The Use of Nitrous Oxide Sedation in Dentistry

Jun 29, 2022 | General Dentistry

The Use of Nitrous Oxide Sedation in Dentistry

Are you dreading your visit to the dentist? That’s okay. Dental check-ups can be scary, even for adults. Maybe dentists’ offices make you nervous, or maybe you are just scared about the upcoming procedure, but no matter the problem, some nitrous oxide should fix your problem. And with how common the use of nitrous oxide in dentistry is, you can easily find a dentist to administer this sedative.

Nitrous oxide sedation in dentistry is a common practice. So, what is the difference between sedation and the use of nitrous oxide? To answer your question, the distinction here is in degree, not kind. Nitrous oxide is a sedative substance, differing from other anesthesia only in its mildness.

From helping contain patient anxiety to reducing untoward movement during dental procedures, nitrous oxide is an invaluable sedative in the dental world. Its effective analgesic and anxiolytic properties are a mainstay in dentistry practices today. An American Dental Association survey reveals that 70% of dental practices that use sedation choose nitrous oxide sedation.

Key Takeaways

  • Nitrous oxide sedation helps patients relax during dental procedures.
  • It’s a mild sedative that slows the body’s reactions and targets the nervous system.
  • Administered through a nose mask, patients may feel euphoric and relaxed but remain conscious.
  • Proper usage can relieve stress and anxiety, suitable for long procedures and patients with sensitive teeth or bad gag reflex.
  • Nitrous oxide has low risks and is well-suited for patients with high blood pressure or asthma, but misuse can lead to potential recreational drug use or coma.

What is nitrous oxide?

Nitrous oxide (N₂O) is simply the scientific name of the substance commonly known as laughing gas. Despite its name, this gas does not make you laugh. Instead, it works as a mild sedative by helping slow the body’s reactions- a necessity for anxious patients.

The result is a calm, floaty feeling, followed by either a tingling sensation or a heaviness in the limbs.

Since N₂O affects the nervous system, it may even cause mild hallucinations. This effect, combined with the overall light-headedness, may make things seem “funnier” than they are, hence the name “laughing gas.”

How does nitrous oxide sedation work?

Medical professionals use nitrous oxide as a mild anesthetic. It is particularly common in dentistry practices because it is not a strong sedative and thus does not fully put you to sleep. The purpose of this anesthetic is not to lull you to sleep but to make you relaxed enough to undergo a successful operation. This gas you breathe is a mix of nitrous oxide and oxygen. Before undergoing any procedures, your doctor will administer the gas through a mask placed over your nose. The effects of the sedative start to kick in after a few minutes.

Since this substance targets the nervous system, you will suddenly feel euphoric and relaxed. During this period, you will not be asleep; rather, you will experience slowed reactions in your movement and speech. The gas helps you eliminate your nervousness and fear by making you less inhibited. You will be conscious enough to hear and obey all the instructions that the dentist gives you throughout the procedure.

Nausea is a common side effect of using nitrous oxide, and it may kick in as soon as the effects of the substance begin to fade. To avoid this, dentists administer pure oxygen to patients immediately upon removing the mask. Five minutes is the recommended time for the oxygen to clear the nitrous oxide from the lungs successfully.

Use of nitrous oxide in dentistry

Adopting appropriate work practices is important in using nitrous oxide in dentistry. Under the recommendation of the Council on Scientific Affairs and Council on Dental Practice, the following conditions are to be diligently maintained.

  • Administer 100% oxygen to the patient after using the substance as it helps wear off the dental nitrous oxide sedation and return alertness to the body.
  • Conduct semi-annual tests on staff to check exposure levels.
  • Advice patients to limit intake during administration by avoiding breathing through the mouth if possible.
  • Ensure the flow rate is correct and the mask gets properly fitted to the patient.
  • Inspect all components, including reservoir bags, tubes, masks, and connectors, for defects before the day begins.
  • In addition to this, the use of nitrous oxide in dentistry also includes the following.
  • People with low pain thresholds may obsessively worry about the pain even with minor oral procedures. In such cases, the doctor may administer nitrous oxide as anesthesia to help relax your nerves.
  • Since nitrous oxide is a conscious sedative, it is particularly well suited for long procedures. This gas helps keep the patients calm and sedated for long periods while still conscious enough to follow instructions and answer important questions.
  • People with a bad gag reflex and sensitive teeth will also benefit from this substance as it will keep them relaxed enough not to be nervous in the dentist’s chair.

Pros and cons of nitrous oxide sedation

As with most things, the advantages and disadvantages of nitrous oxide go hand in hand. On the one hand, this substance is a low-risk alternative to heavier sedatives for people with high blood pressure. But at the same time, it also has the potential to be a recreational drug among preteens. Proper usage can help relieve stress while misusing it can lead to a coma.

In light of these contrasts, here are the pros and cons of nitrous oxide sedation:


  • Nitrous oxide is a very mild anesthetic that even people with high BP or asthma can take.
  • The gas relaxes you by targeting the nervous system. This method suits patients who are nervous or uncooperative about their dental check-ups.
  • Nitrous oxide helps relieve pain and dulls the body’s reactions instead of putting you to sleep. This way, you remain conscious and aware during the procedure to interact with the medical professional.
  • Dental nitrous oxide sedation is useful in treating patients whose gag reflexes make dental work difficult.


  • Administering nitrous oxide to children may cause side effects like nausea, vomiting, irritation, and headaches.
  • Overexposure to laughing gas can cause anemia or a Vitamin B-12 deficiency.
  • This mode of sedation is not suited for people with mental health disorders or a history of substance abuse as it may exacerbate latent symptoms.
  • Patients with respiratory diseases should always check in with medical professionals before using nitrous oxide to avoid possible breathing difficulties.

Is nitrous oxide safe?

Unlike many other anesthetics and sedatives, the effects of nitrous oxide are very short-lasting. Typically, the tingly, euphoric feeling lasts only as long as the substance continues to get supplied to the patient. Once the doctor removes the mask supplying the gas, the effects also soon fade away.

Some patients may feel the lingering effects of the gas longer than most, but even these usually disappear quickly. This short-effect time of nitrous oxide is one of the reasons why it is usually safe to use. You have even less to worry about when a certified medical practitioner is in charge of the administration.

However, as uncommon as it is, nitrous oxide can be dangerous in two main situations. The first case occurs when you have an unknown allergic reaction to the gas. In such scenarios, you should seek medical assistance immediately after experiencing symptoms like irritation in the eye, nose, and throat area.

Nitrous oxide can also pose a threat to your health when misused. To overdose on this substance, you need large amounts of gas; thus, this scenario is typically not possible in a routine medical check-up. Instead, overdosing occurs when people with access to large quantities of the substance decide to abuse it or use it recreationally.

Reliable dental nitrous oxide sedation

For all its benefits, the main concern when using nitrous oxide is responsibility. The substance is most effective when you find a medical professional to administer it with care. With the right team, you can even weather getting new dental crowns with minimum anxiety.

If you think laughing gas could be a good alternative to acupressure or stronger sedatives, you might benefit from contacting us for your next dental check-up.

Eddie Kuo, DDS

Eddie Kuo, DDS

Owner @ New Leaf Rohnert Park

Professional Degrees

University of California at Davis – BS in Biological Sciences with emphasis in Neurology, Physiology, Behaviors

University of the Pacific Arthur A. Dugoni School of Dentistry, Doctorate of Dental Surgery

State University of New York at Buffalo – General Practice Residency at Erie County Medical Center

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