Nitrous or Sedation

One of the most frequently asked questions we have from parents is what the difference is between nitrous oxide and conscious sedation. So this week we’re giving you clear and concise answers on the difference between each one!

Nitrous Oxide

Oftentimes, dental offices administer nitrous oxide, most commonly known as laughing gas, through a nose piece. The American Academy of Pediatric Dentistry (AAPD) recommends nitrous oxide as a safe and effective way to help children cooperate for the duration of their dental visits for a variety of reasons:

  • To reduce or eliminate fear and anxiety throughout the appointment.
  • To enhance communication between the patient and the dentist. With laughing gas, the child is able to be calmed down enough where the dentist can provide proper instructions for opening or closing their mouth and moving their head in a certain direction. 
  • To instill a positive attitude towards dental care. When appointments are able to go over smoothly because of the nitrous oxide allowing the child to be calm, it helps the child come back for their next visit without the nervousness that they may have had prior to their appointment. 

Nitrous oxide may also be utilized for an appointment to help with a gag reflex. Additionally, this type of nitrous oxide can be used for adults during their routine dental visits when they need treatments such as fillings, crowns, or root canals. 

At PDAO, we plan for the use of nitrous oxide at all of our in-office treatment appointments because we are confident that the use of the laughing gas will benefit the child. All of our assistants go through specific training that is required for them to be able to help administer the nitrous oxide. While the dentist is always in charge of the numbers/percentages and how it’s given, the assistants are fully qualified on being able to administer nitrous as well.

Nitrous oxide is given at the beginning of the appointment, and typically the child will be breathing the nitrous oxide for approximately ten minutes prior to the numbing. Then once all the treatment has been completed, they will breath a regular percentage of oxygen and be brought off the nitrous oxide for the end of the appointment. 

Patients are not allowed to leave the offices until the decrease in nitrous oxide happens. This ensures that we are able to safely and effectively complete the treatment in the office.


Sedation differs from nitrous oxide in a few different ways. The most common is that it’s actually medication that is given to the child prior to their appointment. At PDAO, all our dentists who perform conscious sedation appointments are licensed. It’s very important that you make sure that any dentist you see has this license through their state. 

There are many things that correlate with conscious sedation as far as how long the appointment takes and the fact that the dentists are not seeing any other patients for the duration of your child’s visit, which is why there are different types of fees for sedation appointments. Dentists will administer the sedation medications and then they will remain monitoring your child’s vitals through the entire appointment. 

Similarly to nitrous oxide, the AAPD recommends sedatives for certain reasons:

  • To reduce or eliminate fear and anxiety throughout the appointment. And although this is indicated for nitrous oxide as well, sedation is recommended for children who have not responded well to other behavioral techniques. Then they would be upgraded to a conscious sedation appointment.
  • Another reason is due to any medical conditions or physical ailments they may have. 

As far as behavioral differences between nitrous oxide and conscious sedation, on laughing gas, children will most likely just become sleepy or euphoric, whereas during conscious sedation they will potentially be more subdued. Furthermore, with nitrous oxide being flushed out at the end of their appointment, your child does not leave the office with it in their system. However, with conscious sedation, since it’s a medication, it will still be in your child’s system when they go home. The timeframes for the medication will be provided at the appointment, but it’s important for somebody to be home and monitoring them until the medication wears off. 

Lastly, there are instances where dentists will use nitrous oxide and conscious sedation at the same time, which is completely safe!

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