Inhalation sedation

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Pain and fear are the factors that cause making the decision to come to the dentist difficult. That is why almost 40% of the population avoid reporting to the dentist. Sedation with the use of N20/O2 makes it possible to avoid these barriers. By using inhalation sedation, reduction in the patient’s consciousness is achieved, and pain perception Is partially eliminated. Throughout the procedure, however, we have contact with the patient – it is an important safety measure.

The influence of N2O/O2 gas mixture on the patient

Under the influence of the gas, the patient becomes calm, submissive, and indifferent, to the external environment. Children show an incredible tendency to day-dream. They “dream” of swimming, flying, being on an aeroplane, in a balloon, space rocket, or on a merry-go-round.

The child inhales a mixture of gas that smells like e.g. bubble gum through a mask put on the child’s nose. People who have problems breathing can take the mask home in order to practice breathing through this device, as it includes inhaling through the nose and exhaling through the open mouth (even though it may seem easy, it is not).

During inhalation sedation, sudden noises, loud conversation or shouting should be avoided, as it is easy for the child to “wake up” then. The best effects are achieved in silence and peace.

The role of the patient and the assistant is to talk calmly, tell fairy tales, as it makes it easier for the patient to achieve the state of calmness and full relaxation. Each additional person in the dental office distracts the patient’s attention, which may have negative impact on the effect of N2O/O2. Inhalation sedation can also be used in adult patients.

How do we determine whether you can try inhalation sedation?

Inhalation sedation is rarely successful in children under 3 because of the lack of cooperation. It is very important for us to know whether there have been any attempts to treat the child using “force”, as in some children trauma, which develops due to such attempts, causes such strong psychic trauma that further dental treatment can be performed only in general anaesthesia.

Indications and contraindications

  • Strong fear of any kind of treatment.
  • Fear of injections in children and in adults.
  • Strong gag-reflex.
  • Hyperactivity .
  • Long, monotonous or particularly unpleasant surgical or prosthodontic procedures, e.g. taking maxillary impression in patients with strong gag reflex.
  • Scaling.
  • Opening symptomatic necrotic teeth.
  • Incipient caries preparation.
  • Common cold, hypertrophy of the pharyngeal tonsil – obstruction of the upper respiratory tract.
  • 1st trimester of pregnancy.
  • Mental disorders.
  • Multiple sclerosis, porphyria.
  • Myasthenia gravis.
  • Bronchiectasis, emphysema.
  • Alcohol addiction (particularly in ex-addicts).
  • No cooperation from the patient’s side.

Diseases in which the use of inhalation sedation is indicated

  • Asthma – N2O gas does not irritate the respiratory tract. Decrease in stress levels cause the risk of attack to decrease. The mixture administered to the patient includes 50% of oxygen. This improves the function of breathing and the patient’s well-being
  • Epilepsy – lower stress levels cause the risk of attack to diminish
  • Cardiovascular disorders – N2O has no pronounced effect on the cardiovascular system. The patient receives oxygen at an increased concentration (50%), and higher amounts of the gas reach coronary arteries. Moreover, the need for oxygen is reduced because no stress is observed
  • Hypertension – N20 does not influence the vascular system. Decreasing stress- and anxiety levels protects the Patient from a sudden increase in blood pressure during the procedure
  • Haemophilia – thanks to the use of N20 we can avoid, in some cases, needle injections

How to prepare for the procedure?

  Before the procedure
  • Do not eat for at least 2-3 hours before the procedure.
  • Do not drink alcohol for at least 24 hours before the procedure.
  • Pregnant patients must inform the dentist about the fact that they are expecting.
  After the procedure
  • Children should remain under the supervision of an adult for the whole day after surgery.
  • Full recovery is very quick. The influence of gas stops a few minutes after the device is turned off.
  • The Patient can drive 30 minutes after surgery.

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Wielkopolskie Centrum Medyczne
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