Inhalation sedation has a long history of usage due to the many advantages of nitrous oxide versus other forms such as oral or intravenous sedation. Nitrous oxide is widely used in dentistry for over a century and it is considered as the most versatile and safe method of dental sedation. It has very few side effects and it can be used by most of the patients to manage dental anxiety and pain.
Because of its specific pharmacokinetic properties, nitrous oxide can offer significant benefits to the anxiety patient and it also has several advantages over other dental sedation methods. Advantages of nitrous oxide include:
Nitrous oxide sedation is very effective for mild to moderate anxiety. The basic advantage of nitrous oxide sedation is that it can help transform patients with dental anxiety into relaxed and fully co-operative patients by relieving the stress, fear and anxiety associated with dental visits. The fact that many patients have little or no memory of their dental treatment under sedation reduces the fear for the next appointments.
Nitrous oxide does not only reduces anxiety, but it also has analgesic properties by increasing the patient’s threshold of pain. Although it offers only mild pain control, this can be enough for simple not invasive procedures, reducing the need for additional local anesthesia. Its pain relieving action can help people who have difficulty getting numb.
Nitrous oxide provides light sedation, meaning that the patient remains conscious being able to communicate with the dentist and respond to instructions, and the protective reflexes are maintained.
If during a regular dental visit, your dentist finds out that you need a treatment for which you will be more comfortable when sedated, you will need to schedule a next appointment if any other sedation method t han nitrous oxide is used. For oral sedation you must have taken a pill prior to the appointment and with iv sedation you have to be escorted by someone to drive you home after the treatment. With inhalation dentistry you do not need any prior arrangements; you can be sedated immediately.
It is fast acting with its anti-anxiety and pain killing effect felt within 2-3 minutes. All the dentist has to do is to place a mask over your nose, administer the nitrous oxide and you will be relaxed in seconds.
Patients with fear of needles will appreciate the fact that no shots are required for inhalation sedation. For simple treatments you may not need shots for local anesthesia either. But even if you need, you will be so relaxed by the nitrous oxide that you will not care about getting a shot.
The depth of inhalation sedation can be adjusted easily and precisely at any time by regulating the nitrous oxide percentage in the N2O /oxygen mixture. The ability to adjust the sedation level to the exact amount needed to provide patient’s comfort and safety is the main advantage of nitrous oxide versus other types of conscious dental sedation. In oral sedation dentistry the sedative can only be provided in set dosages. With nitrous oxide the gas can be provided incrementally allowing the dentist to observe patient response and determine the appropriate sedation for achieving an optimal level of relaxation for the patient.
With oral sedation, which can also be used for light conscious sedation, the length of treatment is predetermined by the amount of sedative given to the patient before the procedure (because the effects of pills or intravenous drugs last for a specific time span). Nitrous oxide has the advantage that the patient can remain sedated for exactly as long the dentist needs to complete the procedure just by maintaining the flow of N2O.
Nitrous oxide usage in sedation dentistry has a proven safety record with very limited side effects. The fact that sedation is quickly reversible by just stopping the administration of the gas reduces significantly the risks in combination with proper equipment, patient monitoring and a properly trained dentist.
Recovery time after the flow of nitrous oxide is discontinued is short. You will be given 100% oxygen for 3-5 minutes which is usually enough for full recovery. Within this period 99% of nitrous oxide is expelled from the lungs and its action disappears without after effects such as a ‘hangover’ effect that is common after taking oral sedatives. You can return to normal activities immediately after.
Another benefit of nitrous oxide sedation is that you do not need someone to escort you to and from the dental office. In a few minutes after the procedure, as soon as the dentist has confirmed that you have fully recovered from the inhalation sedation, you can drive home at your own.
Nitrous oxide can cover the sedation needs of most patients with dental anxiety either adults or children. It provides an alternative for medically compromised patients suffering from conditions such as cardiovascular disease, bleeding disorders , liver and kidney disorders who are not suitable candidates for iv sedation and general anesthesia.
The cost of inhalation sedation is slightly lower than oral sedation, and significantly lower compared to iv sedation and dental general anesthesia. Due to its low cost, nitrous oxide is the most accessible type of dental sedation, preferred by patients who need help to fight their dental anxiety but they can not afford intravenous sedation or general anesthesia.
Having a relaxed patient helps the dentist to make more efficient use of time. Complex treatments can be completed in a smaller number of appointments or even in a single dental visit.
A patient who does not have to worry about anxiety and pain during the dental visit can build a more positive view about the dentist and dental treatments. For this reason nitrous oxide sedation can lead to a much better dental health for the patient.
Nitrous oxide can provide only mild pain control. It is not a substitute for local dental anesthesia during invasive dental surgery.
Increased dosage of nitrous oxide may cause nausea or vomiting if you have a full stomach.
It can only offer light to moderate sedation. This may not be enough for extremely phobic patients who need a deeper level of sedation. It is also not suitable for claustrophobic patients who may not feel comfortably with the mask covering their nose. Nitrous oxide can provide adequate comfort for most of the patients, but it can not be compared with the level of comfort of deep sedation.
Some people will not achieve adequate sedation with permissible levels of oxygen.
Nitrous oxide can not help for post-treatment pain control. Its pain relieving action is lost just a few minutes after the administration of the gas is stopped.
Because of its euphoric effect (it is not called laughing gas for no reason) you may want to avoid nitrous oxide if you are too much afraid of getting embarrassed. The several videos in the web have proven that you may do or say some silly things when sedated.
Inhalation sedation is not indicated for people with respiratory problems (asthma or emphysema) or difficulty breathing in through the nose. Patients with a cold are better to avoid inhalation sedation until they can breath normally. Learn more about nitrous oxide sedation contraindications.