Sedation dentistry refers to the use of sedation during dental treatment. Sedation is most commonly used during extensive procedures, for patients with dental phobia or for patients who find it difficult to sit still. There are different types of sedation, including nitrous oxide ("laughing gas"), IV sedation, oral sedatives and general anesthetic.

Sedation can range from the use of nitrous oxide to calm a patient to general anesthetics used to put patients to sleep. Patients with dental phobia, low pain tolerance, major dental treatment, physical handicaps or strong gag reflexes may require sedation. Procedures like fillings, crowns, bridges, root canals, extractions, cosmetic procedures and periodontal treatments often require sedation.

Sedation is endorsed by the American Dental Association and is an effective way to make many patients comfortable during their dental visit. Before using a sedative or anesthetic, it is important to tell your dentist about any medications or medical treatments you are receiving. Before administering any sedative or anesthetic, your dentist will talk to you about the process of sedation and pre- and post-sedation instructions.

"Laughing Gas"
Nitrous oxide, more commonly known as laughing gas, is often used as a conscious sedative during a dental visit. The gas is administered with a mixture of oxygen and has a calming effect that helps phobic or anxious patients relax during their dental treatment. Because it is a mild sedative, patients are still conscious and can talk to their dentist during their visit. After treatment, the nitrous is turned off and oxygen is administered for five to 10 minutes to help flush any remaining gas. The effects wear off almost immediately. Nitrous oxide rarely has side effects, although some patients may experience minor nausea and constipation. Your doctor will provide you with pre- and post-sedation instructions.

Why should I consider Nitrous oxide?
Nitrous Oxide is considered to be the primary sedation for orthodontic treatment because it is the safest. Often called laughing gas, it is non-allergenic and non-irritating. Most patients report little to no side affects. Patients also report reduced discomfort and worry from the local anesthesia (indeed, in some cases Nitrous Oxide can take the place of an injection) and are both conscious and aware during their appointments. As the depth of sedation can be altered to suit the individual conditions of each patient, it can help maintain a state of relaxation by decreasing a patient's gag reflex and saliva flow while reducing anxiety. Because the effects take only a few minutes to work, treatment can begin almost immediately after administration of the gas. In addition, the effects take only a few minutes to wear off, allowing patients to drive and return to work or home immediately after the treatment.

Who can use Nitrous Oxide?
As there are few side affects, nearly everyone. Those with asthma, severe bronchitis or other lung disorders should, however, consult with their orthodontist before treatment. In addition, any changes in a patient's medical history should be reported before using Nitrous Oxide.

What if I'm pregnant?
For those expecting, Nitrous Oxide is the primary sedative. It does cross the placenta, but it has no effect on most organ systems, it is not metabolized by the body and it is altogether dismissed from the body very quickly after treatment. However, patients should feel free to discuss Nitrous Oxide with their obstetrician before treatment.

How is it administered?
A machine that regulates the balance of nitrogen and oxygen will be attached to a soft rubber hood. The hood will be placed over the mouth and patients will be permitted to breathe in and out through their noses as they would normally. Over the course of treatment, patients will be administered larger percentages of oxygen, so that by the end of the appointment, they should feel normal.

How does it feel?
Generally, patients have reported slight tingling in hands and feet, and/or a slight numbness in their hands, legs, feet, tongues, and other soft tissue areas in their mouths. In addition, warmth and euphoria, accompanied by feelings of heaviness or lightness may be experienced. Finally, some patients report slightly muffled hearing, sometimes occasioned by a temporary ringing.

These symptoms should only be experienced while directly under the Nitrous Oxide. As the levels of nitrogen are lessened, the symptoms should desist. Therefore, if a patient feels any discomfort, he can discontinue the effects simply by breathing through his mouth. By the end of treatment, the patient should feel normal.

Patients should not feel giddy, sleepy, or nauseous. The patient should inform his doctor if such symptoms occur.

How should I prepare?
Patients should discuss any concerns or updates in medical records with their doctor before treatment and mention any medications they may be taking. Before treatment, it is recommended that patients avoid large meals, and they should also use the restroom to maximize their comfort. In addition, during application, patients should breathe through their nose and try not to talk, as this will expedite the treatment.

Remember, Nitrous Oxide is a safe, comfortable, and reversible instrument to help you relax during treatment!