You've probably heard of laughing gas. It shows up regularly on television, usually as a tool for comedic relief. On shows like The Simpsons and Batman, laughing gas always results in uncontrollable laughter. But is it really a laughing matter?
At Lowry Dental, we use laughing gas for inhalation conscious sedation. Although it can sometimes make people laugh, the most likely result is just a calming of the nerves. It produces a dreamy state that can help the patient get through a dental procedure. People with anxiety often find it to be particularly helpful.
It's the common name for the chemical compound nitrous oxide.
Nitrous oxide is made up of two atoms of nitrogen bonded to one atom of oxygen. It is a colorless and non-flammable gas. Laughing gas is typically administered with the addition of pure oxygen.
Sweet air is another nickname for nitrous oxide because it has a faint, slightly sweet odor. Although there is an element of sweetness to the smell, there is also a metallic aspect to the odor.
Nitrous oxide was first synthesized in 1772. In its earliest uses, it was seen as a potential treatment for lung diseases like tuberculosis. Although this wasn't a successful therapeutic use, it allowed researcher Humphry Davy to make the discovery that nitrous oxide had promise for use as an anesthetic. It wasn't until 1844, though, that nitrous oxide was actually used in this way. Dentist Horace Wells of Hartford, Connecticut used laughing gas to treat a number of patients undergoing dental procedures with great success.
Since then, nitrous oxide has been a mainstay in dental use. It's not strong enough for use as an anesthetic in most medical situations but it's ideally suited for helping patients get through uncomfortable dental procedures with minimal pain and anxiety.
Nitrous oxide activates parts of the brain's reward system and causes a release of the neurotransmitter dopamine. This leads to a euphoric effect. This feeling of happiness is what may make it more likely for some people to laugh when on nitrous oxide.
It also has an anti-anxiety effect because it activates a specific type of GABA receptor in the brain.
Finally, it has a pain-relieving effect because it activates the body's endogenous opioids or natural pain killers.
Nitrous oxide is non-toxic, although it can be quite intoxicating with prolonged exposure. There's no risk of excessive exposure as part of a dental procedure at our office. We're well-versed in administering nitrous oxide and our procedure rooms are well-ventilated.
Although nitrous oxide has proven to be a valuable aid in dentistry, some people have taken to misusing the chemical as a recreational drug. This actually started even before it was discovered to have anesthetic properties and before its first use in dental procedures. Starting in 1799, the British upper class had "laughing gas parties." Since then, it has been widely misused around the world. In fact, it's become a major problem in the UK of late. The British government has had to put a number of warnings about the drug and even moved to ban its sale.
When administered in a controlled setting and in a proper dose, nitrous oxide is not dangerous. It's non-allergenic, so all people should be able to tolerate it well.
We follow all guidelines from the American Dental Association and the Council on Scientific Affairs for the safe administration of nitrous oxide. We also have a lot of experience with it and have a proven track record.
Nitrous oxide is perfectly safe for children. We use it often to help kids through a dental procedure that might feel a little scary. There are no unusual adverse risks for children. With kids, the ratio we use may be as high as a 70:30 mix with more oxygen than nitrous oxide.
The Experience is Easy and Nitrous Oxide is Generally Well-Tolerated.The exact experience varies from person to person but laughing gas is well-tolerated by almost everyone. The experience of having laughing gas is pretty simple. All you have to do is breathe.
At the right doses, there aren't any side effects to laughing gas, other than the desired ones. These include a state of relaxation, feelings of happiness, feeling somewhat lightheaded, and possibly feeling tingly and warm.
If you fall asleep or start to feel nauseous, it's a sign that you've had too much. At Lowry Dental, we are careful not only to administer the drug carefully but also to make sure you know how to tell us if you're not feeling well.
What most patients tell us is that laughing gas just makes the experience of a dental procedure easier. People who are particularly nervous about the dentist find that it reduces their overall stress and anxiety about the experience. It can also be helpful for people with sensitive gag reflexes.
We will usually administer 100 percent oxygen after the end of the procedure. This is particularly important with children since they desaturate more rapidly than adults.
There's nothing about nitrous oxide that automatically causes laughter. In other words, it's nothing like how it is on TV. When Batman villain Egghead released a canister of nitrous oxide and Batman and Robin immediately started giggling and couldn't stop, it was just fun television. When we administer nitrous oxide to our patients, there is only occasionally any laughter. That is, unless we tell a few jokes. Nitrous oxide may make the laughter response a little easier, so we find it's a helpful time to make us feel like our jokes are actually funny.
Laughter itself might be beneficial to the experience, though. Believe it or not, laughing actually triggers the release of all kinds of feel-good chemicals in the body. So actually laughing from laughing gas might further increase the pain-relieving properties of nitrous oxide.
You might notice some difficulties with motor skills and attention after having laughing gas. It may take 15 minutes or so for the effects of nitrous oxide to wear off. For this reason, it's often a good idea to get a ride home afterward. You can also just hang out in our comfortable waiting room for a bit until the effects have worn off.
Some people worry that nitrous oxide will make them spill secrets but this is a misconception. Laughing gas may make you slightly more disinhibited but for most people, it won't be enough to cause any unusual behavior. Your secrets are safe!
We're happy to help you decide whether or not nitrous oxide is a good choice. It's certainly not called for in every procedure or for every individual. For many, just talking through the details of a procedure is enough to help calm the nerves. Some people will be fine with distraction as a technique for dealing with dental anxiety. For those who need a little more help staying calm and comfortable, nitrous oxide can be a good tool. For others, nitrous oxide isn't enough and oral conscious sedation might be called for. We can talk you through the pros and cons of your different options.
We want your dental experience to be as comfortable and worry-free as possible. For some, laughing gas makes the experience of a filling or a root canal more bearable. If you want to talk to us about using laughing gas or schedule an appointment, get in touch today. Our family wants to help your family have healthy and great looking smiles for years to come. Whether we use nitrous oxide during your appointment or not, we promise that you aren't required to laugh at our jokes.