Nitrous oxide and its abuse

Article Abstract:

Illicit drug use may take place when legal drugs are used in illegal or unapproved ways; nitrous oxide (laughing gas) is a legal drug that has been illicitly used. Widely used by dentists and by the food and automobile industries, the substance has toxic characteristics. These are most likely to be realized when the gas is used for recreational purposes. While large numbers of the general population do not indulge in such activities, a large proportion of medical and dental students reported using nitrous oxide for recreational purposes in the late 1970s. Among dentists, a poll taken in 1979 indicated that between 1 and 2 percent used nitrous oxide in this manner. Occupational exposure to trace amounts of this gas does not appear to cause neurologic disease, but chronic exposure to greater doses does cause problems. In published reports, the greatest proportion of cases of nitrous oxide toxic myeloneuropathy (a degenerative disease of the spinal cord) was among dentists. Although only a small number of subjects was studied, it is likely that many dental professionals abuse this gas. Nitrous oxide is toxic to the nervous system, both central and peripheral, and to the blood-forming system. Most affected subjects engage in chronic heavy use, with the majority of symptoms disappearing if the practice ceases. Recovery is slow, however, and neurologic abnormalities may linger for several months. Nitrous oxide in sufficient quantities can even cause death. Other symptoms include oral frostbite, prolonged delirium, mood disorders, and the presence of air in areas of the chest outside the lung. Abnormalities of the blood-forming system are rare, but have been reported with extremely high use. This was discovered when patients were treated for tetanus by exposure to nitrous oxide. Recreational use of nitrous oxide should be discouraged and regarded as a drug abuse problem. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Dentists, Recreation, Drug use

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The combined effect of nitrous oxide and oxygen and electrical stimulation during restorative dental treatment

Article Abstract:

Electrical energy was first used for pain control in dentistry in the era of classical Greek civilization, but throughout most of history since that time, medications have been favored over electrically induced analgesia. In 1967, electrical analgesia was reintroduced and since then several devices have been studied. These devices include electromagnetic coils in hand-held instruments and transcutaneous electronic nerve stimulation apparatuses. Reports of the degree of analgesia achieved have varied, and most recently there have been positive reports regarding electrical analgesia in restorative and periodontal treatments. Three methods of pain control were compared during restorative dental procedures in a group of 124 adult subjects. One-third received only electrical analgesic, one-third were given nitrous oxide ('laughing gas') and oxygen, and the rest were treated with nitrous oxide, oxygen, and electrical analgesic. Both the nitrous oxide/oxygen alone and the electrical stimulation alone had a high failure rate; patients were not pleased with the results. But the combination of electrical analgesia and nitrous oxide/oxygen resulted in a satisfactory and significantly higher rate of success (81 percent) when used in the setting of restorative dentistry. Patients reported they preferred this approach over local anesthesia even if pain control was not complete, because no injection was necessary. Also, electrically induced analgesia may be more successful on front teeth than molars, and no difference was noted between anxious and calm patients in terms of response to electrical analgesia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Dentistry

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Quantification and analysis of pain in nonsurgical scaling and/or root planning

Article Abstract:

Nonsurgical scaling and/or root planning (SRP) is an effective treatment for periodontitis. Some of the challenges encountered while analyzing the clinical study data are explored, and the anesthetic efficacy of Oraqix, a noninjectable anesthetic gel, are presented.

Product information, Care and treatment, Periodontitis

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