At Winchester Dental, patient comfort is very important to us. We offer nitrous oxide as a mild form of sedation during certain procedures. In this interview, Dr. Gio Iuculano and dental assistant Julie Tavenner answer basic questions about the use of nitrous oxide.

What is nitrous oxide?

It’s a colorless, odorless gas that eliminates pain and introduces a pleasurable feeling to ease anxiety. When administered in small, carefully controlled doses for limited amounts of time, nitrous oxide is a safe and effective dental sedative.

When do you offer nitrous oxide?

If we see that a patient is slightly nervous, we’ll offer nitrous oxide, especially if the patient must drive immediately after their visit. While other options might linger in the patient’s system, nitrous oxide wears off quickly. For patients who are very nervous and won’t be driving, we sometimes offer a combination of nitrous oxide (in gas form) and Valium (in pill form). Nitrous oxide is also useful for children, because it’s administered as a gas and not a pill.

How is nitrous oxide administered?

Patients breathe in the gas through a small mask that fits over the nose. The mask has two tubes; one that delivers the sedative gas and one that removes waste gas as the patient breathes.

Are there patients for whom or health situations for which nitrous oxide is not recommended?

Since the gas is administered through the nose, anyone with a cold or nasal/sinus congestion from allergies would not be able to breathe it in effectively. Additionally, we don’t recommend this option for patients with the following health conditions:

  • Bronchitis
  • Cystic Fibrosis
  • Emphysema
  • Mitochondrial disease
  • First trimester of pregnancy
  • Multiple sclerosis
  • Recent surgery of the eye or middle ear

Nitrous oxide is also known as laughing gas. What should a patient do if he or she would like sedation but is concerned about laughing uncontrollably?

Fortunately, we’ve never encountered that situation. We normally administer the sedative in a mixture of 30% nitrous oxide and 70% oxygen, and these percentages are carefully controlled to keep patients from laughing and from experiencing nausea (which can occur when the percentage of nitrous oxide is too high). The effects of nitrous oxide are sometimes compared to those of a couple of alcoholic drinks, though this varies from patient to patient.

Once a dental procedure is finished, how quickly does nitrous oxide wear off?

It wears off almost instantly. This allows patients to return to their usual routine right away—work, school, caring for family, etc. It’s a helpful option for keeping our patients comfortable, and that’s important to us!