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Palos Pediatric Dentistry
kids dentist | palos heights il

Nitrous Oxide for Anxious Kids

March 10, 2018
Posted By: Dr. Richard Facko
two kids with toothbrushes | dental anxiety

Whenever possible, we work with families to help prevent cavities in children.  From healthy diet to brushing techniques, our office focuses on prevention at each check-up visit.  Sometimes, children with cavities are referred from other offices.  At other times, despite everyone's best efforts, one of our regular patients is diagnosed with cavities.  Don't worry!  We have plenty of treatment options to keep your children safe and comfortable throughout the whole process!

For children without anxiety, or with a minimal amount of anxiety related to dental treatment, nitrous oxide may be the perfect treatment option.  The greatest benefit of nitrous oxide is that it has minimal side effects.  It is often adequate to prevent cooperative children from becoming anxious during a dental treatment visit. Nitrous oxide “enhances” a child’s ability to cooperate. For that reason, it is usually ineffective in very young children who are “pre-cooperative”. For very young children, alternative treatments are usually indicated.

What exactly is it?

Nitrous oxide is a colorless and nearly-odorless gas.  Some describe it as having a slightly sweet smell.  It is used for several minutes before beginning dental treatment, and remains throughout treatment.  Patients who are treated with nitrous oxide remain awake throughout the procedure.  It raises the pain threshold for some patients, and allows others to remain calm and still for longer dental appointments.  Children experience a mild level of relaxation with minimal effect on their respiratory system.  They are able to maintain normal breathing, blood pressure, and oxygen levels on their own.  Because of the wide margin of safety and long history of use, the use of nitrous oxide in children is very common.

Nitrous oxide is rapidly absorbed into the bloodstream. This advantage means that it doesn’t take very long (only a few minutes) to start working, and it is also expelled from the body rapidly. Unlike more invasive methods, children leave the office in a normal mental state and are able to resume normal activity right away.

Are there any downsides?

The most significant downside to treatment with nitrous oxide is related to its greatest strength - it is not very potent.  For children who have had a history of challenging visits at the dentist, or for children with higher levels of anxiety, nitrous oxide may not be effective. In these circumstances, there are more profound levels of sedation/relaxation that can be achieved using other methods. The most common adverse reaction to nitrous oxide is nausea and vomiting, which is reported to occur in 0.5% (1 in 200) of patients.

Nitrous oxide is one of many tools that we may employ for children with dental needs (fillings, crowns, extractions, etc.). It allows children to tolerate slightly more challenging procedures than they would be able to tolerate on their own. For very young or very anxious children, other treatment options may provide a more desirable outcome. The use of any behavior management technique is best determined with a conversation about the risks and benefits of all available options. If you are interested in treatment with nitrous oxide for your child, or for more information, you can contact our office any time.

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