{"id":"https://openalex.org/W7201849802","doi":"https://doi.org/10.1038/s41415-026-9882-5","title":"The environmental impact of free-flow versus on-demand gas release for dental inhalation sedation","display_name":"The environmental impact of free-flow versus on-demand gas release for dental inhalation sedation","publication_year":2026,"publication_date":"2026-08-07","ids":{"openalex":"https://openalex.org/W7201849802","doi":"https://doi.org/10.1038/s41415-026-9882-5","pmid":"https://pubmed.ncbi.nlm.nih.gov/42567911"},"language":"en","primary_location":{"id":"doi:10.1038/s41415-026-9882-5","doi":"https://doi.org/10.1038/s41415-026-9882-5","is_oa":true,"landing_page_url":"https://doi.org/10.1038/s41415-026-9882-5","pdf_url":"https://www.nature.com/articles/s41415-026-9882-5.pdf","source":{"id":"https://openalex.org/S176204532","display_name":"BDJ","issn_l":"0007-0610","issn":["0007-0610","1476-5373"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"British Dental Journal","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://www.nature.com/articles/s41415-026-9882-5.pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5087408350","display_name":"Alexandra Lyne","orcid":"https://orcid.org/0000-0001-6559-7408","observed_orcids":["https://orcid.org/0000-0001-6559-7408"]},"institutions":[{"id":"https://openalex.org/I4210157535","display_name":"Eastman Dental Hospital","ror":"https://ror.org/055jskg35","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I1340918713","https://openalex.org/I4210157535"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"Alexandra Lyne","raw_affiliation_strings":["Paediatric Dentistry, Eastman Dental Institute, Rockefeller, 21 University Street, London, WC1E 6DE, UK; Royal National ENT and Eastman Dental Hospitals, Department of Paediatric Dentistry, 250 Euston Road, London, NW1 2PG, United Kingdom. alexandra.lyne@nhs.net"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Paediatric Dentistry, Eastman Dental Institute, Rockefeller, 21 University Street, London, WC1E 6DE, UK; Royal National ENT and Eastman Dental Hospitals, Department of Paediatric Dentistry, 250 Euston Road, London, NW1 2PG, United Kingdom. alexandra.lyne@nhs.net","institution_ids":["https://openalex.org/I4210157535"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5145978173","display_name":"Lyndsay Muirhead","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210157535","display_name":"Eastman Dental Hospital","ror":"https://ror.org/055jskg35","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I1340918713","https://openalex.org/I4210157535"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Lyndsay Muirhead","raw_affiliation_strings":["Royal National ENT and Eastman Dental Hospitals, Department of Paediatric Dentistry, 250 Euston Road, London, NW1 2PG, United Kingdom"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Royal National ENT and Eastman Dental Hospitals, Department of Paediatric Dentistry, 250 Euston Road, London, NW1 2PG, United Kingdom","institution_ids":["https://openalex.org/I4210157535"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5031565020","display_name":"Katherine Angus","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Katherine Angus","raw_affiliation_strings":["UCLPartners, Hale House, 76-78 Portland Place, London, W1B 1NT, United Kingdom"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"UCLPartners, Hale House, 76-78 Portland Place, London, W1B 1NT, United Kingdom","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5145971321","display_name":"Laxmi Ale-Gurung","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210157535","display_name":"Eastman Dental Hospital","ror":"https://ror.org/055jskg35","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I1340918713","https://openalex.org/I4210157535"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Laxmi Ale-Gurung","raw_affiliation_strings":["Royal National ENT and Eastman Dental Hospitals, Department of Paediatric Dentistry, 250 Euston Road, London, NW1 2PG, United Kingdom"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Royal National ENT and Eastman Dental Hospitals, Department of Paediatric Dentistry, 250 Euston Road, London, NW1 2PG, United Kingdom","institution_ids":["https://openalex.org/I4210157535"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5087408350"],"corresponding_institution_ids":["https://openalex.org/I4210157535"],"apc_list":{"value":5190,"currency":"USD","value_usd":5190},"apc_paid":{"value":5190,"currency":"USD","value_usd":5190},"fwci":19.0029,"has_fulltext":true,"cited_by_count":3,"citation_normalized_percentile":{"value":0.98842407,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":96,"max":97},"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10436","display_name":"Anesthesia and Sedative Agents","score":0.6991999745368958,"subfield":{"id":"https://openalex.org/subfields/2703","display_name":"Anesthesiology and Pain Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10436","display_name":"Anesthesia and Sedative Agents","score":0.6991999745368958,"subfield":{"id":"https://openalex.org/subfields/2703","display_name":"Anesthesiology and Pain Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12145","display_name":"Dental Anxiety and Anesthesia Techniques","score":0.263700008392334,"subfield":{"id":"https://openalex.org/subfields/3504","display_name":"Oral Surgery"},"field":{"id":"https://openalex.org/fields/35","display_name":"Dentistry"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12930","display_name":"Biomedical and Chemical Research","score":0.008700000122189522,"subfield":{"id":"https://openalex.org/subfields/2737","display_name":"Physiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/nitrous-oxide","display_name":"nitrous oxide","score":0.9120000004768372},{"id":"https://openalex.org/keywords/silhouette","display_name":"silhouette","score":0.4970000088214874},{"id":"https://openalex.org/keywords/environmental-impact","display_name":"environmental impact","score":0.8640000224113464},{"id":"https://openalex.org/keywords/carbon-footprint","display_name":"carbon footprint","score":0.4309999942779541},{"id":"https://openalex.org/keywords/sedation-success-rate","display_name":"sedation success rate","score":0.703000009059906}],"concepts":[{"id":"https://openalex.org/C2776814716","wikidata":"https://www.wikidata.org/wiki/Q574801","display_name":"Sedation","level":2,"score":0.8127999901771545},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6890000104904175},{"id":"https://openalex.org/C2776954882","wikidata":"https://www.wikidata.org/wiki/Q840343","display_name":"Inhalation","level":2,"score":0.6481000185012817},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.6237999796867371},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.4489000141620636},{"id":"https://openalex.org/C39300077","wikidata":"https://www.wikidata.org/wiki/Q9530","display_name":"Breathing","level":2,"score":0.412200003862381},{"id":"https://openalex.org/C2777573673","wikidata":"https://www.wikidata.org/wiki/Q905750","display_name":"Nitrous oxide","level":2,"score":0.4000000059604645},{"id":"https://openalex.org/C8213797","wikidata":"https://www.wikidata.org/wiki/Q754250","display_name":"Respiratory rate","level":4,"score":0.3589000105857849},{"id":"https://openalex.org/C148043351","wikidata":"https://www.wikidata.org/wiki/Q4456944","display_name":"Current (fluid)","level":2,"score":0.350600004196167},{"id":"https://openalex.org/C172120300","wikidata":"https://www.wikidata.org/wiki/Q1134348","display_name":"Volumetric flow rate","level":2,"score":0.31540000438690186},{"id":"https://openalex.org/C20556612","wikidata":"https://www.wikidata.org/wiki/Q4469374","display_name":"Volume (thermodynamics)","level":2,"score":0.2946000099182129},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.2937000095844269},{"id":"https://openalex.org/C2777354188","wikidata":"https://www.wikidata.org/wiki/Q5503034","display_name":"Fresh gas flow","level":3,"score":0.29190000891685486},{"id":"https://openalex.org/C2991918945","wikidata":"https://www.wikidata.org/wiki/Q12128","display_name":"Dental practice","level":2,"score":0.27239999175071716},{"id":"https://openalex.org/C3019038464","wikidata":"https://www.wikidata.org/wiki/Q1340889","display_name":"Endotracheal tube","level":3,"score":0.2526000142097473}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1038/s41415-026-9882-5","doi":"https://doi.org/10.1038/s41415-026-9882-5","is_oa":true,"landing_page_url":"https://doi.org/10.1038/s41415-026-9882-5","pdf_url":"https://www.nature.com/articles/s41415-026-9882-5.pdf","source":{"id":"https://openalex.org/S176204532","display_name":"BDJ","issn_l":"0007-0610","issn":["0007-0610","1476-5373"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"British Dental Journal","raw_type":"journal-article"},{"id":"pmid:42567911","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42567911","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"British dental journal","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1038/s41415-026-9882-5","doi":"https://doi.org/10.1038/s41415-026-9882-5","is_oa":true,"landing_page_url":"https://doi.org/10.1038/s41415-026-9882-5","pdf_url":"https://www.nature.com/articles/s41415-026-9882-5.pdf","source":{"id":"https://openalex.org/S176204532","display_name":"BDJ","issn_l":"0007-0610","issn":["0007-0610","1476-5373"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"British Dental Journal","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9537000060081482}],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320325311","display_name":"University College London Hospitals NHS Foundation Trust","ror":"https://ror.org/042fqyp44"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7201849802.pdf","grobid_xml":"https://content.openalex.org/works/W7201849802.grobid-xml"},"referenced_works_count":2,"referenced_works":["https://openalex.org/W4395955048","https://openalex.org/W7125512473"],"related_works":["https://openalex.org/W2014380654","https://openalex.org/W7221091383","https://openalex.org/W2046768489","https://openalex.org/W2946910133","https://openalex.org/W4301519656","https://openalex.org/W251385569","https://openalex.org/W66266208","https://openalex.org/W1583848961","https://openalex.org/W4300466720","https://openalex.org/W3144105170"],"abstract_inverted_index":{"Aim":[0],"To":[1],"evaluate":[2],"three":[3,36],"clinical":[4,37,139],"techniques":[5,38,86,158],"(current":[6],"practice,":[7],"Silhouette":[8,83],"with":[9,141],"a":[10,42,131,146],"flow":[11,132],"rate":[12,111,133,167],"protocol,":[13],"and":[14,67,84,101,117,119,156,159],"eAdvantage)":[15],"for":[16,114,121,126],"inhalation":[17,74,127],"sedation.":[18],"Methods":[19],"This":[20,150],"study":[21],"was":[22,112],"conducted":[23],"at":[24],"the":[25,49,79,91,138,142],"Eastman":[26],"Dental":[27],"Hospital":[28],"(London,":[29],"UK)":[30],"using":[31],"quality":[32],"improvement":[33],"methodology.":[34],"The":[35,109],"were":[39,46,76],"used":[40,58,97],"over":[41],"six-week":[43],"period.":[44,81],"Data":[45],"collected":[47],"on":[48,130],"volume":[50,92],"of":[51,73,93,148],"nitrous":[52],"oxide":[53],"(N":[54],"2":[55,95],"O)":[56],"gas":[57],"per":[59,98],"patient,":[60],"success":[61,110],"rate,":[62],"as":[63,65],"well":[64],"patient":[66,99,143],"staff":[68],"feedback.":[69],"Results":[70],"Ninety-eight":[71],"episodes":[72],"sedation":[75,128],"observed":[77],"during":[78],"pilot":[80],"Both":[82],"eAdvantage":[85],"demonstrated":[87],"impressive":[88],"reductions":[89],"in":[90],"N":[94],"O":[96],"(58%":[100],"70%,":[102],"respectively)":[103],"when":[104],"compared":[105],"to":[106],"current":[107,115],"practice.":[108],"97%":[113],"practice":[116,125],"eAdvantage,":[118],"86%":[120],"Silhouette.":[122],"Conclusion":[123],"Current":[124],"relies":[129],"that":[134,161],"is":[135,152],"set":[136],"by":[137],"team,":[140],"breathing":[144],"from":[145],"reservoir":[147],"gas.":[149],"technique":[151],"potentially":[153],"over-delivering":[154],"gas,":[155],"new":[157],"equipment":[160],"reduce":[162],"or":[163],"eliminate":[164],"this":[165],"free-flow":[166],"show":[168],"significant":[169],"environmental":[170],"benefits.":[171]},"counts_by_year":[{"year":2026,"cited_by_count":3}],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-08-08T00:00:00"}