Maybe it is a racing heart in the waiting room, or dread in the parking lot. You have heard that laughing gas or a sedation pill can make a visit easier. When you compare nitrous vs oral sedation, two questions matter most. What will each one feel like in the chair, and what does the rest of the day look like afterward?
I get it, and you are not the only one. I used to be very, very dental phobic myself, so I can totally relate. I used to have a horrible gag reflex. You can read more of that story on my page. At our office in Henderson we offer both options, nitrous oxide and oral sedation, so here is the plain version of how they differ.
Nitrous vs oral sedation: what is the real difference?
The biggest difference is how each one gets into your body. That one fact explains almost everything else, including how fast it works, whether it can be adjusted and whether you can drive home.
Nitrous oxide is a gas that you breathe, so it enters through your lungs. Per the American Dental Association, it is mixed with oxygen and breathed in through a small mask that fits over your nose. From your lungs it passes into your blood, so it starts working quickly. It also does not dissolve well in the blood, so it does not stay long either. The ADA notes that nitrous has the fastest onset of the inhaled agents, and that its low solubility lets the body remove it rapidly.
Oral sedation is a pill you swallow, and the ADA's sedation guidelines describe this route as absorption through the digestive tract.
The same guidelines describe giving a breathed-in drug in small added steps until the effect is right. So the gas can be adjusted during the visit, and it leaves when you stop breathing it. The pill builds and fades on your body's timetable instead.
What does laughing gas actually feel like?
You breathe through your nose as normal, and within a few minutes the effect starts. The ADA says you may feel light-headed or notice a tingling in your arms and legs. Some people say their arms and legs feel heavy instead. Underneath those sensations, the aim is that you feel calm and comfortable.
You stay aware the whole time, and you can hear what is said to you and answer it. If the feeling is more than you want, say so, because the amount you breathe can be adjusted.
When the treatment is done, the gas stops and your lungs do the rest. The effects wear off soon after the mask is removed, the ADA says. That is why, after nitrous here, you are clear to drive yourself home.
What does a sedation pill feel like?
You take the pill before you arrive, and it goes deeper than the gas. The aim is that you feel calm and drowsy through the visit, and that drowsiness does not lift the moment we finish.
You are still not unconscious, so you can hear me, answer questions and follow along.
Because the pill lingers afterward, you need someone to drive you home. We talk through what to arrange, and you sign off on it in writing before anything is given.
Why can you drive after nitrous but not after the pill?
It goes straight back to the route. Nitrous leaves the way it came in, because the ADA says your body clears it by breathing it out. That is why it wears off within minutes of the mask coming off. The ADA's guidance for dentists is to give pure oxygen for five minutes before the mask is removed.
A pill has no mask to take off. Once you swallow it, it keeps working until your body clears it, so the effect lingers after you leave. Even at the lightest level of sedation the ADA defines, thinking and coordination may be modestly affected. Driving needs both, so after the pill someone else takes the wheel.
What happens if fear keeps you away?
When fear keeps you away, whatever is going on in your mouth keeps going. Gum disease is a good example. Two of the signs a dentist measures are how deep the pockets around your teeth are, and whether your gums bleed when gently probed. Neither one hurts, so the disease can move along quietly while you stay away. You can read more about how we treat gum disease.
Sometimes the cost of not doing anything could end up being even higher down the road, financially and for your overall health. Sedation is one way to make the visit happen instead of putting it off again.
How do you choose between nitrous and oral sedation?
You do not have to decide any of this before you call. The ADA lists what a dentist weighs when choosing sedation. It names the type of procedure, your overall health, any allergies and how anxious you feel.
That is how we approach it here, so sedation is decided at your exam, not at the last minute in the chair. I review your health history and current medications, and then we talk through whether nitrous, oral sedation or neither fits you. A longer visit with several things to take care of is one reason sedation comes up.
Once you are settled, we monitor you throughout your visit and check in regularly. Blankets, headphones and a stress ball are at the front desk for any visit, sedated or not.
The cost of sedation depends on which option fits your visit, so we do not quote a number over the phone. It is written down as part of your plan before anything starts. When we sit down together, these are good questions to ask:
- Which option fits this visit, and why that one?
- What do I need to arrange beforehand, and do I need a driver?
- How will I feel afterward, and for how long?
- What does the sedation line on my plan cost, and is it separate from the treatment?
For more on how it works at our office, see how sedation works at Smiles by Goh. If you have not been here before, read what a first visit looks like, or browse our FAQ page.
Common questions about nitrous and oral sedation
Will I be asleep?
No, both options keep you relaxed and responsive rather than unconscious. You can still hear me, answer questions and follow along, just more calmly than you would without it.
Can I drive home after laughing gas?
Yes, the gas wears off within minutes of the mask coming off, and you are clear to drive yourself. After oral sedation you cannot, because the pill lingers, so you arrange a ride before the visit.
What does sedation cost?
It depends on which option fits your visit, so we do not quote a number over the phone. The cost is written down as part of your plan before anything starts, so you decide with the number in front of you.
Can sedation help with a strong gag reflex?
It can. I used to have a horrible gag reflex myself. If yours makes routine visits hard, sedation is one of the more direct ways to make a visit workable. At your exam we talk through your gag reflex, what is being done and your health history. Then we decide together whether nitrous, a pill or neither fits.
Call us at 702-732-3754 and tell us what makes a visit hard, whether that is the sound, the needle or the chair itself.