Clinical Research Directory

Inclusion Criteria: * Children aged between 4 to 8 years old. * Dental anxiety confirmed by a baseline Frankl Behavior Rating Scale score of 1 (Definitely Negative) or 2 (Negative) during initial examination. * Healthy pediatric patients categorized under American Society of Anesthesiologists (ASA) class I or II physical status. * Confirmed patent nasal airway without active congestion, and verified compliance with standard ASA NPO (fasting) rules. * Planned dental interventions requiring local anesthesia confined to a maximum of two quadrants (e.g., pulpotomies, pulpectomies, stainless steel crowns, or uncomplicated primary extractions). * Expected operational duration spanning 20 to 30 minutes, with a definitive termination threshold at 45 minutes. * Provision of signed, informed written consent by a parent or legal guardian. Exclusion Criteria: * Pathological nasal airway obstructions, severely enlarged adenoids, or active upper respiratory tract infections. * Mouth breathers or patients with structural craniofacial anomalies impeding proper nasal hood adaptation * Known systemic contraindications or allergies to benzodiazepines, nitrous oxide or local anesthetic agents. * Severe tonsillar hypertrophy classified as Class 3 or Class 4 on the Brodsky Scale, introducing airway obstruction risks. * Cognitive, developmental, or psychological delays that impair standard behavioral monitoring scales.