Laughing Gas Has a Serious Environmental Impact

Nitrous oxide has long been a mainstay of dental sedation, particularly in pediatric care, offering predictable anxiolysis and high clinical success. Recent data confirm that inhalation sedation remains effective, with a national success rate exceeding 90%, even as concerns grow about its environmental impact.

In clinical settings using active scavenging systems, investigators found that emissions varied widely based on delivery practices. The average flow rate was nearly 6 liters per minute, with administration lasting close to 30 minutes per appointment. Importantly, flow rate had a greater influence on total nitrous oxide emissions than gas concentration. In practical terms, higher-than-necessary flow rates increased greenhouse gas release without improving patient outcomes.

Nitrous oxide is a potent greenhouse gas with a long atmospheric lifespan, making dental use a small but meaningful contributor to healthcare-related emissions. While there is currently no direct, equivalent alternative for inhalation sedation, this does not eliminate the responsibility to minimize environmental harm. Adjusting flow rates to the lowest effective level represents an immediate, clinically neutral opportunity to reduce emissions.

The findings also challenge routine practices such as acclimatization visits under sedation. These appointments did not improve procedural success but did increase nitrous oxide use, raising questions about their value from both a clinical and environmental standpoint.

For dental teams, the path forward centers on stewardship rather than elimination. Routine monitoring of nitrous oxide use, standardized staff training, and reassessment of sedation protocols can significantly reduce waste. Click here to read more.