International Journal of Paediatric Dentistry 2010; 20: 65-75Aims. First, to compare the relative effectiveness of inhalation sedation using (A) nitrous oxide and oxygen with (B) nitrous oxide, sevoflurane, and oxygen in the management of children receiving dental extractions. Secondly, to determine patient and guardian preference between the two sedation techniques. Materials and methods. A randomized, controlled, double-blinded, cross-over, pilot clinical trial was undertaken. Thirty patients aged 6-15 years, ASA category I or II, who required two identical dental extractions with inhalation sedation were recruited. At the first session, patients were randomly allocated to receiving treatment with sedation Method A or B. At the second session, the alternative sedation protocol was employed. Results. Overall, 80% of patients successfully completed treatment at both appointments. There was no statistically significant difference between either the success rate of the two methods or in guardian preference between the two modes of sedation. There was a statistically significant difference in patient preference in favour of Method B. Conclusions. The results from this pilot study would suggest no increased benefit, in terms of treatment completion, from the additional use of sevoflurane in combination with nitrous oxide and oxygen. There was, however, a small but significant patient preference in favour of nitrous oxide with sevoflurane and oxygen.