Nitrous oxide in dentistry

Nitrous oxide in dentistry 

The application of Nitrous oxide in dentistry: An analysis 

Nitrous oxidealso known as nitrous oxide or N2O is a proven and versatile anaesthetic that is used in dentistry to relieve pain and induce a state of relaxation in patients. This article explains how nitrous oxide works, its effect on the body and the advantages and disadvantages of its use in dental practice. 

How nitrous oxide works in dentistry

Nitrous oxide is administered via a mixture with oxygen in a fixed ratio, typically 30-70% nitrous oxide and 70-30% oxygen. The function of nitrous oxide is based on its ability to influence oxygen transport in the body. Two important mechanisms are activated: 

1. increased oxygen releaseNitrous oxide blocks the enzyme methionine synthase, which is necessary for the conversion of homocysteine to methionine. This increases the availability of tetrahydrofolate (THF), which promotes the conversion of vitamin B12 into its active form. The increased formation of THF enables a more efficient release of oxygen in the tissues, which leads to an improved oxygen supply. 

2. vasodilation: Nitrous oxide acts as a vasodilator by relaxing the smooth muscles of the blood vessels. This vasodilation leads to an expansion of the capillaries and thus to improved blood flow to the tissues, which is particularly useful in dentistry. 

Effect of nitrous oxide in the body:

In dentistry, nitrous oxide is administered via a mixture with oxygen in a fixed ratio, typically 30-70% nitrous oxide and 70-30% oxygen. The way nitrous oxide works is based on its ability to influence oxygen transport in the body. Two important mechanisms are activated: 

1. increased oxygen release: nitrous oxide blocks the enzyme methionine synthase, which is necessary for the conversion of homocysteine to methionine. This increases the availability of tetrahydrofolate (THF), which promotes the conversion of vitamin B12 into its active form. The increased formation of THF enables a more efficient release of oxygen in the tissues, which leads to an improved oxygen supply. 

2. vasodilation: nitrous oxide acts as a vasodilator by relaxing the smooth muscles of the blood vessels. This vasodilation leads to an expansion of the capillaries and thus to improved blood flow to the tissues, which is particularly useful in dentistry. 

Effect of nitrous oxide in the brain:

Effect of nitrous oxide in the brain

The effects of nitrous oxide in the brain are of particular interest as they are closely related to the analgesic and anxiolytic properties of the gas. Nitrous oxide affects the central nervous system (CNS) in several ways: 

1. activation of the opioid receptorsNitrous oxide activates the opioid receptors in the brain, which are responsible for pain relief. This leads to the release of the body's own endorphins, which reduce the sensation of pain and create a pleasant feeling of well-being. 

2. increased activity of the GABA systemLaughing gas increases the effect of the neurotransmitter gamma-aminobutyric acid (GABA), which transmits inhibitory signals in the brain. This increased GABA activity causes a general dampening of nerve cell activity, which leads to relaxation and a reduction in anxiety. 

3. NMDA receptor antagonismNitrous oxide acts as an N-methyl-D-aspartate (NMDA) receptor antagonist, which means that it inhibits the activity of these excitatory receptors. As a result, the processing of pain stimuli in the brain is reduced. 

4. increase in cerebral blood flow: As already mentioned, nitrous oxide leads to vasodilation, which improves blood flow to the brain. This is particularly relevant as an adequate oxygen supply to the brain is crucial during dental treatment. 

These effects in the brain help to ensure that the patient has a pleasant and pain-free experience during dental treatment with nitrous oxide. 

Knowledge of the effects of nitrous oxide in the brain and its positive influence on the central nervous system and cerebral blood flow is a crucial aspect of its use in dentistry. 

Nitrous oxide offers a safe and effective method of increasing treatment comfort and reducing anxiety. 

Nitrous oxide in dentistry, gagging patients

Nitrous oxide for gagging patients

Another remarkable property of nitrous oxide is its ability to minimise the gag reflex in patients. This is particularly relevant as many patients with a pronounced gag reflex can find dental treatment uncomfortable. The effects of nitrous oxide on the gag reflex can be explained by mechanisms: 

  1. Centralised damping of reflexesNitrous oxide acts centrally on the nervous system and leads to a general dampening of reflexes, including the gag reflex. By influencing neuronal excitability, the responsiveness of the gag reflex is reduced, resulting in reduced sensitivity. 
  1. Gag reflexes can often be intensified by anxiety and tension. However, nitrous oxide induces a calming effect on the patient, reduces feelings of anxiety and promotes general relaxation. This relaxing effect helps to minimise the gag reflex as the patient is less susceptible to stress-induced reflexes. 

Nitrous oxide in dentistry:

Nitrous oxide is a valuable tool in dentistry that enables fast and easily controllable pain relief and relaxation. When used appropriately, it offers numerous advantages for patients and dentists, and any disadvantages are generally minimal. 

We have summarised the most important questions relating to the use of nitrous oxide in this Blog post summarised. The question of how dentists become nitrous oxide users can also be answered in this Technical article read more.  

The perfect access including all-round support can of course be provided by the Specialists in nitrous oxide sedation expect. You can also find us on Facebook and Instagram. Many interesting videos on laughing gas sedation can be found on our YouTube channel. If you have any questions, please use the contact form on our website or the Baldus expert chat here on baldus-sedation.de   

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