How do laughing gas, oral sedation and IV sedation compare for anxious patients?

Dental anxiety is real, and sedation can make it easier to get the care you need. Three common options are laughing gas, oral sedation and IV sedation. Each generally provides a different level of relaxation and may be better suited to certain patients or procedures. Understanding how they compare can help you feel more prepared for your visit. 

What you will learn in this article: 

• Laughing gas, oral sedation and IV sedation provide different levels of relaxation for patients with dental anxiety. 

• Minimal and moderate sedation keep you awake, while deep sedation leaves you barely awake. 

• Laughing gas wears off quickly, but oral and IV sedation generally require someone to drive you home. 

• Your dental provider will review your health, medications, anxiety level and planned procedure before recommending sedation. 

Ready to take the first step? Schedule an appointment with an Aspen Dental provider to discuss which sedation option may fit your needs. 

Sedation is a normal part of dental care 

According to the American Dental Association (ADA), some medicines can make dental visits more relaxing and comfortable. When choosing an approach, your dental provider will consider your anxiety, treatment, overall health and allergy history.¹

There are four levels of sedation: 

• Minimal sedation: You feel relaxed and remain fully awake. 

• Moderate sedation: You feel sleepy but can still respond. 

• Deep sedation: You are barely awake. 

• General anesthesia: You are fully unconscious.² 

Laughing gas, oral sedation and IV sedation may be used to provide different levels of sedation. The medication and dose, along with your individual response, help determine the best option. 

The ADA notes that local anesthesia numbs a specific part of the mouth to help prevent pain during treatment.¹ Your care team will determine the appropriate approach for you. 

Laughing gas 

Laughing gas is one of the gentlest dental sedation options. It is a mixture of nitrous oxide and oxygen that you breathe through a small mask placed over your nose. Administering laughing gas does not require an IV. 

• Onset: It begins working within a few minutes. 

• Depth: Laughing gas is generally used for minimal sedation. You remain awake and able to communicate throughout your visit. 

• Recovery: Its effects usually fade quickly after the mask is removed. Your dental provider may give you oxygen for a few minutes afterward and will let you know when it is safe to leave or drive. 

• Best for: Patients with mild dental anxiety or those who want a sedation option that wears off quickly. 

Keep in mind that laughing gas does not necessarily eliminate the need for local anesthesia. Depending on your treatment, your dental provider may still need to numb the area. The cost varies by office and insurance coverage. Ask your care team for an estimate before treatment. 

Oral sedation 

Oral sedation involves taking medication by mouth before your procedure to help you feel calmer and drowsier. 

• Onset: Oral sedation takes time to begin working. Your dental provider will tell you when and how to take the medication. 

• Depth: Depending on the medication and dose, oral sedation may provide minimal or moderate sedation. You remain conscious but may feel very sleepy. 

• Recovery: You may continue to feel drowsy after your appointment. You will need a responsible adult to drive you home and should follow your dental provider’s recovery instructions. 

• Best for: Patients with moderate dental anxiety who would prefer to avoid having an IV placed. 

Oral sedation can affect each person differently. Because the medication is taken in advance, it cannot be adjusted as quickly during the procedure as IV sedation can. 

Cost depends on the medication, office and insurance coverage. Ask your care team what to expect. 

IV sedation 

IV sedation is administered directly into a vein, allowing the medication to begin working quickly. A sedative medication is given this way to help you relax throughout the procedure. 

• Onset: It generally begins working within minutes. 

• Depth: IV sedation may provide moderate or deep sedation. You may remain able to respond during treatment but remember little or nothing about the visit afterward. 

• Recovery: You will need a responsible adult to drive you home. Plan to rest for the remainder of the day and follow all instructions from your care team. 

• Best for: Patients with moderate to severe dental anxiety or those undergoing longer or more complex procedures. The ADA notes that complex treatments may call for deeper sedation.¹

One advantage of IV sedation is that the medication can be adjusted throughout the procedure. Your care team will monitor you closely while you are sedated. 

How your dental provider chooses 

Your dental provider considers several factors when determining which sedation option may be appropriate for you. These include: 

• Your level of dental anxiety 

• The type and length of the procedure 

• Your overall health and medical history 

• Allergies and current medications¹ 

• Your previous experiences with sedation or anesthesia  

Tell your dental provider how nervous you feel and what specifically concerns you. The more your care team knows, the better they can tailor your care. 

If you have more questions, contact your dental provider and they can explain which options are available and whether a referral may be needed. 

How do laughing gas, oral sedation and IV sedation compare for anxious patients? FAQs 

These are some of the most common questions patients have about sedation for dental procedures.  

Is dental sedation safe if I have a health condition? 

Certain conditions can change which sedation option is safest for you. Sleep apnea, pregnancy and certain heart conditions are among the factors your dental provider will screen for and may need to plan around, sometimes in consultation with your physician.³ This is why a full, honest health history matters before any sedation decision is made. 

Share all medications and supplements you take, including over-the-counter products. Certain medical conditions or medications may affect which sedation options are appropriate.  

How will I feel during sedation? 

It depends on the medication and level of sedation. With laughing gas, you may feel relaxed, calm or slightly lightheaded while remaining awake and aware. With oral sedation, you will likely feel drowsy but should still be able to respond. With IV sedation, you may enter a deeper state of relaxation and remember little about the procedure afterward. 

Can children receive dental sedation? 

Yes. Sedation may be used to help children safely receive dental care. The ADA recommends asking who will evaluate your child beforehand and review details such as allergies, medicines, past illnesses and hospital stays.²

Can I eat before a sedation appointment? 

It depends on the type and level of sedation. Your dental provider will give you specific instructions about when to stop eating or drinking and whether you should take your usual medications. 

Sources 

¹ American Dental Association, MouthHealthy: “Anesthesia and Sedation.” https://www.mouthhealthy.org/all-topics-a-z/anesthesia-and-sedation 

² American Dental Association, MouthHealthy: “Anesthesia and Sedation for Your Child.” https://www.mouthhealthy.org/all-topics-a-z/anesthesia-and-sedation-for-your-child 
³ American Dental Association: "ADA Guidelines for the Use of Sedation and General Anesthesia by Dentists." https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/library/oral-health-topics/ada_sedation_use_guidelines.pdf