How dangerous is nitrous oxide when used by an oral surgeon when extracting teeth?

Question

I am scheduled to have 3 teeth extracted and am afraid of general anesthesia due to diabetes, asthma and high blood pressure. Have opted for nitrous oxide, instead. What are the risks and will I feel pain during the extractions?

Answer 1

I'm a dentist.

You have little to worry about, for a few reasons.

First of all, oral and maxillofacial surgeons are well-trained when it comes to anesthesia and handling medical emergencies.

Second, nitrous oxide is a general anesthetic that does not produce a state of general anesthesia by itself. There is a concept concerning inhalational anesthetics called "minimum alveolar concentration" (MAC), which refers to the minimum concentration (in terms of percentage of anesthetic in the total gas content of your lungs) at which 50% of patients will be under a state of general anesthesia. The inhalational anesthetics that they use in the operating room (e.g. sevoflurane, desflurane) have MACs of 1% to 4%. Nitrous oxide has a MAC of 110%, a concentration that cannot be achieved at normal atmospheric pressure. That means, at normal atmospheric pressure, it is virtually impossible for you to be put under a state of general anesthesia with nitrous oxide. You may doze off under nitrous oxide, but you are far from being under general anesthesia. There's a big difference. General anesthesia is defined as a state where a person will not respond to a 1-centimeter incision on an un-anesthetized area of the body. If you were asleep on nitrous and someone cut you with a blade without numbing the area first, you'd still wake up and hit the roof. Nitrous is very, very safe.

With regard to your diabetes and high blood pressure, neither of these are contraindications to the use of nitrous. In fact, hypertension is an excellent reason to use nitrous, because it relaxes you and hence will help keep your blood pressure from rising during the procedure. Nitrous oxide also dilates blood vessels, which helps reduce blood pressure.

You've got nothing to worry about. You may even consider getting some intravenous sedation with the procedure. Of course, with IV sedation, you will need someone to drive you. With nitrous alone, you can drive yourself home.

Answer 2

i just had four teeth extracted and used nitrous oxide. they also use novacaine so no, you won't feel a thing! i was also given a valume (sp?) and i actually fell asleep while he was doing the surgery. i had a few moments of panicing because i felt like i was choking on my spit! but it passed and i was fine. you'll actually laugh for no reason i always thought it was a joke until i actually went through it and started laughing for no reason at all. i had no side effects from it. the hydrocodone they gave me to take afterwards however did make me EXTREMELY sick. so i had no pain meds for 24 hours because i had to wait to be able to drive and pick up the prescription for the percocet. i'm guessing it's wisdom teeth you're getting out? if so best of luck. that first couple days was hell!!

Answer 3

First off...when it comes to dentist's..I'm the biggest chicken chit alive! I won't even let them give me novacaine without FIRST giving me nitrous oxide. My point is, ..no matter how scared you are, the nitrous will relax you and diminish that fear somewhat. You may still feel a little apprehensive, but not enough to make you nix the surgery. Secondly, once you've had the nitrous, (and have given them the go ahead ) they will give you novacaine, and you won't feel anything at all. I had ALL my teeth removed. Nitrous oxide was a God send to me.

Answer 4

There really are not many risks with nitrous. I had extensive dental work done over a long period of time and used nitrous every time. It does make one feel more relaxed and not on edge. It did nothing for the pain. I also had Novocaine used to avoid pain.

Answer 5

if you're nervous about the laughing gas, ask for a smaller dose. some people (myself included) are sensitive to nitrous oxide so feel very sick with a high dose. they will be happy to adjust the level to your needs. the gas is really to calm you down to get the novacain shots and also if your anxiety levels are lowered, the medications will also work better (if you get an intravenous as well, like an I.V. form of valium). you really won't feel any pain. you'll probably fall asleep.

Answer 6

I don't know but it was good at the Grateful Dead concert a few years back!