration and proficiency testing where they will administer and monitor nitrous oxide. Coursework 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

Course Requirements


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

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 the registration fee and submitted documentation, the participant will be emailed specific course information.

Participation (Hands-On) Course Guidelines:

  • Course attendees are required to wear personal protective equipment (PPE) and clinical attire during hands-on activities. Participants need to bring their own N95 mask, face shield, head covering, land ab coats to the course and must be used as required.
  • In the event that the course includes the use/handling of human tissue, it is UMSOD CE’s understanding that all participants are current with Hepatitis B vaccinations.
  • All course participants must wear long pants (to the ankle).
  • If the course includes drilling or grinding, protective eyewear and face masks are required and must be worn during the duration of that specific activity.
  • Gloves must not be worn when using the model trimmers or dental lathes.
  • Medium to long hair must be pinned or tied back for safety reasons.
  • Dangling jewelry should be removed prior to performing any hands-on activity.
  • No hats, shorts, or open-toed shoes are allowed in the Simulation Lab or any clinical or research area during the course.
  • We request that cell phones be turned to silent or vibrate during the course, so as to not distract others in the learning environment.

Cancellation and Refund Policies