Nitrous Oxide: Why Don’t Dentists Use Anymore?

Dentist Not Use Nitrous Oxide

Dentists have a wide range of tools at their disposal when undertaking oral surgeries and other sorts of dental operations. This includes the use of several gases and solutions for pain alleviation. One of the most used gases before was Nitrous Oxide, commonly known as “Laughing Gas”. Why did dentists stop using this gas and what replaced its role in dentistry procedures?

Nitrous Oxide, or Laughing Gas, was introduced into the body via inhalation. Nowadays, it has been replaced with general anesthesia like ketamine, propofol, and isoflurane. This is due to potential side effects that may be induced by exposure to laughing gas. Although some dentistry practices still make use of Nitrous Oxide, the main consensus is that using it can lead to unnecessary risks for the patient.

For more information regarding this topic, we’ve put together this article regarding the effects of Nitrous Oxide and why it’s now being phased out of service. Keep reading and we’ll also delve into the different things that have replaced laughing gas in the clinic!

Why Don’t Dentists Use Nitrous Oxide Anymore?

According to various academic sources, Nitrous Oxide was first used in the 19th century by Horace Wells, an American Dentist. It was first used for pain relief during tooth extractions, with its uses slowly growing throughout the years. Now, it has been used in a variety of different dental cases thanks to its speedy onset of effects and the fact no needles are involved in its application.

Anesthetics and Sedatives like Nitrous Oxide are particularly useful in cases where a patient feels some form of dental anxiety. Also known as DFA, Dental Fear and Anxiety may manifest in different ways like delaying appointments, physical struggle, and other behavioral responses. Dentists found that sedation was an effective method to deal with the difficulties caused by severe DFA.

However, these benefits were found to be outweighed by the potential risks that the use of Nitrous Oxide brings to patients. One such risk is that people with a Vitamin B12 deficiency might have severely negative interactions with the gas. A study found that patients with lower B12 levels may experience neurological problems caused by several bodily processes being interrupted.

Another risk found brought to light by a study is that Nitrous Oxide is likely to increase the chance of wound infections after administration. An experiment found that patients that underwent Nitrous Oxide exposure had an increased risk for feelings of nausea and bouts of vomiting.

Some sources have stated that the use of Nitrous Oxide in clinical settings have caused deaths due to hypoxia. In all cases, pipeline flaws within the gas’ delivery system has caused a series of Nitrous Oxide-related deaths from 2002 to 2007.

This was caused by the machine only delivering Nitrous Oxide without any amount of oxygen, causing the patients to succumb to a lack of delivered oxygen. Although the number of cases is small within the 5-year timeframe, it shows that mismanagement and lack of maintenance can be an issue when it comes to gas administration.

How Do Dentists Decide When To Use Nitrous Oxide?

Although the use of nitrous oxide is being phased out, there are still times when patient sedation may be required. Dentists decide whether a patient is a candidate for sedation through a scoreboard where they measure a patient’s need for sedation. Some factors that affect the decision involve the patient’s anxiety, medical and behavioral factors, and how complex the operation is.

Should a need for sedation be found, the patient must also be physically healthy before sedation. There is some leeway granted to patients experiencing mild systemic diseases, but most cases require a patient to at least be somewhat healthy. A guideline for pre-sedation assessment has been released by the American Society of Anesthesiologists or ASA.

There are also sub-categories of sedation that affects different bodily functions. These range from Minimal Sedation, Moderate Sedation, Deep Sedation, and eventually General Anesthesia. You may ask your dentist or any reporting anesthesiologists nearby about your operation and the effects of the anesthetics or sedatives to be used. Along with that, ask about what safeguards are in place to ensure your safety should an emergency happen.

Anesthesia In Place of Laughing Gas

Luckily, the old technique of using Nitrous Oxide for sedation is on its way out as its replacements are slowly becoming more mainstream. One of the most common ways to do so is to avoid sedation altogether in favor of using different anesthetics for managing dental pain.

Topical, Local, and General Anesthetics all have their use in the dental profession. Topical anesthetics are typically applied to numb areas of the mouth before injecting the local anesthetic t be used for the operation. Another method of pain control is by using vibrating stimuli to distract nerves while a needle is being inserted. This helps to fool the patient’s perception of pain through and minimize experiences of discomfort.

Should the operation require the patient to be rendered unconscious, the preferred way of going about this is by using general anesthetics. It may even be used during operations where a patient’s anxiety is causing severe difficulties. It may also be deemed necessary for patients experiencing special health conditions like Autism, Trismus, and many others.

Non-invasive Management of Dental Anxiety

For Dentists, it’s important for the patient to regularly check on their dental health. This can be a challenge for patients who are already experiencing some degree of dental anxiety before the appointment. That’s why some dentists employ non-invasive measures to assure patients of their safety and comfort throughout their meet.

One such method is by creating a relaxing and ambient environment within their clinics. If a patient sees the clinic as unthreatening and peaceful, it can help to alleviate fears regarding the upcoming appointment. The dentist also must build a good rapport with their patient by using communication strategies and reassuring statements when describing operations. This sympathetic approach can cause patients to be less hesitant during the meeting.

Not to Miss: What Do Dentists Use To Numb Your Mouth?

Kelly Wilson
Kelly Wilson
Dream big, play hard, take the wins and embrace the losses.

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