Key points
- The combination of inhaled nitrous oxide and oxygen is a safe and effective means of managing pain and anxiety in dentistry, when used appropriately.
- There is an inherent safety margin for the proper administration of nitrous oxide-oxygen sedation.
- At least 12 delivery system audio and visual safety features have been developed to help avoid adverse events during nitrous oxide-oxygen administration.
- Adopting appropriate work practices and following recommendations from the ADA Council on Scientific Affairs and Council on Practice may help dental offices safely use nitrous oxide-oxygen.
- National Institute for Occupational Safety and Health (NIOSH) research indicates that controls such as system maintenance, proper ventilation and good work practices can effectively reduce nitrous oxide concentrations in dental operatories to approximately 25 ppm (i.e., 45 milligrams per cubic meter) during analgesia administration (i.e., the exposure limit recommended by NIOSH).