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Nitrous oxide, sometimes called laughing gas, is a gas that can help children feel calm during a dental visit. Here is what it feels like, how it helps, and what grown-ups should know.
Nitrous oxide is a gas you breathe in through a small mask that sits on your nose. It is mixed with oxygen. It can help you feel calm and relaxed. You stay awake the whole time, and you can still hear and talk to the team.
Your goal today: learn what nitrous oxide feels like, and how to breathe with the nose mask.
Breathe in slowly through your nose, like smelling a flower. Tell the team how you feel.
Nitrous oxide helps your body feel calm. It does not put you to sleep, and it wears off a few minutes after you stop breathing it.
Every office does it a little differently, but it usually goes like this:
The AAPD lists several ways nitrous oxide can make a dental visit easier. Here are three big ones.
It can lower worry and fear, so the visit feels more comfortable.
It can help you keep still, and make a long visit less tiring.
It can help if you gag easily when things are in your mouth.
Slowly, in and out through your nose, with your mouth closed.
No. You stay awake, and you can hear and talk to the team the whole time.
Safe and effective. The AAPD calls nitrous oxide with oxygen a safe and effective way to reduce anxiety, ease discomfort and help a child communicate with the dental team, and it notes that parents prefer it over more advanced options such as restraint or general anesthesia. Your child stays awake, keeps responding to the team and keeps protective reflexes. It starts working and wears off within a few minutes.
What it does not do. Nitrous oxide does not numb the tooth, so a numbing injection (local anesthetic) may still be needed for some treatment. It also leaves the body quickly, so it does not give pain relief after the visit. It works best when a child accepts the nose mask and breathes through the nose, and the team keeps reassuring and guiding your child throughout.
Share your child’s full health history, including medicines, and tell the office if your child has a cold, blocked nose or ear infection. The AAPD says fasting is not required, though a light meal is sometimes suggested. Follow your dentist’s instructions. The dentist will ask for your consent before using nitrous oxide.
The AAPD says nitrous oxide with oxygen has an excellent safety record and serious side effects are rare. The team watches your child closely the whole time, and offices that use it must have trained staff and emergency equipment ready.
The most common are nausea and vomiting, which happen in about 1 in 100 children or fewer. They are more likely with longer use, higher levels of gas, or a heavy meal beforehand. Less common effects include headache, dizziness and feeling restless or uncomfortable. Some children do not like the feeling of the mask or of losing control. Tell the team right away if your child feels unwell.
The AAPD says fasting is not required for nitrous oxide alone, but a heavy meal beforehand makes nausea more likely, so a light meal is sometimes suggested. Always follow the instructions your dentist gives you.
The AAPD lists conditions where it may not be used, including: a cold, sinus infection or allergies that block the nose; a recent ear infection; ear, nose or throat surgery in the last 14 days; certain lung diseases; raised eye pressure (glaucoma) or recent eye surgery; untreated vitamin B12 deficiency; certain cancer medicines; the first trimester of pregnancy; and some serious emotional conditions or drug dependency. Children with other medical conditions, special health care needs, airway differences or very large tonsils need individual consideration, and the dentist may consult your child’s doctor first.
Yes, asthma does not rule it out. The AAPD notes that nitrous oxide does not irritate the airways and may even lower stress that can trigger an asthma attack. Tell the dentist about your child’s asthma and medicines.
Possibly. Nitrous oxide helps with worry and discomfort, but it does not numb the tooth. For a filling or other treatment, the dentist may still use local anesthetic.
When the nitrous oxide is turned off, your child breathes plain oxygen for at least 5 minutes. The AAPD says your child must be back to their usual self before leaving. Most children recover within a few minutes.
With nitrous oxide alone, your child stays awake and keeps responding normally. Sedation uses other medicines to make a child more deeply relaxed or sleepy, and needs more monitoring. The AAPD notes that combining nitrous oxide with other sedating medicines can deepen sedation. See Sedation.
The clinical statements on this page come from the American Academy of Pediatric Dentistry (AAPD) best practice on the use of nitrous oxide for pediatric dental patients. Gas concentrations and flow rates are clinical details for the dental team and are left out on purpose.
Review status: pending. No named reviewer or review date yet.
This website is for education only and does not replace care from your dentist, physician, or emergency services.