Local anesthetic numbs the area completely, and nitrous oxide (laughing gas) takes the edge off nerves. You stay awake and recover within minutes.
Every oral surgery procedure starts with local anesthetic, the medication that numbs the area being treated. For many procedures, such as a simple extraction, a single implant, a biopsy or a frenectomy, local anesthetic is all you need. Adding nitrous oxide, often called laughing gas, helps you feel calmer while staying fully awake. Many patients choose this combination because recovery is so quick.
Local anesthetic
Your surgeon first applies a numbing gel to the gum, then gives the anesthetic slowly through a very fine needle. Most people feel a brief pinch or pressure. Within a few minutes the area is numb: you'll still feel pressure and movement during the procedure, but not sharp pain. If anything feels sharp, tell your surgeon and more anesthetic can be given. Numbness lasts a few hours, and longer-acting anesthetic is sometimes used to keep you comfortable after surgery.
Nitrous oxide
Nitrous oxide is a mild sedative gas mixed with oxygen and breathed through a small, soft mask over your nose. Within a few minutes most people feel relaxed, warm and a little light, sometimes with tingling in the hands or feet. You remain awake, can talk and respond, and are aware of what is happening. Your surgeon adjusts the level to suit you.
When the procedure ends, you breathe pure oxygen for a few minutes, and the effects wear off quickly. Most adults can drive themselves home and go back to work or school, which makes nitrous oxide a good option for people who want to feel calmer without arranging a driver or fasting. It is also useful for nervous children and teens having shorter procedures.
Nitrous oxide isn't suitable for everyone. Tell your surgeon if you are pregnant, have a blocked nose or a severe cold, certain lung conditions, a recent eye or ear surgery, or a vitamin B12 deficiency.
Choosing the right option
At your consultation your surgeon talks you through every option, from local anesthetic alone to IV sedation and general anesthesia, and helps you choose based on the procedure, your health and how you feel about it. There is no wrong answer. Some patients who expect to want sedation find local anesthetic and nitrous oxide is enough; others prefer to remember nothing. Whatever you choose, your surgeon explains each step as it happens and checks in with you throughout.
Local anesthetic is included in the cost of every procedure. Nitrous oxide has a small separate fee, shown on your one written quote.
