nitrous oxide dentistryThe fear and anxiety of visiting dental clinics is actually common. With nitrous oxide sedation, this fear can be masked and replaced with assurance, calm and happiness.

Nitrous oxide (N2O), popularly known as Laughing gas is a colorless and odorless gas is non irritant in nature. It is known to create pleasurable sensation in the one who inhales it.

It was in the early 19th century that an American dentist named Horace Wells discovered that the gas could be used in dental procedures and used it on himself with very good results.

The method of administering N2O to patients have improved in the last decade and it is now considered completely safe and supremely effective.

Nitrous oxide sedation dentistry is useful if

  • You are unnerved by dental visits.
  • The external stimulus such as the noise of the drilling machine, smell of various chemicals bothers you.
  • You have complicated dental problems which require various visits.
  • You have sensitive teeth and bad gag reflex.
  • You have a busy scheduled with little time to spare for dental appointments.
  • You fear needles, injections etc.
  • The various numbing medications used at the dental clinic don’t work well for you.

Facts about N2O

  • It relaxes the nerves and calms the anxious mind.
  • It has both analgesic (pain relieving) and anxiolytic effect(anxiety reducing).
  • Unlike other sedation techniques which need the use of anesthetic as well, this gas mixture acts as ‘ a two-in-one.
  • It is a non-invasive procedure.
  • The action starts immediately after administration and the effect is seen soon.
  • Typically, within 3 minutes of inhalation, the calming and soothing effect starts in.
  • Bodily side-effects are mild or nil; a small increase in blood pressure is common.
  • Unlike other anaesthetics, there is no change in the rate of heart beat.
  • Unlike other sedatives, the nitrous oxide can be administered in increments until the desired effect sets in. So there is a lesser chance of an overdose.
  • It has been regarded to be safe and is even used commonly in paediatric dentistry.
  • Allergic symptoms to nitrous oxide have not been reported.
  • It is proven safe for patients with medical conditions like heart disease, epilepsy, liver disorders etc.
  • The nitrous oxide quickly leaves the body system and so a healthier option among the sedatives.( within 3-5 minutes after stopping supply of nitrous oxide). Hence there is no ‘hangover effect’.
  • Not necessary for anyone to accompany the patient to the dentist or back home(if the dental procedure is relatively simple).

How is Nitrous oxide administered?

  • A mixture comprising of 25-50% Nitrous oxide and the remaining oxygen is common when the purpose of usage is to reduce anxiety.
  • A mixture of Nitrous oxide and oxygen gas is stored in canisters and is administered to the patient with the help of a tube called nasal canula and a nasal inhalation mask with partitions for inhalation for delivering the analgesic and exhalation which is connected to vacuum.
  • The flow is regulated with the help of a valve.
  • The equipment is calibrated at regular intervals to ascertain a leaf proof and guaranteed service system.
  • New disposable masks are also available which doesn’t need sterilization after usage and hence user friendly
  • Certain features are included in the modern inhalation sedation systems like an alarm, oxygen flush button, emergency air inlet, lock system etc
  • The mixture of gases is administered to the patient by gradually increasing the concentration until desired. This method is known as titration in dentistry. This method takes time but is recommended for reducing any chances of overdose

Summary of Effects

  • Analgesic effect: It interacts with the opioid receptors in the mid-brain and activates the descending inhibitory path ways.This alters the way pain is processed in the spinal cord region.
  • Anxiolytic effect: By interacting with the receptors, the effect of GABA (Gamma Amino Butyric acid, a neurotransmitter ) is enhanced. Pre-synaptic cells are inhibited to transmit a nerve impulse and this reduces anxiety and stress.

Pure N2O cannot be used for extended durations and as such the dose administered for dental procedures is a mix of N2O and O2. Many dentists use N2O-O2 mixture with equal proportions of both gases – this mix is commonly known as ethanox.

Nitrous oxide fffectsSoon after inhalation there is definite light-headedness, followed by a vibrating and tingling sensation after which most patients will feel warmer and a feeling of happiness and well-being. The picture on the left shows a patient numb, dizzy and happy after N2O administration.

Higher levels of sedation can induce sleepiness. If over-sedated, the patient will experience nausea and extreme sleepiness to the point that it will be almost impossible to speak or even keep the eyes open.

Side effects

  • This is rarely seen; though the most noticed one being nausea and vomiting which is attributed to the usage of higher concentration of Nitrous oxide in the mixture.
  • Only 1% of the children administered have been found to have even mild side effects.
  • The effect can be reversed by removing the supply of Nitrous oxide and providing the patient with plenty of oxygen supply


It is not completely known whether it causes teratogenic effects ( birth defects) and so is not recommended if one is in their first trimester of pregnancy. People with cardiac dysfunction and those with persistent nasal congestion. It is also not typically administered for people with claustrophobia(fear of feeling trapped in enclosed spaces). Hence a complete disclosure of your medical history with your dental practitioner is very essential to help him determine the best method suitable for you.

The dental team who provide sedation dentistry care need to have undergone a special training. You might want to enquire if your dentist has the permit and license to give sedation treatments.

If you are looking for a nitrous oxide sedation dentist in Edmonton, please call our Edmonton Clinic at 780-471-4842. At Beverly Heights Dental, Dr.Vidya Janardhanan is fully qualified and certified to administer sedation dentistry treatments.