Visiting the dentist creates anxiety for many children, and as parents, watching your little one feel nervous or fearful is incredibly difficult. We want every dental experience for your child to be positive, safe, and free from trauma. Fortunately, modern pediatric dentistry offers several ways to help children relax during their appointments. When a child needs help staying calm, we often look at two primary options: nitrous oxide, commonly called laughing gas, and oral conscious sedation.
Choosing between these methods depends on your child's specific needs and the extent of the dental work. We always prioritize safety and comfort, and we want you to feel confident in the decision about your child's care. When you learn how each method works and its benefits, you can work with our team to find the right path. This guide explains the differences between these two common forms of sedation dentistry, so you know exactly what to expect.
What Is Laughing Gas and When Do We Use It?
Nitrous oxide, or laughing gas, stands as the most common form of mild sedation in pediatric dentistry. We place a small mask that feels soft and comfortable over your child's nose and introduce this safe, sweet-smelling gas. When your child breathes normally, relaxation and euphoria set in within moments. Laughing gas helps your child remain fully awake—always able to hear us and respond to questions or instructions. Your child simply feels less anxious and finds the sights and sounds of the dental office less overwhelming.
We see laughing gas work wonders for children who have mild anxiety or feel nervous about specific parts of a procedure, such as the numbing injection. Because we can easily control the effects, adjusting sedation levels moment by moment, your child remains comfortable. At the end of the procedure, we start a flow of pure oxygen for a few minutes. Oxygen quickly clears the nitrous oxide from your child's system, helping them return to normal almost immediately.
The Mechanism of Nitrous Oxide
Nitrous oxide reduces anxiety (anxiolytic effect) and offers some pain relief. Children describe “floating” or “tingling” sensations in their arms and legs, which distract and calm them. A cooperative but nervous child can sit still for a filling or crown with the help of laughing gas. The sedation works and wears off rapidly. Your child does not need to fast for long periods before using laughing gas, though we suggest a light meal to decrease the chance of nausea, a rare side effect. The gas leaves the body quickly, so school or other regular activities can continue right after the appointment.
Ideal Candidates for Mild Sedation
We recommend laughing gas for children old enough to wear the nasal mask and breathe through their nose. A severe cold, allergies, or enlarged tonsils may block nasal breathing, making laughing gas less effective. This option is suitable for shorter procedures or for children who usually cooperate but need a little support to get through treatment. Children with severe dental phobia or those too young to understand instructions most likely need a deeper level of sedation than laughing gas provides.
Exploring Oral Conscious Sedation for Deeper Relaxation
Children who feel more anxious or need more extensive treatment often need oral conscious sedation. When you arrive at our office, we give your child a liquid medication to drink. The medication quickly makes your child drowsy and very relaxed. Your child remains conscious and responds to touch or voice, but awareness of surroundings decreases significantly.
Oral sedation brings a deeper level of relaxation than laughing gas. Many children relax so much that they drift into a light sleep, though we can always wake them gently. Medications that we use allow children to “forget” the procedure, which can prevent the development of dental fear later. This “amnesia” is a great benefit for a child who struggles to sit still or is terrified of dental visits.
How Oral Sedation Differs from Nitrous Oxide
The effects of oral sedation linger much longer than those of laughing gas. The medication needs time to work and time to leave the body. We require fasting—no food or drink for a specific number of hours before the appointment—to protect your child's safety. Fasting prevents aspiration (breathing in stomach contents) if the sedation causes nausea. After the appointment, your child will likely feel sleepy and unsteady for the rest of the day. Plan to monitor your child closely at home and keep them resting on the couch or in bed until they fully recover.
The Safety Protocols We Follow
We place your child’s safety at the top of our priority list for oral sedation. Throughout the visit, we monitor your child’s heart rate, oxygen levels, and blood pressure using advanced equipment. A dedicated team member remains at your child’s side, always attentive to their breathing and comfort. We determine the medication dosage by carefully considering your child's weight, age, and medical history. Although oral sedation remains extremely safe when professionals administer it, parents must commit to following pre-appointment fasting and post-appointment supervision, even more than with laughing gas.
Key Differences: Making the Right Choice for Your Family
Deciding between laughing gas and oral sedation usually depends on the child’s anxiety, the amount of work needed, and the child’s ability to cooperate. We consider your child’s personality and dental needs to guide our choice. If your child needs extensive work, such as multiple fillings or crowns on different sides of the mouth, asking a young child to sit still for an hour with just laughing gas does not seem realistic. Oral sedation can let us finish more dental work in fewer visits, sparing your child from multiple stressful appointments.
For a single, quick filling on a slightly anxious seven-year-old, oral sedation would be too much. Laughing gas will likely provide enough relaxation for a 20-minute procedure, with no fasting or a day of recovery at home required. Our goal is always to use the least invasive method needed for a safe, high-quality outcome.
Comparing Recovery Times
The time your child needs to recover helps set these choices apart. After laughing gas, recovery is immediate. You leave the office, and your child returns to everyday life. With oral sedation, your child continues to recover at home. They might feel irritable, groggy, or emotional as they wake up fully. Managing this period requires you to take time off work and keep your child out of school or daycare. Parents can prepare for downtime by creating a calm, comfortable place at home beforehand.
Matching the Sedation to the Treatment Plan
Treatment details play an essential role. Some children have strong gag reflexes, which can make dental work difficult—laughing gas can help suppress it. If the gag reflex is very severe, or your child is young and cannot keep their mouth open, oral sedation relaxes the muscles further and allows us to work safely. We constantly evaluate your child's airway and complete medical history. Certain health conditions may make laughing gas safer, even for longer or more complex procedures.
Making the Final Decision Together
No universal “best” option exists for every child: only the right choice for your family at this moment. We act as partners with you throughout this process. Your insights about your child’s temperament, medical history, and ability to handle new situations help us create a custom sedation plan.
Choosing sedation does not mean your child is “bad” or “difficult.” Many young children simply have not developed coping abilities for the sensory overload at the dentist. Sedation helps bridge that gap and supports your child’s emotional well-being while we ensure excellent health care. Whether we use the gentle boost of laughing gas or the more profound calm of oral sedation, our entire team wants your child to have a healthy smile—and feel happy about returning to the dentist.
Frequently Asked Questions About Sedation Dentistry
Is dental sedation safe for young children?
Yes, dental sedation is extremely safe when trained pediatric dentists follow strict safety guidelines. We follow the standards set by the American Academy of Pediatric Dentistry. Before every sedation appointment, we review your child’s medical history and current medications in detail. During the procedure, whether we use laughing gas or oral medication, we closely monitor your child’s vital signs. Our team practices and trains for every possibility, always putting your child’s safety first.
Will my child fall asleep during the procedure?
With laughing gas, your child will almost always stay awake. Relaxation may make your child close their eyes, but they remain conscious and responsive. With oral sedation, children are much more likely to fall asleep due to the more substantial sedative effect. We can always wake your child easily with a gentle voice or touch. Even if your child stays awake while under oral sedation, the medicine often creates a dreamlike state and usually erases any memory of the procedure.
We are ABQ Pediatric Dentistry, a dedicated team of specialists who serve families in Albuquerque, New Mexico. We believe every child deserves a dental home where they feel safe, respected, and cared for. Our practice provides compassionate, high-quality dental care personalized to infants, children, and teens. If you have questions about sedation options or want to schedule an appointment, please get in touch with us today.