How many of you can say you love going to the dentist? I can. Thanks to Pavarotti and Nitrous Oxide. I don’t know how many dentists do this now, but I put it on my top 100 of life experiences.
My dentist asked me if I wanted Nitrous and I said to do whatever made it less painful. Then they ask if I want an IPOD to listen to music. I don’t own an IPOD and I’ve really missed the boat on this one – the sound is INCREDIBLE! I dial through the selections and they have a Pavarotti folder of songs so I dial it in. Then they put on the Nitrous Oxide mask and ask me if I feel anything. Nope….
This nitrous stuff kind of creeps up on you real slow like….
In a couple minutes Panis Angelicus comes in with Luciano Pavarotti and a boychoir. My personal choice for one of the most beautiful songs ever written. And there I am sailing on Pavarotti’s vocal lines – like I’m surfing on a wave. It was absolutely beautiful. I try to remember feelings like that so I can recreate them later “sober”. The strongest feeling I get from it is disassociation. A disassociation of the boundary between listener and performer – as if you become a point (like a hanging microphone) in the middle of the performance.
Over an hour went by. I guess they were working on my teeth, I don’t know. I was listening to a concert. And very sad when they were finished – I wanted to listen to more music! At one point the dental tech tapped me, smiled and started conducting wildly – she knew I was having the time of my life.
My nephew tells me that they let him play video games at the dentist. Hey, when did dentists start doing all this and become so hip and cool? When I was a kid do you know what the big gimmick of dentists was? The Treasure Box. When you were done, you could choose one toy from the treasure box. And I took this task very seriously. Sometimes I would sit in front of the box for twenty minutes, because you could only choose one toy – and I didn’t want to make the wrong choice. Hey Doc, keep the toy – give me the Nitrous.
Now before anyone jumps on my case for talking about how great Nitrous is; do you remember the old days where you had to sit there for an hour at the dentist hearing constant scraping and gurgling. And if you still have a problem with it, I’ll be happy to go with you on your next visit to the dentist and sit next to you while you request no pain killers of any kind. Think of the fun we’ll have.
Until then: I LOVE MY DENTIST!
ABOUT NITROUS OXIDE
Nitrous oxide, dinitrogen oxide or dinitrogen monoxide, is a chemical compound with chemical formula N2O. Under room conditions, it is a colorless non-flammable gas, with a pleasant, slightly sweet odor and taste. It is used in surgery and dentistry for its anaesthetic and analgesic effects, where it is commonly known as “laughing gas” due to the euphoric effects of inhaling it.
History of Nitrous Oxide
The gas was first synthesized by English chemist and natural philosopher Joseph Priestley in 1775, who called it phlogisticated nitrous air. Priestley describes the preparation of “nitrous air diminished” by heating iron filings dampened with nitric acid in Experiments and Observations on Different Kinds of Air, (1775). Priestley was delighted with his discovery: “I have now discovered an air five or six times as good as common air… nothing I ever did has surprised me more, or is more satisfactory.” Humphry Davy in the 1790s tested the gas on himself and some of his friends, including the poets Samuel Taylor Coleridge and Robert Southey. They soon realised that nitrous oxide considerably dulled the sensation of pain, even if the inhaler were still semi-conscious. After it was publicized extensively by Gardner Quincy Colton in the United States in the 1840s, it came into use as an anaesthetic, particularly by dentists, who do not typically have access to the services of an anesthesiologist and who may benefit from a patient who can respond to verbal commands.
Inhalant Effects
Nitrous oxide (N2O) is a dissociative drug that can cause analgesia, depersonalization, derealization, dizziness, euphoria, flanging of sound, and slight hallucinations.
Use In Medicine
In the 1800s, nitrous oxide was used by dentists and surgeons for its mild analgesic properties. Today, nitrous oxide is used in dental procedures to provide inhalation sedation and reduce patient anxiety. In small doses in a medical or dental setting, nitrous oxide is very safe, because the nitrous oxide is mixed with a sufficient amount of oxygen using a regulator valve. However, extended, heavy use of inhaled nitrous oxide has been associated with Olney’s lesions in rats, though it is not necessarily possible to extrapolate it to humans.
Previously, nitrous oxide was typically administered by dentists through a demand-valve inhaler over the nose that only releases gas when the patient inhales through the nose; full-face masks are not used by dentists, so that the patient’s mouth can be worked on while the patient continues to inhale the gas. Current use involves constant supply flowmeters which allow the proportion of nitrous oxide and the combined gas flow rate to be individually adjusted. The masks still obviously cover only the nose.
Because nitrous oxide is minimally metabolized, it retains its potency when exhaled into the room by the patient and can pose an intoxicating and prolonged-exposure hazard to the clinic staff if the room is poorly ventilated. Where nitrous oxide is administered, a continuous-flow fresh-air ventilation system or nitrous-scavenging system is used, to prevent waste gas buildup.
Nitrous oxide is a weak general anesthetic, and so is generally not used alone in general anaesthesia. However, it has a very low short-term toxicity and is an excellent analgesic. In addition, its lower solubility in blood means it has a very rapid onset and offset, so a 50/50 mixture of nitrous oxide and oxygen (“gas and air”, supplied under the trade name Entonox) is commonly used for pain relief during childbirth, for dental procedures, and in emergency medicine.
In general anesthesia it is used as a carrier gas in a 2:1 ratio with oxygen for more powerful general anaesthetic agents such as sevoflurane or desflurane. It has a MAC (Minimum Alveolar Concentration) of 105% and a blood:gas partition coefficient of 0.Α46. Less than 0.004% is metabolised in humans.