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Your guide to nitrous oxide/oxygen sedation

  • What is nitrous oxide?

    Nitrous oxide is an odorless and colorless gas. In the early 1800s a British scientist found that inhaling nitrous produces highly pleasurable sensations. New York dentist Horace Wells learned in 1844 that nitrous could distract patients from acute pain such as the type associated with tooth extraction. Dentistry has relied upon nitrous oxide ever since then, but the techniques, type of gas mixture and delivery methods have been greatly improved.

  • What is nitrous oxide/oxygen sedation?

    Undiluted nitrous oxide - as it was used in the nineteenth century - can cause hypoxia. Hypoxia occurs when the body is deprived of an adequate oxygen supply, leading to dizziness and other problems. Fortunately scientists have found that combining nitrous oxide with oxygen all but eliminates the danger of hypoxia. This mixture is now used to calm many millions of anxious patients annually, all around the world. Nitrous oxide and oxygen sedation is used not only in dental offices but in hospitals and outpatient and inpatient settings.

  • What is the effect of this type of sedation?

    Sedation encourages a state of relaxation. It ranges along a spectrum from minimal on one end to general anesthesia on the other (this generally applies to surgery patients in a hospital setting). During minimal sedation patients can still hear, see and respond to the action taking place around them. Sedated patients are much less likely to experience anxiety as a result of these environmental stimuli.

    Nitrous oxide and oxygen sedation falls within the mildest category of sedation. Patients may feel tingling or a sense of well-being. However they remain alert. Once inhalation is discontinued the effects end also, often within seconds.

  • What is laughing gas?

    Laughing gas refers to nitrous oxide and oxygen sedation. When scientists first studied the effects of nitrous oxide they noticed that users felt so giddy or ecstatic while breathing the gas that they often laughed or giggled. Nitrous oxide and oxygen sedation is still known by the term laughing gas in many parts of the world.
  • How is nitrous oxide and oxygen sedation given to patients?

    Nitrous oxide and oxygen gases are stored in canisters and delivered to patients via a tube and small mask. A flowmeter regulates the amount of nitrous oxide and oxygen delivered. This simple and straightforward system is easy for the dentist and dental staff to operate and maintain.

  • Is nitrous oxide and oxygen sedation safe?

    Because nitrous oxide and oxygen sedation has become a mainstay of medical and dental practice, researchers have been able to study it across many decades. They know how nitrous oxide and oxygen sedation affects very young patients, pregnant women and the elderly. They have documented reactions that occur between nitrous and the medications millions of people take every day. This careful research has revealed that nitrous oxide and oxygen sedation is extremely safe for the vast majority of people.

    Among the most famous studies is that conducted by Dr. Gardner Colton of New York's Columbia University. Colton documented more than 193,000 cases without a fatality. The work of Dr. Niels Bjorn was even more striking. He followed over 4 million cases, again without finding a single death.

    Nitrous oxide and oxygen sedation carries few if any side effects and produces no known allergic response. For these reasons it makes a nearly ideal form of anxiety relief in the contemporary dental office.

  • Which patients are appropriate for nitrous oxide and oxygen sedation?

    Patients ranging from the very young to the elderly have been safely treated with nitrous oxide and oxygen sedation.
    Who is not a good candidate for nitrous oxide and oxygen sedation?

    Women in their first trimester of pregnancy are not good candidates for nitrous oxide and oxygen sedation. Patients with emphysema or those who have recently undergone ear surgery should also avoid nitrous.

  • Are there any side effects?

    While rare, side effects have been linked to the use of nitrous oxide and oxygen sedation. These most often include nausea and vomiting, and result because too much nitrous oxide has been used. Several studies confirm the lack of side effects for children-- fewer than 1 percent were reported, and most were symptoms of nausea and vomiting. Side effects are quickly reversed with the elimination of nitrous and the addition of pure oxygen gas.

  • Can nitrous oxide and oxygen sedation be used for any type of pain relief?

    Nitrous oxide and oxygen sedation is an analgesic, which means it relieves pain and anxiety. However, it is a very weak anesthetic (numbing agent). That means it would not be effective at blocking pain over long periods of time, such as the hours necessary to complete a typical surgical procedure.

  • Does my dentist or the office staff need special training?

    Your dentist and the dental office staff do need special training to administer nitrous oxide and oxygen sedation. Depending on the state or province you live in they also require a permit to provide this service. You should never hesitate to ask the dentist or staff member if you have any questions about techniques, side effects equipment or training.

  • How do I know whether the equipment is functioning properly?

    The flowmeter ensures that patients receive the right mixture of nitrous oxide and oxygen gas. (This percentage will range according to your specific needs and situation.) The flowmeter contains a safeguard which actually prevents the delivery of unsafe levels. Some states and provinces require that this equipment be certified either annually or biannually.

  • Is exposure to excessive nitrous oxide dangerous?

    Studies around the world have assessed the dangers of exposure to nitrous oxide in the dental setting. These have generally concluded that the amount of gas a patient receives during treatment is too small to be hazardous.

    Research is less conclusive regarding the exposure of dental staff to nitrous oxide gas. And government regulations urge precautions be used to reduce the levels of unscavenged gas staff experience. For this reason you may be asked to wear a small plastic mask as well as minimize how much you talk. If this happens be assured your dental team is simply following current best practices about how to create the safest possible environment for all.

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