Nitrous Oxide Less Popular with Dentists

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Two out of three dentists offer nitrous oxide, this survey found, but many docs don't prefer it - 18% never use it and another 13% rarely do.

"I offered nitrous oxide for twenty years, but there was little demand," said one dentist. "I'm glad I don't offer it anymore."

"I became a re-born believer in nitrous when I had dentistry done in my own mouth," offered another. "Whatever we can do to relieve our patients' anxiety also reduces our own and increases our bottom line!"

Specialists are significantly more likely than general dentists to offer nitrous oxide.

Of course, since specialists often perform more intensive procedures than general dentists, they may have need for more sedation dentistry options.

Rural dentists are distinctly more likely to offer inhalation sedation to their dental patients than are urban doctors.

Here are some dentist comments on the topic:

Better off without it

"I offered nitrous oxide for twenty years, but there was little demand for it. Insurance companies refused to cover any cost and patients were unwilling to pay even a nominal amount. Now that state regulators want to pile on a stack of new paperwork requirements, I'm glad I don't offer nitrous oxide any more." (California dentist)
"I think it's nuts to use nitrous...the dentist and staff are breathing it (which has been shown to cause miscarriages and neurological problems, along with who wants a "high" dentist), it's takes tons of time to set up, it's expensive, the equipment is WAY expensive, some people get sick or very weird on it, can have sexual fantasies (like thinking the dentist molested them), and halcion works so much better. Just my opinion..." (Washington dentist)

Works wonder for some patients

"I became a re-born believer in nitrous when I had dentistry done in my own mouth. It was so much easier with the nitrous oxide than without. I even had it plumbed into my new office when it was built several years ago. Whatever we can do to relieve our patients' anxiety also reduces our own and increases our bottom line!" (Florida dentist)
"Good Stuff for the right patient - our patients know we offer nitrous, but on treatment day elect to "Just see how it goes" and it goes well. I find anxiety reduction does not always require drugs and WOW what a great feeling for those that with a little help can have a great outcome." (North Carolina dentist)
"It's nice for children and really nervous patients. It does make it harder to work around....but it's there when I need it. I would have an adult pay for it, but I would give it to kids for my sanity." (General dentist)

It's expensive

"I charge for using nitrous. This eliminates those that don't really need it. It is expensive to use (cost of gas and staff that must be with the patient at all times)." (Washington dentist)
"It's too cumbersome and hard to work around. If we do, I charge at least $100." (Minnesota dentist)

Other ways to ease dental anxiety

"I have found that a modern, comfortable office with soothing music, comfortable environment, a great staff, and a caring dentist beats out the calming effects of nitrous oxide any day! I rarely ever have the need to use nitrous oxide for our patients (maybe once every 6 months)." (Ohio Prosthodontist)

Do patients even want it?

"People don't ask for it as much as they did 20 years ago. Maybe I'm just getting really good at this Dentistry thing!" (Illinois dentist)
"It is offered as an option to any patient, but only a small percentage use it." (Maine dentist)
"I find that the patients who request gas are not very desirable." (Alaska dentist)

Offer it everyone

"Why wouldn't you? I hear from patients that their previous Dentist did not offer N2O! So they came to me because I did." (Texas dentist)
"Nitrous should be available in all offices. This is just good customer service. It is not the dentist's decision whether or not a patient needs it. All patients should be asked if they would like it. Charge a reasonable fee and it is money in the bank." (Texas dentist)
"I offer it to everyone." (Iowa dentist)
"I always ask if they want Nitrous, and go from there." (Minnesota dentist)

Laughing gas safety concerns

"Studies show it has been linked to spontaneous abortion in women of child bearing age and has affected spermatogenesis." (California dentist)

Some prefer oral conscious sedation

"I use benzodiazepam." (Georgia dentist)
"Primarily kids, and many times with an oral sedative." (South Carolina dentist)

Getting high on nitrous

"Great for parties but I'm getting too old to play with the assistants and the laughing gas." (Indiana dentist)

Is sleep dentistry really where it's at?

"When I first built my office I had central nitrous in every operatory. As I became more comfortable with my patients there seemed to be less need with time. The vast majority of my patients are quite relaxed due I think to the office atmosphere. I believe I am more relaxed not having to worry about zoned out patients. The greatest part of dentistry is the interaction with patients and their families. Nitrous oxide and the latest craze "sleep dentistry" limit those interactions. Perhaps I now see less of the patients that require these services. In many ways these were never easy patients from a management point of view. (Did I say that politely enough?) Dentists become happier when they realize they don't have to be everything to everyone. One of the hardest parts of dentistry is making it look easy. For me not offering nitrous anymore it has become a little easier." ( Massachusetts dentist)

Note: Survey sample included 197 respondents.