Inhalation sedation comes by many, many names.  Laughing gas, relative analgesia, RA, happy gas, nitrous, and N2O-O2 are all used to describe this technique of sedation which involved administering the N2O gas through a nose piece to achieve what has also been described as “representing the most nearly ‘ideal’ clinical sedative circumstance”…

N2O is simply a gas which you can breathe in. It has no color, smell, and doesn’t irritate. Interestingly, we still don’t know exactly how nitrous oxide works and probably works via multiple different ways at once. It’s been observed that N2O depresses almost all forms of sensation, hearing, touch and pain, and also reduces the emotional centres in the brain that produce anxiety. N2O doesn’t inhibit the ability to concentrate or perform intelligent acts and has no effect on memory either.

 

Frequently Asked Questions

Why is nitrous oxide so useful in dentistry for anxious patients?

To summarise the effects of nitrous oxide:

  • it kills pain
  • it causes a pleasurable feeling and
  • it is extremely safe.

Happy gas very rapidly takes effect and it wears off completely after about two or three minutes.

How is it administered?

Firstly, patients are given pure oxygen for about 2 minutes until the N2O is slowly introduced into the breathing mask. The concentration of nitrous is slowly increased until it achieves the desired effect on the patient.

After 5 minutes or so of breathing in the gas, you should feel a euphoric feeling spread throughout your body. Some people describe feeling warm and fuzzy, others feel like they are ‘happy drunk’.

Happiness, euphoria and a ‘floating sensation’ are quite common effects. Sometimes it has effects on your hearing and vision as well, making you feel light-headed and often causing you to start to giggle, which is why it is called “laughing gas”.

Rarely though, if you experience any unpleasant symptoms, let your dentist know so that they can adjust the percentage of N2O. Alternatively, just take the mask off. This almost never happens if the concentration is slowly taken up to achieve effect and usually occurs when the concentration is started at too high a level.

At the end of the procedure, 100% oxygen is again given to dissipate all the gas out of the lungs and patients recover almost immediately.

What are the advantages of nitrous oxide?
  •  Nitrous works very rapidly – it reaches the brain within 20 seconds, and relaxation and pain-killing properties develop after 2 or 3 minutes.
  •  The depth of sedation can be changed from moment to moment (called “titration”), allowing the person who administers the gas to increase or decrease the depth of sedation. Other sedation techniques don’t allow for this. For example, with IV sedation, it’s easy to deepen the level of sedation, but difficult to lessen it. Whereas with laughing gas, the effects are almost instant, giving the doctor fine control over the level of sedation to the patient.
  •  The gas can be switched off when not needed and then switched on again, and used for exactly the time that is required.
  •  There’s no “hangover” effect – the gas is eliminated from the body within 3 to 5 minutes after the gas supply is stopped. You can safely drive home and don’t need an escort.
  •  No fasting is required before the procedure.
  •  For some procedures, it can be used instead of local anaesthesia – especially when the procedures involve the gums rather than teeth (e. g. cleaning)
  •  For people who are afraid of dental needles,  getting laughing gas first can help you feel relaxed enough and reduce pain enough to allow the dentist to administer the local anaesthetic.
  •  Inhalation sedation is very safe and has no negative effects to the heart, lungs, liver, kidneys, or brain.
  •  It can be used safely and is very effective in treating children.
  •  It can be used very effectively in eliminating or minimizing severe gagging.
  •  It is very cost effective and much cheaper than IV sedation or a general anaesthetic
Are there any disadvantages?

The main disadvantages of happy gas are as follows:

  • Some people are not comfortable with the effects of laughing gas
  • Some people will not achieve adequate sedation with the maximum concentration allowable.
  • If you can’t breathe through your nose, or you feel too claustrophobic when something is put over your nose, it can’t be used.
  • It also can’t be used in patients with severe lung problems.
What is the Compass Dental Care difference?
  • All of our staff are highly trained in all types of sedation and pain control. We understand what it takes to treat patients with dental anxiety and have extensive experience treating these patients. Dr Thien Pham, the dental surgeon and principal dentist has studied IV sedation and pain control at a post-graduate level and has been entrusted by the Australian Defence Force to treat their members.
  • In fact, all of our dentists and specialists working in our facility have done or are currently doing post-graduate training and further study as they are committed to providing you excellence in the quality of work.
  • We are able to treat you in most cases without an additional referral to an outside specialist saving you both time and money.
  • Our facility is equipped with N2O and designed specifically to accommodate IV sedation.
  • General anaesthetics services are provided by us via Darwin Day Surgery, the only day surgery facility in the Northern Territory to have achieved accreditation against the 10 national health standards.
  • Call us today to make an appointment to discuss your treatment needs so that we are able to tailor a solution that meets your individual requirements.