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Nitrous Oxide (Laughing Gas)

Commonly known as laughing gas, nitrous oxide was first introduced it into dentistry by Dr. Horace Wells in the mid 1800s. He believed so strongly in the use of this clear, slightly sweet-scented gas, that he volunteered to be the first to demonstrate its application in dentistry while having one of his teeth extracted. Since then, nitrous oxide has become one of the most popular and safe options for relieving dental anxiety.

Nitrous oxide can reduce pain, produce pleasant feelings, and sometimes create a slight numbing sensation. Patients often begin to feel its effects after breathing the gas for as little as two to five minutes. Some people experience mild lightheadedness. Others get the giggles, giving nitrous oxide its nickname. The effects of the gas only last a short time and wear off quickly once its administration is discontinued.

The gas is safe to use for longer visits when mixed with oxygen. This combination is what is used in dental offices and contains no less than 30 percent oxygen. Depending on the concentration and length of administration, a variety of sensations may be experienced. After an initial feeling of light-headedness, a patient may experience a tingling sensation followed by warmth. They often then feel a sense of well-being, euphoria, or floating. On rare occasions the patient may feel sleepy or nauseous. These are signs that the nitrous oxide should be stopped. Patients experiencing these symptoms should simply let their dentist know or remove their nasal hood (a rubber mask placed only over the nose).

Nitrous oxide should be administered beginning at a low level and gradually increased (titrated) since tolerance to the gas varies. Bad experiences with nitrous oxide are likely due to improper administration or too high of a concentration of nitrous.

The gas is released from portable or central tanks and is delivered through a tube attached to a nasal hood placed over a patient’s nose. Medical and dental professionals receive training to appropriately adjust the flow of nitrous oxide and oxygen gases to create the desired effect. All that a patient needs to do is breathe normally.

Since the gas reaches the brain within seconds, its effect can be felt in the form of pain relief in as little as two minutes. Once administration is discontinued, it clears from the body almost as quickly. A patient can be rendered fully conscious again moments later without any side effects. Nitrous oxide has a profound effect on the nerves of the gums. It can often be used in place of local anesthesia to treat gum disease or to make injections more comfortable. Nitrous oxide is one of the safest forms of sedation available in medical science today.

If you are considering using nitrous oxide at your next dental visit, be sure to eat a small meal within four hours prior to your appointment. Larger meals can increase nausea. As with all forms of sedation, every individual responds differently, so it’s important to discuss your medical history and expectations with your dentist. Nitrous oxide may be inappropriate for medical conditions such as multiple sclerosis (MS), emphysema, and some other respiratory illnesses, but it is well tolerated by most people.