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Laughing Gas (Nitrous Oxide) During Sedation Dentistry

The most commonly employed technique used in conscious sedation dentistry is inhalation sedation with nitrous oxide and oxygen (N₂0-0₂) or "laughing gas". It is estimated that approximately 35% of U.S. dentists use this technique to relieve dental anxiety.

The goal sought when laughing gas is used is to eliminate dental anxiety, making the patient more comfortable while the sedation dentist is able to more effectively complete the planned dental care procedure while the patient is sedated. Consult with your dentist to find out if this procedure right for you.

A small rubber inhaler will be placed over the patient's nose and adjusted so that the patient is comfortable. At this time, the patient will be breathing 100% oxygen.

Some patients at their first laughing gas visit will feel that they are not getting enough "air." The patient should tell the sedation dentist and he or she will provide them with even more oxygen to breathe.

Once the patient is comfortable breathing oxygen, the dentist gradually will introduce nitrous oxide. Over the next three to five minutes, the patient will be asked, "What are you feeling?" as the amount of nitrous oxide is slowly increased.

The signs and symptoms that most patients experience when receiving laughing gas include an initial feeling of lightheadedness, which gradually leads to an all-over feeling of warmth. Many persons mention a comfortable "vibrating" or "humming" sensation. It is common to feel one's fingertips and hands become "numb."

This same sensation may develop in the mouth - a benefit to the sedation dentist (and patient) during the dental care treatment. Some patients will mention that their arms and legs feel "very light." Interestingly, other patients will say that their arms and legs feel "so heavy I can't even move them."

If either of these occurs to the patient, it is perfectly normal. The individual might notice that they are perspiring a little, too. This is a normal effect of nitrous oxide and oxygen dentistry.

The sedation dentist will talk with the patient throughout the dental care procedure and the individual will be able to respond without any problem. This is a major advantage, and a safety feature, of conscious sedation using laughing gas.

If, at any time during the procedure, the patient feels that they are getting too much nitrous oxide or if they begin to feel uncomfortable, they should tell the dentist immediately and within seconds the dentist can adjust the flow of gases, and the patient will feel more comfortable again.

At the conclusion of the sedation dentistry treatment, the patient will once again receive 100% oxygen (for a minimum of three to five minutes). At the end of this time, the person should feel absolutely back to normal. If they still feel even a little bit sedated, the dentist should give the patient oxygen for a few more minutes.

Most dentists permit the fully-recovered laughing gas patient to leave the dental office unescorted and to resume their normal activities. In some situations where a patient recovers more slowly, they might be required to have an escort (friend or relative) drive them home.

Laughing gas inhalation sedation is highly effective in the management of mild to moderate levels of dental anxiety. It also is an excellent technique in persons who are extreme gaggers; laughing gas usually eliminates or minimizes gagging in most patients.

Finally, laughing gas is highly recommended for apprehensive patients who have medical problems such as angina pectoris, persons who have had a heart attack, or persons with high blood pressure, asthma or epilepsy.

Inhalation sedation dentistry should not be used with persons who are claustrophobic or with persons who are unable to breathe through their nose. Please discuss these with your dentist before treatment using laughing gas begins.

By Stanley F. Malamed, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

New Dental Care Technology And Your Teeth

The world of modern dentistry is embracing exciting advances in technology for increased patient comfort, care, and convenience. Here are some ways dentistry is taking oral care into the new millennium.

• Air Abrasion: High-speed delivery of "blasting particles" to a decayed tooth can replace the drill in many cases. The fine stream of air and aluminum oxide provides dentists with a more precise tool for removing decay quickly, without damaging surrounding sections of the tooth. This exciting dental treatment is also a plus for patients because it normally doesn't require any local anesthesia. While air abrasion may not be suitable for large areas of decay or the removal of silver fillings, it can be used to repair tiny cracks, remove stains, and smooth the tooth surface so that bonding materials adhere to the tooth.
• Intra-oral Cameras: A tiny camera inserted into the patient's mouth allows the dentist to show the patient the exact nature of the problem. The image is enlarged and sent to a monitor that the patient and doctor view together. When patients can see the specific area in need of treatment, they're more likely to understand and accept the dentist's recommendation.
• Lasers: Research continues at a fast pace in laser dentistry. Lasers have been used for years in a limited capacity, but their role in oral surgery is likely to increase.
• Digitized X-rays: Computerized technology will allow a small sensor inside the patient's mouth to take the X-ray and immediately display it on a computer screen, eliminating film and darkroom processing, and reducing the radiation exposure for the patient.
• Computers: There is a growing recognition of the role that computers can play in dental care. In the future, patient records may be kept on computer disks, including visual images captured on intraoral cameras. A computerized workstation beside the patient's chair will give the dentist the ability to view the patient's history from disk. The dentist might also use a voice-recognition system to ask the computer to assist in finding that data, or generate a "before and after" image so the patient can preview the result of dental treatment before it is done.
• CD-ROM: Patient education will be a snap with information stored on CD-ROM. Procedures can be explained to patients in advance and post-operative instructions can be provided for them to take home.

With a new hi-tech face on modern dentistry, patients can look forward to a new face in dentistry and greater comfort with more byte!"

By Brian J. Gray, DDS, MAGD, FICO

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.