Nitrous Gas ( laughing gas ) & Oral Sedation
For many patients, dental visits can be very stressful. For this reason, many avoid going to the dentist and consequently do not get the proper dental care necessary to maintain a healthy mouth. Our office offers nitrous gas (laughing gas) to take the edge off the anxiety some patients experience. Likewise, a sedative pill may be taken in advance to make your dental visit easier.
Nitrous Oxide is a sweet-smelling, non-irritating, colorless gas that you can breathe.
Nitrous Oxide has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe, the patient receives 50-70% oxygen with no less than 30% nitrous oxide.
The patient is able to breathe on their own and remains in control of all bodily functions.
The patient may experience mild amnesia and may fall asleep, not remembering all of what happened during their appointment.
Nitrous gas is a very safe and effective gas that works well for 75% of patients. The effect is felt in a few minutes and can be adjusted to comfortable levels throughout the treatment. The most common side effect is nausea, which is seen in 1% of patients and can be resolved by adjusting the level of the gas.
There are many advantages to using Nitrous Oxide
- The depth of sedation can be altered at any time to increase or decrease sedation.
- There is no after effect such as a “hangover”.
- Inhalation sedation is safe with no side effects on your heart and lungs, etc.
- Inhalation sedation is very effective in minimizing gagging.
- It works rapidly as it reaches the brain within 20 seconds. In as little as 2-3 minutes its relaxation and pain killing properties develop.
- The recovery is 100% within five minutes after the gas is stopped, and 100% oxygen is given.
- Patients do not need to bring a companion or driver.
You may want to ask your dentist for a “5-minute trial” to see how you feel with this type of sedation method before proceeding.
Do you experience high levels of anxiety when visiting the dentist? You may be a candidate for Sedation Dentistry.
Advantages to patients include:
- Treatment is completed when you are in a more relaxed mood.
- You will have less difficulty sitting through a lengthy procedure.
- Multiple treatments and full mouth restorations can occur at during the same visit.
- Less discomfort after treatment.
The most commonly prescribed dental related drugs that treat anxiety belong to the “benzodiazepine” family. Drugs such as Valium, Halcion, Xanax, or Ativan. These drugs decrease anxiety by binding and toning down activity within “fear” receptors in the brain.
There are two different types of Benzodiazepines:
- Sedative-Hypnotics: These drugs induce calm, including drowsiness and even sleep. This sleep state is actually a form of hypnosis which is a form of physiological sleep.
- Anti-Anxiety Drugs: These are drugs which relieve anxiety and induce a state of calm and relaxation.
While benzodiazepines act as sedatives AND anti-anxiety drugs, some are highly targeted at areas within the brain which focus on sleep. Others act in a more specific way and target fear centers in the brain. In most cases, higher doses act as sedatives and induce sleep, while in lower doses, they reduce anxiety without sedation.
Benzodiazepines are also Central Nervous System (CNS) depressants (i.e. there can be a decline in blood pressure and breathing). It is important to note that they shouldn’t be mixed with other CNS depressants such as alcohol. Its important that you utilize the dose your dentist or doctor recommends. It is possible to overdose, and overdoses could lower your breathing to dangerously low levels, which could result in coma or death.
Please note that you shouldn’t travel on your own after you’ve taken any of these drugs. Make sure you have an escort, even if you traveled by bus or foot! It’s easy to become disorientated.
When not to take benzodiazepines:
Some of these drugs can affect your liver and heart. It’s important to check with your practitioner and/or pharmacist. You should be sure to inform your doctor or dentist if any of the following apply: known allergy to the drug, narrow-angle glaucoma, pregnancy, severe respiratory disease (COPD), congestive heart failure (CHF), impaired kidney or liver function, depression/bipolar disorder/psychoses, chronic bronchitis and some other conditions. It’s also important to let us know if you are taking other medications. There could be possible drug interactions.
When oral sedation is given, the effect is slow, and long, lasting for a few hours after the appointment. Therefore, the patient MUST have a driver or a companion. The medication may make the patient drowsy for a few hours.
Medical history and expectations must be evaluated prior to the administration of nitrous gas or a prescription for sedative medication.