Is nitrous oxide (laughing gas) safe for toddlers and children?

Most pediatric dental appointments are completely pain and anxiety free.

But sometimes, your dentist may need a little help making your child feel completely comfortable - especially during restorative appointments like getting a filling or nerve treatment.

Local anesthetic is used to block the pain and physical discomfort that's the cause of most anxiety felt by toddlers and children during these appointments.

When local anesthetic isn't enough to make your loved one feel completely comfortable, your dentist may suggest using nitrous oxide gas (commonly referred to as laughing gas).

But how does nitrous oxide work, and is it safe?

Nitrous oxide is used safely and effectively every day for patients of all ages, and you may be surprised to learn that it's especially effective with toddlers and young children.

How does nitrous oxide (laughing gas) work?

Nitrous oxide is a colourless with a faint, sweet smell.

The purpose of nitrous gas is to reduce anxiety and the potential for excessive movement from young dental patients, generally during filling appointments which are longer and require more cooperation than regular check-ups.

It causes a sense of euphoria (often accompanied by a case of the giggles) with little effect on the respiratory system.

The beauty of nitrous oxide gas it that its effects are felt almost immediately, generally taking effect within less than a minute of wearing the nasal mask.

Its effects are also almost immediately reversible, returning the patient to their pre-existing state within moments of removing the mask.

This means that nitrous oxide can be introduced quickly mid-appointment, without interrupting treatment to wait for another type of sedative to take effect.

Although nitrous oxide gas has mild pain relief benefits, it's always used with local anesthetic for restorative treatments, relieving any physical discomfort that can cause fear or anxiety.

It also reduces the gag reflex. This raises the comfort level and cooperation of a patient who gags easily or worries about gagging or vomiting during treatment.

How safe is nitrous oxide (laughing gas)?

Expert use of nitrous oxide gas is completely safe for use with toddlers and young children.

Adverse effects from use of nitrous oxide are rare. 

The most common adverse effects are nausea or vomiting, occurring in just 0.5% of patients, according to the American Academy of Pediatric Dentistry.

Fasting isn't required for patients receiving nitrous oxide, however your dentist may recommend your child consume only a light meal at least two hours prior to your appointment.

Unlike general anesthetic and some pharmaceutical interventions, your little one stays completely conscious and able to respond normally to verbal commands while maintaining their protective reflexes throughout the entire appointment.

The effects of nitrous gas inhalation are also far more predictable than many pharmaceuticals.

At Monarch, little details make a big difference

Our Kid Friendly Care helps even the most anxious kids (and parents) feel comfortable and safe in our care.

We also know that wearing a nasal mask for the first time can take some getting used, so we make it fun by offering a variety of latex free scented nasal hood masks for your child to choose from!

Patients are encouraged to choose their favourite scent and take it home so they can practice wearing it before their appointment.

Like all forms of paediatric anesthesia, only Monarch doctors administer nitrous oxide gas.

Every child has a slightly different reaction. Using your child's body weight and other visual cues, our doctors will adjust the gas level to just the right concentration needed to make anxious kids feel safe and comfortable.

In some cases, we'll even turn the nitrous oxide gas off completely and rely upon the placebo effect after your child has settled into the chair.

All Monarch offices are equipped with special badges which read the nitrous oxide levels in the office so we can monitor exposure of other patients, parents and staff in the office but not administering or directly inhaling the nitrous oxide gas.

Every Monarch family member is a friendly, trained professional who has extensive experience working with kids, and we pay attention to the details to make every visit as successful and fun as possible!

About the authors

Doctors Peter Chan, John Hung, Elsa Hui-Derksen, Jennifer Yee, Mark Casafrancisco & Jonathan Hung and associates are pediatric dental specialists at Monarch Dental Centre.

With over 55,000 patients seen at offices in Burnaby, Port Moody and Surrey, BC, we've developed Kid Friendly Care to make your family's dentist visits easy and fun.

Our FREE Brushing Reward Chart makes getting your toddler or child to brush their teeth twice daily easy and fun!