Nitrous oxide, commonly known as laughing gas, is an inhalant drug that is often used by dentists as a safe “local sedation method” for anxious, pain-sensitive patients.

It is similar to many medicinal drugs—it is not for everyone, it can be abused, and it has both pros and cons for someone with a history of substance abuse.

“A guide for the practitioners” from the International Journal of Advanced Research, lists the following objectives for use of nitrous oxide: “reduce untoward movement in reaction to treatment, enhance communication and patient cooperation, reduce gagging, and to increase tolerance for longer appointments.”

About Nitrous Oxide Abuse

The same article also explains some scenarios where they do not recommend using nitrous oxide, one of them being if the patient has “severe emotional disturbances or drug related dependencies.” While it could certainly be interpreted as generalizing to list these two conditions as interchangeable, the warning is still there.

Even if laughing gas is used appropriately for dental procedures, it can still be abused like many other medicinal drugs. As a Colgate article explains, anesthesiologists support the use of nitrous gas because of how quickly its relaxing pleasurable feelings can take effect. While this is indeed effective for the dentistry business, it can also be a red-flag for anyone with a drug abuse history.

Additional concerns include the normality of many people’s exposure to laughing gas through dentist appointments and the drug’s wide availability. Nitrous oxide can be purchased at grocery and baking stores, sold as small cartridges that are intended for use in making whipped cream. The gas can be inhaled to seek a quick high.

Abusing nitrous in this way is extremely dangerous as it is not mixed with oxygen like it is at the dentist’s office. Not only can this lead to addiction, but it can also cause asphyxiation and lead to brain damage or even death.

Nitrous Oxide Abuse Among Dental Professionals

Like all medications, there is always the concern of ready accessibility to the professionals administering it. Maia Szalavits interviewed Dr. Dennis Bohlin, a dentist who has recovered from a nitrous addiction. “I just saw it like ‘Miller Time’ at the end of the day…It was there and available. I was stressed, and it seemed safer than alcohol. You’re not going to get a DWI while flying in the dental chair, so it was a drug of opportunity (Time).”

Szalavits explains that Bohlin sought out treatment when his addiction caused neuropathy (numbness and pain) and loss of fine motor coordination in his fingers and toes which “was obviously not conducive to dental practice.”

Although Bohlin knew dentists who had become immobile and who had passed away as consequences of their nitrous addictions, he felt rather alone when in support groups as few people shared his experience; “You get into a drug like that and you feel unique, and that mitigates against recovery because you feel weird.” Thankfully, he found recovery treatment where he felt comfortable and welcomed—even if the people he was sharing with could not relate to his specific substance use history—they could support him and relate to the process.

Bohlin’s nerves healed, and he has now been nitrous-free for almost 30 years. He was able to continue his practice and advocate for addiction recovery.

“Although addiction to nitrous is uncommon, its abuse can have serious consequences (Time).”

Alternatives to Nitrous Oxide

If you have a history of substance use or are in recovery, laughing gas might not be wise for you, but that doesn’t mean you have to avoid the dentist or endure excruciating pain. Check out these alternative relaxation and pain relief methods:

  • Clearly communicate with your dentist and recovery team any concerns that you have about your substance use history and pain. Your team can suggest coping techniques and your dentist can take breaks and be especially careful.
  • Try some of these pain-ease practices and medicines that can substitute for opioid painkillers.
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