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What is N2O?
Nitrous oxide is a colorless, odorless to sweet-smelling inorganic gas that was first used in surgical and dental anesthesia in the mid-1800s. Today, the combination of inhaled nitrous oxide and oxygen, when used appropriately, can be a safe and effective means of managing pain and anxiety in dentistry. Referred to as “conscious sedation,” “relative analgesia,” or “nitrous oxide-oxygen sedation,” inhaled nitrous oxide-oxygen is the most used gaseous anesthetic in the world4 and a 2007 survey by the ADA estimated that 70% of dental practices using any form of sedation employed nitrous oxide-oxygen sedation.
What Does Laughing Gas (N2O) Do?
Nitrous oxide (N2O), more commonly referred to as laughing gas, is a mild sedative agent that safely and effectively manages pain and anxiety during dental treatment. The colorless and odorless nitrous oxide is mixed with oxygen and inhaled through a small mask that fits over your nose. Patients are asked to breathe normally and should feel the effects of the laughing gas within minutes.
Contrary to its name, laughing gas does not necessarily make you laugh! The nitrous oxide slows down your nervous system to make you feel less inhibited. You may feel light-headed, tingly, or even heaviness in your arms or legs. Ultimately, you should be calm and comfortable throughout the procedure. You might even giggle a time or two.
The Benefits of Laughing Gas
Dentists choose nitrous oxide because it is a safe and effective method for sedation. The laughing gas works quickly to relax patients, and the effects wear off quickly by breathing pure oxygen through a mask. Plus, the nitrous oxide does not put you to sleep, so you can hear and respond to any of the dentist's questions or instructions.
Most patients do not experience adverse reactions to laughing gas. However, they can occur if the nitrous oxide levels rise too high or if the amount being inhaled quickly changes. The California Dental Association (CDA) lists several side effects, including:
Headaches, Shivering, Excessive sweating, Nausea or Vomiting, and Sleepiness.
After the nitrous oxide is turned off, patients need to receive oxygen for at least five minutes to avoid headaches. The oxygen purges the remaining gas from the lungs while helping the patient become more alert and awake. Patients can also help prevent nausea or vomiting by eating lightly before the procedure and avoiding a big meal for up to three hours afterward. Consult your dentist on whether or not it is safe to drive post-procedure.
What is Laughing Gas Used For?
The American Academy of Pediatric Dentistry (AAPD) recommends the use of nitrous oxide for these indications:
- Patients who are fearful, anxious, or uncooperative
- Patients with special health care needs
- Patients with gag reflexes that interfere with dental care
- Patients who do not respond adequately to local anesthesia
- Younger patients who must undergo lengthy dental procedures
Nitrous Oxide for Children
Is nitrous oxide equally safe for children? The AAPD states that laughing gas is considered generally acceptable to children and can be titrated easily. Many children show enthusiasm for using the gas and report feeling a tingling or warming sensation. The laughing gas can help expedite procedures that are not particularly uncomfortable but require the child not to move for extended periods. However, some children may experience nausea or have difficulty wearing the mask. Discuss options for sedation with your child's dentist when planning dental treatment.
Who Shouldn't Use Laughing Gas?
While nitrous oxide is considered a safe and effective sedative, it might not be the right choice for you. The AAPD lists several risk factors for using laughing gas. Tell your dentist if you have any of the following conditions:
- Currently in the first trimester of pregnancy
- A history of respiratory illnesses like chronic obstructive pulmonary disease (COPD)
- A vitamin B-12 deficiency
- A history of substance abuse
- An enzyme condition methylenetetrahydrofolate reductase deficiency
- A history of mental health conditions
Laughing gas can be a useful tool for easing anxiety and pain during dental procedures. If you think you might benefit from using nitrous oxide for your next appointment or operation, talk to your dentist about available options.