In order to get certified to give patients nitrous oxide (commonly called laughing gas), I have to administer it several times to prove my competence.
Last Friday afternoon, I was able to give a patient nitrous oxide and literally change his perception of dentistry.
He loved it. I asked him about his dental fear and he said something like, “You know when you’re in an airplane and there’s a sudden rush of unexpected turbulance, you grab onto the handles of your seat. That’s how I am at the dentist.”
On Friday though, he said he felt great. He was telling jokes in the dental chair and having a great time. He said that the nitrous oxide made him feel great, he said he felt like he was drunk.
He was a fairly young guy that had simply avoided going to the dentist and ended up with a few lost teeth and a lot of teeth in bad shape. Nitrous oxide has given him the ability to overcome his dental anxiety and sit in the chair.
Nitrous Oxide in Dentistry
As you can see in this picture above, nitrous oxide is given to a patient through a mask that is placed over the nose. In addition to nitrous oxide, we run oxygen into the mask so that the patient is always getting more oxygen than they would just by breathing in regular air.
An advantage of nitrous oxide over other forms of sedation is that it works pretty fast. Within a few minutes, the patient is relaxed. Also, when you have finished your dental procedure, the recovery is fairly rapid as well. You are able to drive home after the appointment since you don’t remain drowsy.
Is Nitrous Oxide Dangerous?
Nitrous oxide is safe when it is administered with adequate oxygen. Although side effects are fairly rare, the most common side effect of nitrous oxide is nausea.
Nitrous oxide may be harmful with long-term exposure. This doesn’t really apply to patients, it’s more for those people who work at dental offices and get exposed to it every day for years.
Regarding possible long-term negative effects of nitrous oxide, Pinkham’s Pediatric Dentistry textbook states, “Retrospective survey studies of dental office personnel who were exposed to trace levels of nitrous oxide suggest a possible association with nan increased incidence of spontaneous abortions, congenital malformations, certain cancers, liver disease, kidney disease, and neurologic disease.”
Conclusion
Nitrous oxide can help many patients overcome their dental anxiety. I have a patient with a lot of dental fear that gets nitrous oxide every time he comes in. He loves how it calms him and allows him to get his needed dental work done.
Do you have any questions or comments about nitrous oxide in dentistry? I’d love to hear what you have to say in the comments section below. Thanks for reading!
I started having problems with dental anxiety later in life after many years with no problems. For some reason, I suddenly started having extreme pain and couldn’t tolerate the simplest procedure, possibly due to the fact I live with chronic pain and take narcotics on a daily basis. My dentist initially tried using valium with me which worked but left me unable to drive. Then one day, he tried Nitrous and it was like a switch was turned off in me. I can now go though major dental work, even 2-3 root canals at a time along with 4 fillings and tolerate it well. It’s almost like I go into a deep hypnotic state and I barely remember a lot of the appointment. I’m not sure if that’s the true desired effect but I become quite sedated. I’ve had IV sedation once and honestly felt Nitrous was nearly as effective.
Nitrous oxide is a mainstay at our office and is used for both children and adults alike. With good techniques for children and adults usually nitrous only has to be given once or twice. By the third and fourth visit the patient is usually so comfortable with us that there is no longer a need for nitrous. Then you know you’ve done a great job understanding the patients fears by using your words and your techniques for painless dentistry.
can the nitrous oxide replace the local anesthetic injection? i react to adrenaline and am looking for an alternative.
Although nitrous really has helped me in the padt it was certainly not a replace,ent for the injections. I still needed the injections to block the pain of the procedures but without the nitrous I could not handle the procedures at all. With nitrous i handked the dental work fairly well up to and including minor surgery even after my teeth were all removed. Last January i had to have my gums fixed due to some weird stuff going on after the extractions. Without the nitrous i woukd have never got thru it. It was difficult as it was!
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Nitrous oxide is a mainstay at our office and is used for both children and adults alike. With good techniques for children and adults usually nitrous only has to be given once or twice
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Thank you for the great article. People who experience anxiety have to speak to their dentists about all available options to ease down the fear. Laughing gas (nitrous oxide) is a great way to reduce the anxiety. Other methods include talking to your dentist and opening up about your fears. For example, we had a patient last week who avoided visiting the dentist for 10 years. His is a heavy clencher and cant hold his mouth open for too long and he afraid of losing control during the procedure. We agreed to establish breaks when needed and with the help of laughing gas, he was happy and the procedure went smoothly and fast.
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Thank you for telling the story of how your patient who lost teeth because of dental anxiety was able to confront his fear through nitrous oxide. I know that its use can be seen as controversial since there have been cases of dentists who have abused it themselves. Hopefully, more guidelines will come into place to prevent that from happening and allow more patients like yours to get the help the need.
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I know that its use can be seen as controversial since there have been cases of dentists who have abused it themselves. Hopefully, more guidelines will come into place to prevent that from happening and allow more patients like yours to get the help the need.
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