Introduction
Nitrous Oxide (N20) more commonly known as ‘laughing gas’ is frequently used gas in dentistry. The use of nitrous oxide as a sedative in dentistry enable the patient to remain normal and awake and breathe while the dentist teats the problem. The patient may also fall asleep and may experience forgetfulness about what actually happened during the course of the treatment.
Nitrous oxide is not a pain killer but a sedative which enables dentists to work better. The pleasant taste and color of the anesthetic make it preferable to patients. Nitrous oxide is not inhaled directly; patients are required to first inhale pure 100% oxygen through a mask which is then followed by a mixture of nitrous oxide. The approximate ratio of the mixture is about 20 to 30 percent nitrous oxide to about 70 to 80 percent of oxygen. Nitrous oxide begins to function in about five minutes and is used for conscious sedation during medical procedures related to dentistry. It is extremely helpful in relieving pain among anxious patients.
When inhaled, the patient gets a relaxed feeling which is warm and pleasant. There may be a sensation of numbness in the patient’s mouth, feet and hands. As an anesthetic, nitrous oxide does not put the patient to sleep completely and the patient is still able to respond to the requests and questions of the dentist. The drug, however, produces a relaxed effect on the client which reduces the anxiety and pain of the client and enables the dentist to work without any hindrances or disturbances from the patient and focus on the problem rather than the patient.
Advantages
Nitrous oxide is known to be a safe anesthetic used by dentists to sedate the patient from pain and anxiety. The primary advantage of using nitrous oxide for dental inhalation sedation is that it works well for patients with mild to moderate levels of anxiety. The onset of the effect of the gas is almost instant and the effect begins within about five minutes. Dentists have complete control over the sedation and in case of any kind of discomfort, the oxygen supply can be increased which helps to flush out the gas almost immediately. Patients recover rapidly after being sedated with nitrous oxide and the use has very few side effects. There are no after effects and patient can easily drive back after the dental procedure is over and return to their regular activities.
Disadvantages
Nitrous Oxide is not indicated for patients who have a history of respiratory problems and diseases such as asthma. Care and attention must be taken to when the drug is administered in combination with other drugs to ensure that there is no adverse outcome. In some cases, the motor skills and attention of the patient may be affected for about fifteen minutes. Nitrous oxide is not recommended for patients with certain lung conditions such as bronchitis, or pulmonary diseases. It is not advisable to use the gas for pregnant women.
References
Holroyd I, Roberts GJ. (2000). Inhalation sedation with nitrous oxide: a review. Dent Update, 27.
The Hong Kong College of Anesthesiologists, (1992). Guidelines for sedation.