Nitrous Oxide (Laughing Gas)

Patient anxiety has always been a major issue in dental offices. Practitioners have jumped at any potential tool that could be used to help alleviate this anxiety. Less patient anxiety leads to greater treatment acceptance. With the plethora of pharmaceutical options available these days, dentists have more choices than ever. Many of these choices require specialized training of the dentist and staff as well as specialized safety equipment (pulse oxymeter). Due to its relative safety and efficacy, nitrous oxide remains the leading anxiolytic used in dental offices today.

As previously stated, nitrous oxide is used in the dental office for its calming effects. It enables patients to better tolerate lengthy dental procedures and makes the overall experience more of a positive one. Nitrous is generally administered in a 25-50% mixture with oxygen. It is administered through a small mask that covers the patient’s nose. Some patients may feel uncomfortable having their nose covered so the dentist should closely monitor the patient for the first few minutes of use. Likewise, patients who have trouble breathing through their nose may be better off abstaining from nitrous use. Some patients only require nitrous to overcome their anxiety and fear of receiving an intraoral injection. Good communication with the patient should bring any problems to light early in the procedure.

The Benefits of Nitrous Oxide Sedation

  • Increase patient comfort and enjoyment
  • Safe and effective
  • Potential practice building tool
  • Short recovery time
  • Short duration of onset
  • Easy to administer

When a patient is receiving nitrous oxide for the first time, the dentist or assistant should explain to the patient what the experience would feel like. This discussion should include what to look for in the instance that the patient is receiving too high a dose of the gas. At a proper therapeutic dose, the patient will experience tingling in the hands and feet. They will feel a slight “floating” sensation and a general disconnectedness to what is occurring around them. At a correct therapeutic level, the experience will be very positive for most patients. Communication with the patient is instrumental in ensuring the patient is receiving the correct dose. It is generally recommended that the patient be started on 25% nitrous with the percentage being increased if the desired effect is not being achieved.

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