Nitrous oxide primarily works as an anxiolytic and also has a mild analgesic effect, although an additional local anesthetic is usually required.

Patients describe a pleasant and relaxing effect, as well as a certain detachment from what is going on in the treatment room. Because of the analgesic effect, patients find the injection of the local anesthetic less unpleasant and often barely notice the prick as the needle is inserted. Any gag reflex is usually completely suppressed.

As a result, the dentist and treatment team are able to work more effectively and in a more relaxed environment.

The basic equipment you will need is a flowmeter (mixer), a patient breathing circuit for the supply and removal of the gas mixture, nasal masks, and medical gases (oxygen and nitrous oxide), supplied to the flowmeter via pressure hoses either from gas canisters or from a central gas pipe.

You should also have a pulse oximeter for optimum patient monitoring, which allows you to keep an eye on the patient's pulse and oxygen saturation quickly and easily. It is recommended that all practices have emergency equipment.

Nitrous oxide sedation is an extremely safe method, used by millions worldwide. It is standard practice in many places, including the US and Scandinavia.

The high-quality equipment from Accutron Inc. has a nitrous oxide cut-off, meaning that a maximum of 70% nitrous oxide can be administered to the patient.

Nitrous oxide is supplied in a percentage mixture and can therefore be optimally adjusted to the patient’s needs. As a result, an overdose is practically impossible. Nevertheless, there are certainfactors which rule out the use of nitrous oxide, such as pneumothorax.

Completion of an advanced certified training course is therefore strongly recommended.

Payment is settled with the patient directly.

The valuation standard for dental services in Germany, the BEMA-Z, does not cover nitrous oxide sedation in its catalog of services. The German schedule of fees for dentists does not include a figure for providing this service either. The fee for treatment is generally calculated as being between 50 and 80 euros.

Nitrous oxide inhalation sedation is the fastest available method of dental sedation; the onset and recovery times are just a few minutes each.

Patients are usually able to leave the offices unaccompanied after 15 to 30 minutes and continue their everyday activities as normal.

Nitrous oxide sedation can conveniently be used to carry out even time-intensive treatments in an environment which is pleasant and comfortable for the patient.

There are no time limits or conditions imposed for safety or health reasons, but a break is recommended after four hours of treatment, not only for the sake of the patient but also for the dentist carrying out the treatment and his team.

Because the patient always remains conscious and able to communicate, there is no need for an anesthetist to be present.

Dentists who have completed an advanced certified training course have the necessary skills to offer nitrous oxide sedation in their practice.

With oral sedation, the patient is more deeply sedated, meaning that he cannot leave the practice unaccompanied following treatment. Unlike nitrous oxide, oral sedatives are not inhaled but are instead taken orally. They also only take effect after about an hour and not after a few minutes as is the case with nitrous oxide sedation.

Yes, a certified advanced training course with anesthetists and emergency physicians and the certificate acquired from the course enable you to perform nitrous oxide sedation in your practice.

It is important to evacuate gas from the system to relieve the  pressure regulators and the pressure hoses. To do this, the valves on the gas canisters are turned off and the flow of the two gases is turned up full on the flowmeter. This completely evacuates the gas from the equipment, and you can then easily remove the pressure regulators if necessary, for example to change the canister.

Once the system has been evacuated, the flow of the two gases must be turned off again using the flowmeter.

This is normal because the canisters cool down under pressure, and in warm rooms the moisture in the air collects as condensation.

It happens more on hot days in the summer and in winter when the heating is on a lot.

Nitrous oxide is roughly one and a half times as heavy as air and collects along the ground. For this reason, good ventilation must be ensured during and after nitrous oxide sedation to enable the nitrous oxide to escape.

The concentration at the workstation can be kept at a very low level thanks to the integrated exhaust ventilation in our CE-certified patient breathing circuit and by regularly airing the room.

The current level of oxygen in a canister can be calculated from the nominal volume and the current pressure: at a pressure of 200 bar and a nominal volume of 10 liters, the volume in the canister corresponds to 2,000 liters (200 bar x 10 liters). When the oxygen level reaches 500 liters (50 bar), we recommend that you order a new oxygen canister so that the practice can continue working without any interruption.

The current level of nitrous oxide in a canister can only be determined from the weight. However, it is not possible to constantly weigh the nitrous oxide canister during the normal day-to-dayoperation. As a rule of thumb, if the pressure in the canister drops below 50 bar, there is still enough nitrous oxide remaining for treatment lasting 30-45 minutes.

In light of the information above, it is advisable to keep a canister of nitrous oxide and a canister of oxygen on stock at all times as a precaution. This will enable you to guarantee the smooth running of procedures at the practice.

The reusable nasal masks can be autoclaved at 121°C for 10 minutes.

Thermal disinfection for 10 minutes at 93°C is also acceptable.

We recommend cleaning the reusable nasal masks after every treatment by autoclaving them or cleaning them in a thermal disinfector. The nasal masks should be replaced when the material becomes porous.