Sedation - nitrous oxide sedation at the dentist

Nitrous oxide sedation at the dentist – everything at a glance

The wish of many patients: Go to the dentist without fear

Many people feel afraid of visiting the dentist. Often there is discomfort and a queasy feeling. Stronger symptoms such as sweating or palpitations also occur in anxious patients and ultimately trigger a dental phobia. The result: Postponing check-up or treatment appointments causes dental diseases. If you neglect regular check-ups, plaque and tartar will form unconsciously - an ideal breeding ground for bacteria. This is followed by complaints of caries or gum inflammation, which can lead to tooth loss. Symptoms that indicate a disease of the teeth should therefore be taken seriously. A visit to the dentist should not be an obstacle. Treatment without feeling pain or fear is possible. The modern nitrous oxide sedation method offers the optimal possibility and opportunity to overcome the fear of the dentist.

How do dentists deal with anxious patients?

Since there is a large number of people worldwide who are considered to be anxious patients in medicine, many dentists have specialized in treating dental anxiety. For anxious patients, it is important that their dentist treats them with sensitivity and understanding.

In addition to their medical training, many dentists have already gained a wide range of experience in treating anxious patients. Some even take part in special training courses on the subject of dental fear to provide even better support for those affected.

At the beginning of treatment with an anxious patient, a calming discussion about individual treatment steps and possible alternatives is required. There is a relaxed atmosphere in which the patient feels comfortable and can relax.

Sedation – what does that actually mean?

At a Sedation Patients are calmed: internally with the help of sedatives, for example before a major operation or treatment, and the sensation of pain is reduced. The advantage: During sedation, patients can: continue to breathe independently on the inside and react to external stimuli - they are fully conscious and responsive.

A sedation using Nitrous oxide causes a kind of twilight state by dampening functions in the central nervous system. The medical procedure results in pain and anxiety relief.  

what is Nitrous oxide?

nitrous oxide, N2O or nitrous oxide, is a colorless, odorless, and slightly sweet-tasting gas. In medicine, nitrous oxide is used as an analgesic gas for anesthetic purposes or as a nitrous oxide-oxygen mixture to treat pain in short, moderately painful surgical procedures. Nitrous oxide is quickly absorbed by the body but not processed by the body. Therefore, no nitrous oxide remains in the body after the treatment.

The use of nitrous oxide has long been one of the safe and recommended sedatives for anxious patients, children and patients with swallowing and gag reflexes.

How old is nitrous oxide sedation?

Sedation with nitrous oxide is well-established and was discovered as an analgesic effect as early as the 18th century. It was first used as a pain reliever in the early 1800s when an American dentist had a tooth extracted under nitrous oxide. In the first half of the 19th century, nitrous oxide was mainly used or demonstrated at fairs or parties because of its stimulating effect. In this case, however, it is assumed from today's perspective that the euphoric effects were caused by an overdose of pure nitrous oxide, including the cause of increased hypoxia.

In the mid-19th century, the anesthetic was used in a mixture of oxygen and nitrous oxide for medical treatments and operations.

It was not until the 20th century that the nitrous oxide method was introduced to supplement local anesthesia in dentistry and expanded over the years.

In the past few decades, the use of nitrous oxide sedation has become less and less common. However, with advances in medical technology, the procedure is attracting more attention and is being used more frequently in Germany, especially in dentistry. In many other countries such as the USA or England, the procedure is widespread and is used successfully every day.

Who is laughing gas suitable for?

Nitrous oxide is suitable for almost all patients: indoors who are struggling with anxiety at the doctor. Anxious patients and children from the age of 4 benefit from the safe method. In children, there is a certain maturity to be able to treat it, since the child has to breathe in and out through the nose for a long time.

In particular, nitrous oxide is advantageous if patients: suffer from an above-average reflex to swallow and gag. This reflection is suppressed by the gas mixture.

However, dentists need to weigh possible risks and adapt treatment to their patients in the following cases:

  • Chronic obstructive pulmonary disease (COPD)
  • Severe mental behavior disorder
  • Non-cooperation in case of severe disability
  • pregnancy (first trimester)
  • A recent or existing middle ear infection
  • A completed or pending eye surgery
  • (Strong) cold symptoms

When does the use of nitrous oxide make sense?

The use of nitrous oxide by the dentist makes sense in the case of dental fear/phobia as well as strong swallowing and gag reflexes.

State-of-the-art equipment is used for nitrous oxide sedation, which guarantees an optimal supply of oxygen to the patient.

Laughing gas leads to a relaxed state and can help to suppress fears.

Is laughing gas safe?

In order to be able to carry out a successful treatment, some children need reassurance. Nitrous oxide is the safest and most efficient form of sedation to reduce the child's anxiety and achieve a positive experience. US studies show that 90 percent of American pediatric dentists use nitrous oxide on a daily basis. Gentle sedation is ideal for young patients. For them, the treatment flies by and the doctor can concentrate on his work thanks to the sedation. A visit to the dentist becomes a positive experience – without any fear.

Is nitrous oxide sedation harmful to my body?

no, nitrous oxide sedation is not harmful to the body and has hardly any side effects. Nitrous oxide has long been one of the safest, most researched and oldest sedatives. In many other countries, millions of patients have been successfully sedated with nitrous oxide every day for years.

How does nitrous oxide sedation affect the brain?

Narcotics in medicine act on the central nervous system, i.e. on the brain and spinal cord. Once taking effect, the sedative suppresses our consciousness and make us insensitive to pain. The laughing gas prevents nerves from communicating with each other. In this way, no pain signal is passed from the operating site where the surgeon is working to the patient's brain.

Nerves communicate by emitting chemical signals, which in turn are picked up by neighboring nerves.

Can I drive my own car after a nitrous oxide application?

Yes, just 15 minutes after the treatment the nitrous oxide is exhaled and the patient is fit to drive again.

Do I have to be sober before having nitrous oxide sedation?

No, it is not necessary to be sober before undergoing nitrous oxide treatment. The patient's daily routine is not affected and patients can eat and drink as usual.

How does laughing gas work?

Nitrous oxide transforms the patient's fear: inside before the treatment into deep relaxation. Inhaling nitrous oxide causes inner peace and minimizes the sensation of pain as well as the urge to swallow and gag, triggering a calming feeling of security. The safe and extremely effective patient calming method has already helped millions of people to overcome their fear of dental treatment and is part of everyday treatment in many countries.

The proportion of nitrous oxide on a regulator is slowly increased and individually adjusted so that patients: inside one optimal state of calm condition.

The laughing gas takes effect after just a few minutes and suppresses the fear before it can even arise. In contrast to general anesthetic Patients are: internally fully conscious throughout the treatment and therefore responsive.

Patients treated with nitrous oxide report feeling warm and comfortable.

The duration of action of nitrous oxide is limited to the duration of the sedation. Due to the rapid rise and fall of the gas, it has a rapid onset of action and exit in the body. The analgesic effects occur from a concentration of 20% nitrous oxide in the breathing air, for a narcotic effect the concentration can increase between 40 - 70 percent. After the sedation has ended, the nitrous oxide disappears from the body within 2 minutes and accordingly has no after-effects.

What are the benefits of nitrous oxide sedation?

Nitrous oxide sedation has many advantages for patients, including the very rapid onset of action and the very rapid recovery of normal motor functions and ability to drive, so no accompanying person is required on the day of treatment. Furthermore, the sedative has an anxiolytic effect, it increases the well-being of the patients and decouples them from the treatment. The gentle and light sedative causes few side effects.

The primary advantage is also that no anesthetist is required due to the safe use by the dentist.

Does laughing gas hurt?

no, in medicine, nitrous oxide has long been used as an alternative to general anesthetic deployed. Nitrous oxide has an analgesic, anxiolytic and calming effect.

How does nitrous oxide sedation work?

  1. The practice entrance: Before your first examination, you have had a preliminary discussion with the doctor and have been advised and informed about the subject of nitrous oxide. You can still find out more about nitrous oxide and its benefits in your dental practice - easily through brochures, flyers or by talking to the team.
  • The start of treatment: After being called into the treatment room, you can choose a nitrous oxide nasal mask in your favorite scent and colour. Your responsible doctor will now explain the treatment process step by step in the treatment room. You breathe in the oxygen-nitrous oxide mixture through a custom-fit nose mask, which takes effect after just a few moments. The pulse rate and the oxygen saturation in the blood are measured using a small chamber on the finger.
  • during treatment: At the beginning you breathe in oxygen as a patient 100%, the proportion of nitrous oxide is gradually increased and individually tailored to you. The mixture of oxygen and nitrous oxide makes you more and more relaxed and the doctors can treat you in peace.
  • End of treatment: After the treatment has been carried out, the supply of nitrous oxide is shut off. You now breathe in pure oxygen for 5 minutes. A short time later - after about 15 minutes - the nitrous oxide has evaporated. Your advantage: The daily routine is not affected by the sedation with nitrous oxide.
  • Adoption: You leave the practice with a relaxed feeling, without any fear or anxiety about the next appointment.

How is the ratio of nitrous oxide and oxygen adjusted?

At the beginning of the treatment, the patient is put on a nasal mask through which he can inhale the mixture of oxygen and nitrous oxide. The dentist starts with a dosage of 100% oxygen. After a few minutes, the proportion of nitrous oxide is increased in 10% steps. As the amount of nitrous oxide increases step by step, your dentist will talk to you and ask you how you feel. By exchanging information with the dentist, the mixture can be optimally tailored to the patient. In dentistry, a mixture of 30 to 50, maximum 70%, is common.

Does laughing gas have side effects at the dentist?

The few side effects that nitrous oxide has include nausea, dizziness, vomiting, increased sweating and restlessness.

In most cases, these side effects are due to too high or too fast a dosage of nitrous oxide. These side effects can be adapted to the needs of the patient and prevented by appropriate regulation of the nitrous oxide/oxygen mixture.

Rare side effects are also psychomotor side effects - which are resolved within 15 minutes - and psychiatric side effects, such as dreams and euphoria.

Other possible side effects are:

Cardiovascular side effects:

  • No relevant side effects when used in isolation
  • Slight decrease in heart rate
  • Slight decrease in stroke volume

respiratory side effects

  • Minimal or no respiratory depression
  • if the effect is not sufficient, consider another form of anesthesia

influencing vitamin B12 synthesis, especially for vegans and vegetarians

Symptoms such as tunnel vision, ringing in the ears

According to a survey by the Federal Association for Pediatric Dentists, the Nitrous oxide sedation fewer side effects than local anesthesia.

How much does nitrous oxide sedation cost?

Because it is a simple sedation technique, the use of nitrous oxide is cheaper than general anesthesia. The costs are between 100€ and 190€, depending on the length of the sedation. Treatment with nitrous oxide is particularly suitable for shorter appointments, as the nitrous oxide works quickly and wears off quickly.

Does health insurance pay for treatment with nitrous oxide?

Unfortunately, the sedation of laughing gas is not covered by statutory health insurance. The fee is therefore settled by your doctor himself. Supplemental dental insurance can reduce your own share of the costs. The assumption of costs by private health insurance also depends on the insured rate and benefits.

Which dentist offers a nitrous oxide application?

With our dentist finder on the Baldus homepage, it is possible to search specifically for dentists in your personal area. All known and certified nitrous oxide users are listed in the search.

Do you have to laugh during a nitrous oxide application?

This is not usually the case, but it can happen. The gas stimulates the diaphragm, among other things, which can lead to laughter symptoms. If it should occur, this effect only lasts for a short time and only at the beginning of the sedation.

Laughing gas is also used in its pure state as a drug, after a few seconds an intoxication sets in, in which weak hallucinations, feelings of warmth and happiness are triggered. This also stimulates the diaphragm and can lead to laughter symptoms. However, this is not without danger, the Federal Center for Health Education warns that internal organs and the nervous system are injured.

With nitrous oxide sedation, no pure nitrous oxide is used, but an oxygen-nitrous oxide mixture, so the patient is optimally supplied with oxygen during the entire treatment.

Every patient has individual experiences with a nitrous oxide application at the dentist.

How does laughing gas work for asthmatics?

Bronchial asthma is one of the most common chronic respiratory diseases.

During nitrous oxide sedation, neither the breathing nor the cardiovascular system are affected in healthy patients. Asthmatics in particular find the nitrous oxide treatment pleasant because more oxygen is supplied than is present in the air.

Can all dentists perform nitrous oxide sedation?

Before a nitrous oxide application can take place, there is a corresponding basic requirement for the doctor and the team. According to the CED decision of 2012, a further training course of at least 10-12 hours must be completed. After receiving a certificate, nitrous oxide sedation can be used in the practice without an anesthetist. And only from those who have a certificate have received.

How much does laughing gas stun?

Nitrous oxide induces a relaxed state and has a depressant effect on the body, relieving minor pain such as being bitten by a syringe.

The sedation technique with nitrous oxide can or must be combined with local anesthesia for more complex treatments. Laughing gas is not sufficient for larger treatment measures to take away the pain completely.

Is nitrous oxide a general anesthetic?

no, laughing gas is not general anesthesia. Patients are fully conscious during treatment with nitrous oxide. This has the advantage that the dentist can talk to his patients.

What is the difference between nitrous oxide sedation and general anesthesia?

In the case of general anesthesia, the presence of a trained specialist in anesthesia is required and indispensable during the procedure. The patient gets access and the anesthetic is injected into the bloodstream so that an effect occurs immediately and the patient is then artificially ventilated through the nose. As a result, the patient is completely anesthetized and does not notice anything of the treatment.

In contrast to this is nitrous oxide sedation. Nitrous oxide sedation is the only sedation option in dentistry that is performed with the patient fully conscious. This offers great advantages in communication between the patient and the dentist.

Compared to general anesthesia, nitrous oxide also offers the advantage that the patient consciously gains a positive experience during their treatment, since they are awake all the time and are capable of rational thoughts. In this way, a calm and relaxed treatment can take place.

In addition, the patient does not need an escort after a nitrous oxide application, he can take part in traffic as usual. The situation is different with general anesthesia, in which case an accompanying person is required. In addition, patients with general anesthesia must be careful to appear sober: six hours before anesthesia must not be eaten.

How does nitrous oxide sedation work?

The nose mask:

Before the start of the treatment, the patient is given a nasal mask to put on. The nitrous oxide-oxygen mixture is passed through the nasal mask. The patient breathes in and out through the nose.

In order to ensure an even more pleasant feeling during the treatment, we, the company Baldus Sedation, developed a new one Nasal masks-Product: the disposable double nose masks with fragrance. Patients can choose their favorite scent from six different scents.

Thanks to their perfect fit on the patient's face, the Baldus disposable double nose masks with fragrance guarantee greater wearing comfort, less room air contamination and, thanks to their flat shape, offer more space for the dentist to work. Thanks to the soft, supple inner mask and the transparent outer mask, which sits closer to the face, the patient's breathing is controlled and offers additional safety for the practitioner.

Baldus Sedation products offer more reliability, protection and comfort.

The scavenger system:

The scavenger system is a medical device used during treatment for the patient ventilation circuit. The patient inhales the oxygen-nitrous oxide mixture with the help of the scavenger system and again through it hose set out. Their basic function is a transmission system of hoses for conducting gases.

Inhalation phase:

The oxygen-nitrous oxide mixture is supplied via the hose system and inhaled via the nose mask.

exhalation phase:

When you exhale into the inner mask, one opens membrane and the exhaled gas enters the outer mask. The suction in the outer mask is separate from the inner mask, allowing the patient to inhale without further resistance.

The exhaled gas is over the oval membrane and the aerodynamic guide channels are optimally routed into the vacuum channel.

The double nose mask system successfully protects the personnel from the exhaled gas. The cuddly, autoclavable ones Nasal masks are easy to swap out and are available for both adults and children.

In which medical areas is laughing gas used?

areas of application of nitrous oxide sedation, including:

Especially in dentistry:

  • prosthetics
  • surgery
  • prophylaxis
  • pediatric dentistry
  • endodontics
  • tooth preservation
  • implantology

And many more

But also in other medical areas, such as:

Conclusion: Gentle sedation with nitrous oxide

The nitrous oxide sedation for patients guarantees a safe procedure: Hardly any side effects, relatively low costs and an increase in well-being during the treatment are convincing advantages. The patient is fully conscious and responsive throughout the treatment process, which means that there is no need for a complex general anesthetic. The patient can drive home independently after a nitrous oxide application, he is therefore fit to drive and does not need an accompanying person. The pleasant feeling that occurs during a nitrous oxide treatment speaks for itself.

You have any questions to this topic? Would you like more information about nitrous oxide sedation? Our Baldus experts look forward to yours contact! Our experts are also at your disposal in our chat. You can also find us on Facebook or Instagram

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