Nitrous Oxide…Aka Laughing Gas – Part Three

There are not too many contra-indications to using Nitrous Oxide (N2O)… it is a relatively safe method of helping a patient to relax. However, there are situations in which it is best to avoid using it as a mode of sedation. We will look at these:


Patients who:
-are mouth breathers.
-have a blocked nose I.e., a cold……Individuals need to be able to breathe through their noses in order to benefit from N20.
-suffer from claustrophobia and cannot have a mask placed over their nose.

Other contra-indications are those with medical conditions:
– Multiple Sclerosis.
– Emphysema.
– Severe Chronic Obstructive Pulmonary Disease.
– Bronchitis. The above medical restrictions are because the nasal passages are blocked and they need to be clear in order to use N2O.

Our list of restrictions continues:
– If one is a recovering alcoholic or was/is involved with some type of substance abuse, it would be best to speak to the patient’s doctor before using N2O. The reason for this is that the euphoric feeling of the N2O may push an existing or recovering addict back into their addiction.
– If one has psychiatric problems (tied into the previous point), then it is also advisable to speak to the patients physician first.
– If one is pregnant, then it is best to speak to the patients Obstetrician before using N2O, and it should especially be avoided in the first trimester.


Nitrous Oxide is safe to use if one has the following medical conditions:
– Epilepsy.
– Liver disease.
– Heart disease.
– Diabetes and
– Cerebrovascular disease.

Nitrous Oxide and Children
It is safe but not viable for all children. For example, can they:
• tolerate a mouth piece?
• breathe through their nose?
• follow the dentists instructions?

We are almost finished our discussion of N2O.

In the next blog we will look at some of the frequently asked questions that one may have concerning N2O…Cheers!

Dr. F. Keshavarz Dentistry

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