Although dental visits may be a routine procedure for many, most of the patients will associate dental visits with fear and anxiety. Thankfully, the present dentistry has come up with some types of sedation to enable the patient to feel calm and comfortable during the dental process. Of the various sedation techniques, the best-known and most frequently used one is nitrous oxide, or ‘laughing gas.’ This guide will provide a clear understanding of nitrous oxide sedation in dentistry, as well as its advantages, uses, and precautionary measures based on Royal College of Dental Surgeons of Ontario (RCDSO) requirements.
What is Nitrous Oxide Sedation?
Definition and Overview
Nitrous oxide sedation is a type of conscious sedation where a patient is given a combination of nitrous oxide and oxygen gasses to help him/her to become more comfortable during dental treatments. It is interesting to know that for the patient, nitrous oxide sedation in dentistry is not accompanied by any loss of consciousness, yet the person stays quite relaxed and calm.
History and Development
A colorless, nonflammable gas, nitrous oxide was discovered by English chemist Joseph Priestley in 1773. In the 1800s, dentist Horace Wells started to use nitrous oxide as a tooth anesthesia during dental operations. Since then, nitrous oxide sedation has been deemed safe and reliable in the practice of dentistry in the modern world.
How Nitrous Oxide Sedation Works
Mechanism of Action
Nitrous oxide acts through the mechanism of sedation, which involves the suppression of the activity of nerve cells in the brain, leading to its anxiolytic effect and mild analgesic effect. This is done through a mask that is small and is placed on the nose so that the patient can continue to breathe.
Administration Process
The patient is fitted with a small mask over the nose before the dental procedure commences to prevent air loss. The dentist then increases or reduces the concentration of Nitrous oxide and Oxygen in order to get the required level of sedation. The patient is not put to sleep during the procedure and can freely talk to the dentists and nurses present.
Dosage and Duration
Nitrous oxide sedation in dentistry is used in a controlled manner and the concentration given can be increased or decreased depending on the case. It is a drug that can take effect as soon as one inhales it and wearing off can occur as soon as one stops taking the gas.
Benefits of Nitrous Oxide Sedation
Pain and Anxiety Relief
Nitrous oxide sedation, as one of the benefits, helps to reduce pain and anxiety during dental treatments. Patients who have a dental phobia or who cannot endure pain well would greatly benefit from the relaxing effects of nitrous oxide.
Quick Recovery Time
Nitrous oxide has a number of advantages compared to the other sedation techniques used and one of them is the fact that the effects can be quickly dissipated. As soon as the gas stops being used, its impact is felt for only a matter of minutes, meaning that most patients can resume their normal activities right after the procedure.
Safe for Different Age Groups
Nitrous oxide sedation in dentistry is safe for patients of different ages, for children and elderly people as well. They are also applicable for patients with some health complications, which may disallow their use of other sedation methods.
Applications of Nitrous Oxide Sedation in Dentistry
Common Dental Procedures
Nitrous oxide sedation is commonly used for a variety of dental procedures, including:
- Dental cleanings
- Fillings
- Root canals
- Extractions
- Dental implant placement
Patient Suitability
Nitrous oxide sedation is particularly applicable to fragile patients and those who have dental phobia, or low tolerance to pain, or those needing several treatment procedures. It should also not be used on patients with specific health complications, which include respiratory disorders or pregnancy conditions.
Safety and Side Effects
Potential Risks and Side Effects
Nitrous oxide is precisely safe when provided by a professional dental practitioner who commonly offers it to patients. However, some patients may experience minor side effects, such as:
- Dizziness
- Nausea
- Headache
- Tingling sensations in the hands or feet
Contraindications and Precautions
Nitrous oxide sedation may not be suitable for patients with certain medical conditions, such as:
- Respiratory issues (e.g., COPD, asthma)
- Pregnancy (first trimester)
- Vitamin B12 deficiency
- History of substance abuse
Regulatory Guidelines by RCDSO
In Ontario, the use of nitrous oxide sedation in dentistry is regulated by the RCDSO. Dentists who provide RCDSO nitrous oxide sedation must undergo some certain practice to ensure that safety of the patient is guaranteed and also the right procedure in the delivery of the gas is followed.
Patient Experience with Nitrous Oxide Sedation
What to Expect Before, During, and After the Procedure
Dental check-up shall involve pre-procedure consultation during which a patient shall explain their medical history and issues to the dentist. When undergoing the procedure, the patients will breathe freely through the small mask positioned on the nose only. Nitrous oxide does not actually cause any harm and it has a very rapid recovery time and the patient will be in a position to resume their normal activities.
Patient Testimonials
Dental patients who have been administered nitrous oxide sedation have seldom mentioned unpleasant feelings or effects, and the majority has mentioned less anxious, more comfortable and generally a more relaxed dental experience.
Comparing Nitrous Oxide Sedation with Other Sedation Methods
Oral Sedation
Oral sedation entails taking a prescribed sedative before the procedure to help calm you down during the procedure. It must be noted however that when compared to nitrous oxide sedation in dentistry, oral sedation is effective for anxiety and may have a longer recovery time.
IV Sedation
IV sedation refers to a process whereby sedative products are introduced into the patient’s body through a vein. This method is even more relaxing than nitrous oxide, but it entails more monitoring than nitrous oxide and the period of recovery is lengthy.
General Anesthesia
General anesthesia means that the patient is rendered unconscious during the various procedures which are to be carried out. It is used in operations and cases of extreme phobia of dental procedures where the patient cannot endure ordinary sedation.
Conclusion
Summary of Key Points
Nitrous oxide is the most commonly used technique for making a patient less anxious during the dental procedure. It works fast, has a short post-implementation recovery, and can be used in patients of all ages.
Importance of Consulting with a Dental Professional
The use of nitrous oxide sedation is safe but as a patient you should discuss with your dental professional if this type of sedation is suitable for you.
Frequently Asked Questions
How Quickly Does Nitrous Oxide Take Effect?
Nitrous oxide generally starts working almost immediately upon the patient inhaling it as the patient feels more relaxed and comfortable soon.
Can I Drive After Nitrous Oxide Sedation?
Patients will be much better off within a short span of time after nitrous oxide sedation is complete; most of them are even capable of driving themselves home. Still, it is advisable to talk to your dentist about this and organize an alternative mode of transport just in case.
Is Nitrous Oxide Sedation Covered by Insurance?
Insurance coverage of nitrous oxide sedation depends on the insurance company in question and the individual dental insurance plan. It is recommended that patients discuss with their insurance carrier on whether this method of anesthesia will be covered or not.
In conclusion, it can be stated that nitrous oxide sedation is an essential component of modern dentistry which allows the patient to feel more comfortable during the procedure. This information will enable patients to understand the advantages, uses, and precautions of using nitrous oxide sedation in dentistry hence making the right decision in seeking dental treatment.
