How Nitrous Oxide Works

Nitrous oxide (N2O) is a colorless, odorless gas that has been used for dental sedation and pain relief since the 18th century. It is sometimes called “laughing gas” because one common side effect is that people can feel not only relaxed, but also euphoric, which makes them tend to laugh and be unable to stop.

Despite its long use, we are not entirely certain of the mechanism by which nitrous oxide produces its effects, but recent research has brought us a lot closer to understanding. It seems that, like an opioid, it stimulates certain modulators in the spinal cord that reduce the transmission of pain signals. It produces sedation by the same mechanism as benzodiazepines, the most common oral conscious sedation medication. Both stimulate receptors of γ-aminobutyric acid (GABA), which is also important to drug-free sedation dentistry.

Benefits of Nitrous Oxide

Nitrous oxide has many potential benefits for sedation dentistry patients, including:

  • Reduction or elimination of dental anxiety
  • Additional reduction of pain
  • Encourages positive associations with dental visit
  • Has immediate effect (effective within five minutes)
  • Can be continued as long as necessary
  • Wears off quickly (people recover within five minutes)

Because of these benefits, it is often described as being an ideal sedation dentistry solution, but there are some factors to consider that make it less than perfect.


If nitrous oxide were as ideal as the above list suggests, there would have been no need for dentists and other medical practitioners to seek alternate methods of sedation and pain relief. Some of the reasons why this is not perfect for everyone include:

  • Can’t relieve anxiety before dental appointment
  • Offers only mild sedation—may not be adequate for you
  • Pain relief wears off quickly—some experience more discomfort after a procedure
  • Some people do not like the euphoric effect
  • Isn’t appropriate for people with respiratory problems
  • Can cause neurological problems for people with B12 deficiency

Although the last item is normally only a problem for people who use nitrous oxide as a recreational drug and can use it dangerously, it does remind us that it can be addictive.

Despite its drawbacks, inhaled sedation makes sense for many people. To talk to a sedation dentist in Orange County about nitrous oxide as an option to overcome your anxiety, please request an appointment at Rice Dentistry in Irvine.