What use is nitrous oxide

Have you always dreamed of a relaxed, pain-free and fear-free dental treatment? Then read our article on the subject of dental treatment with nitrous oxide.

Laughing gas or nitrous oxide (NO2) is a colorless and odorless gas. It was first used in dentistry in 1844 to extract a tooth. In other countries, the use of nitrous oxide is much more widespread than here, but more and more practices in Germany are also offering dental treatments with nitrous oxide sedation. It is not without reason that laughing gas is enjoying increasing popularity. The use offers the patient many advantages.


How does nitrous oxide work in the body?

The exact mechanism of action of nitrous oxide is not yet known. Laughing gas is inhaled through the lungs and released into the blood there. It then unfolds its effect in the central nervous system. It is known that it is hardly metabolized in the body and that 99% of it is exhaled directly.


What sensations does nitrous oxide trigger?

Laughing gas has a calming, relaxing and anxiety-relieving effect. Any gag reflex that may occur is suppressed by the laughing gas and the sense of time becomes blurred. As a result, the treatment is perceived as shorter than it actually is. The patient builds positive memories of the dental treatment. In this way, fears about the next visit to the dentist can be avoided in the future.

During the entire sedation, the patient remains awake and responsive, but is in a kind of relaxed state of suspension. Despite the sedation, he is aware of everything and is therefore in control of the situation at all times. The fear of losing control is therefore unfounded.


When and with whom is nitrous oxide used?

Many patients fear dental treatments. Here laughing gas offers a good opportunity to relieve you of the fear of the treatment and to put you in a state of relaxation.

In theory, nitrous oxide can be used in any type of treatment and is an option for anxiety sufferers of almost any age. The prerequisites for a child's laughing gas sedation are sufficient willingness to cooperate and the ability to breathe through the nose for a longer period of time.

There are only a few restrictions on which patients should not be sedated with nitrous oxide. These include, for example, patients with the obstructive pulmonary disease COPD, otitis media, or patients who have recently had certain eye operations.


How does nitrous oxide sedation work?

  • Checking blood pressure

Before the treatment, the blood pressure is measured and the pulse and the oxygen saturation of the blood are continuously checked with a pulse oximeter for the duration of the sedation.

In the next step, a mask that best suits the patient is selected. Often the patient is allowed to choose a pleasant fragrance from a selection. Then the patient puts the mask on his nose himself.

With nitrous oxide sedation, the patient is never fed pure nitrous oxide, but always a mixture of oxygen and nitrous oxide. The mixing ratio can be set on the device, the flow meter. It is not possible to set a nitrous oxide concentration of more than 70%. At the beginning, the patient is ventilated with 100% oxygen for a short time before the nitrous oxide content is slowly increased in 10% steps. With children, a so-called lightning initiation is possible: It can be started directly by adding nitrous oxide. After each increase, the patient waits a little, gets feedback from the patient and, if necessary, increases the concentration further. Normally a 30 to 50% concentration of NO2 is sufficient to achieve a sufficient effect.

Local anesthesia is only applied if the nitrous oxide is effective.

When the patient feels relaxed and relaxed, treatment can begin. If the effect diminishes or is insufficient, it is possible to increase the nitrous oxide content in between. The mask is kept on during the entire treatment and nitrous oxide is continuously inhaled.

After completing the treatment, the nitrous oxide content of the gas mixture is slowly regulated down again. Before the mask is removed, the patient is ventilated with pure oxygen for a few minutes to make sure that all nitrous oxide has left the body and the effect has completely subsided. If the patient feels ready, he can get up and leave the practice. This state is usually reached after a few minutes.


How safe is nitrous oxide sedation?

Laughing gas sedation is considered very safe and is already part of the standard treatment in many countries. Only concentrations that are harmless to health are used in dentistry. Modern nitrous oxide devices have a lock that prevents more than 70% nitrous oxide from being added to the gas mixture. This makes overdosing by the practitioner impossible. When used properly, the few known side effects only occur extremely rarely.

These include nausea, dizziness, headache, or temporary drowsiness.

Serious complications can be ruled out due to the low concentration.


What is the difference to other sedations or general anesthesia?

In contrast to general anesthesia, the patient is not artificially ventilated during the nitrous oxide treatment and therefore does not require an additional anesthetist to monitor the anesthesia. For this reason, nitrous oxide treatment does not involve the usual risks that general anesthesia entails. Laughing gas sedation can be performed by a dentist. In contrast to general anesthesia or sedation with Dormicum, the patient is fully conscious during the entire treatment. Another big difference is that the practice can be left unaccompanied immediately after the treatment and the patient is fully roadworthy after a short time. Laughing gas sedation is the lightest and gentlest form of dental sedation.


Do you need a local anesthetic despite the nitrous oxide sedation?

Laughing gas cannot take over the pure elimination of pain. Therefore, after the initiation of nitrous oxide sedation, the patient still receives a local anesthetic if the treatment measure requires local anesthesia even under normal circumstances.

Some patients are more afraid of the anesthetic injection than of the actual treatment. The previous nitrous oxide sedation helps the patient to relax. The injection of the local anesthetic is hardly noticed and is perceived as unproblematic.


How much does a nitrous oxide treatment cost?

A nitrous oxide treatment is a purely private service and is not covered by the statutory health insurance companies. The cost of nitrous oxide sedation depends on the duration of the treatment. The usual rate is around 60 to 80 euros per 30 minutes. If the treatment lasts longer or if several appointments are carried out in nitrous oxide sedation, it may be cheaper.


Finally, the advantages of nitrous oxide sedation at a glance:

✓ The safest form of dental sedation with the lowest side effect profile

✓ Reduction of anxiety and stress (ideal for anxiety patients)

✓ The sensation of pain is reduced

✓ Suppression of gag reflex

✓ Quick onset of action

✓ No effects on breathing, organs or the cardiovascular system

✓ You retain full awareness during the treatment

✓ Almost immediately ready for use after the treatment

✓ Bad memories of dental treatments can be replaced by new, positive experiences


Are there any questions left?

Our dentists are certified users of nitrous oxide sedation and will be happy to inform you about the treatment options in our MKG Plus dental practice in Münster.