Nitrous oxide

In our dental clinic, we use the Entonox system. It is a mixture of oxygen and nitrous oxide (laughing gas) in a 50:50 ratio. Thanks to this ratio, Entonox is considered a low-risk procedure that affects consciousness, and the presence of an anesthesiologist is not required.

Entonox can be used for adults and children from the age of 6 who can cooperate and wish to receive treatment, but just need a little help. It is not suitable for younger children or those who are resistant and negatively inclined towards treatment (those who do not want to be treated) because it will not achieve the desired effect.

We use Entonox for short, quick, and simple procedures such as: administering anesthesia, extracting a primary tooth in a child, or extracting a permanent tooth in an adult, as well as repairing small occlusal cavities. It is not suitable for: extracting a permanent tooth in a child, root canal treatment, repairing extensive, deep, and interproximal cavities, or procedures involving a rubber dam.

The treatment proceeds with the patient initially inhaling the gas deeply through a mask or mouthpiece until the effect sets in (about 3 minutes). Then we can perform part of the procedure, such as administering anesthesia. The patient can then continue to inhale the gas in several-second intervals as needed to restore the effect, and we can continue with the procedure, e.g., tooth extraction. The effect of the gas quickly wears off, and after 15 minutes, the patient can return to their normal activities, including driving.

During treatment, we utilize the following effects of nitrous oxide:

sedative – mildly depresses consciousness, but the patient continues to breathe freely, perceives, and reacts to stimuli, although they become less “interested” in the treatment

anxiolytic – alleviates anxiety and fear, produces a euphoric effect, and may feel like having had 2-3 drinks of alcohol

analgesic – helps relieve pain and can dull the sensation of the injection

myorelaxant – relaxes muscles and suppresses the gag reflex

Conscious sedation (premedication with syrup)

Conscious sedation is a procedure with minimal depression of consciousness, so an anesthesiologist does not need to be present during the treatment. We perform conscious sedation for children who cannot adequately cooperate during treatment due to fear or their young age. In indicated cases, we can treat children as young as 1 year old using medications from the benzodiazepine group, which are administered orally in a syrup solution 20 minutes before the treatment. Children must fast for the procedure, making it ideal to schedule in the morning and in the presence of two adults.

During the treatment, the child is lethargic and sleepy but still communicates and responds to stimuli. They can move and, if they wish, can defend themselves. This method is mainly used for its amnesic effect; the child will not remember the treatment, preventing a traumatic experience. We do not expect cooperation during the treatment. After the procedure, parents stay with the young patient in the reception area for a few minutes for observation. At home, we recommend a rest period for the remainder of the day. The effects of the medication will gradually wear off in about 3 hours.

We use conscious sedation in cases such as: extraction of a primary tooth, repair of occlusal cavities (on the chewing surface) without involving the dental nerve, repair of interproximal cavities without involving the dental nerve (exclusively with the use of a rubber dam), and treatment of teeth with strip crowns.

Sedation is not suitable in the following cases: extensive destruction of teeth requiring a large number of treatments, root canal treatment, very uncooperative children (those who are combative), significant gag reflex, and extraction of permanent teeth in children.

We use conscious sedation if we can completely treat the child in up to 4 appointments. If more treatments are needed, or if complicated procedures are required, or in cases where children do not cooperate sufficiently even after taking sedatives, we opt for treatment under general anesthesia.

General anesthesia

Conscious sedation is a procedure with minimal depression of consciousness, so an anesthesiologist does not need to be present during the treatment. We perform conscious sedation for children who cannot adequately cooperate during treatment due to fear or their young age. In indicated cases, we can treat children as young as 1 year old using medications from the benzodiazepine group, which are administered orally in a syrup solution 20 minutes before the treatment. Children must fast for the procedure, making it ideal to schedule in the morning and in the presence of two adults.

During the treatment, the child is lethargic and sleepy but still communicates and responds to stimuli. They can move and, if they wish, can defend themselves. This method is mainly used for its amnesic effect; the child will not remember the treatment, preventing a traumatic experience. We do not expect cooperation during the treatment. After the procedure, parents stay with the young patient in the reception area for a few minutes for observation. At home, we recommend a rest period for the remainder of the day. The effects of the medication will gradually wear off in about 3 hours.

We use conscious sedation in cases such as: extraction of a primary tooth, repair of occlusal cavities (on the chewing surface) without involving the dental nerve, repair of interproximal cavities without involving the dental nerve (exclusively with the use of a rubber dam), and treatment of teeth with strip crowns.

Sedation is not suitable in the following cases: extensive destruction of teeth requiring a large number of treatments, root canal treatment, very uncooperative children (those who are combative), significant gag reflex, and extraction of permanent teeth in children.

We use conscious sedation if we can completely treat the child in up to 4 appointments. If more treatments are needed, or if complicated procedures are required, or in cases where children do not cooperate sufficiently even after taking sedatives, we opt for treatment under general anesthesia.