Nitrous has been available for more than 100 years.  Will it ever go out of style?

Hartford Connecticut, December 10, 1844 . . .  Almost 167 years ago Samuel Cooley, a clerk in a retail store, ran around a stage in an intoxicated state, little realizing the major role he was playing in forever altering the degree of pain and suffering that patients throughout the world would experience during surgery.  Cooley had come to attend a popular science lecture in which advances in science were demonstrated.  One demonstration was of the intoxicating effects of “laughing gas,” which Cooley volunteered to inhale.  Also in attendance on that fateful evening was Horace Wells, a local dentist who, on seeing Cooley injure his leg but continue to run about as though nothing had happened, considered there might be a clinical application for this “laughing gas.”  On the following day, December 11, 1844, nitrous oxide (“laughing gas”) was administered to Dr Horace Wells, rendering him unconscious and able to have a wisdom tooth extracted without any awareness of pain.

The world had forever been changed.

In todays high tech age, the discovery of anesthesia is taken for granted.  Local anesthetics are administered to patients when a surgical / dental procedure might be ever so  slightly painful.  Yet in 1844 these drugs DID NOT EXIST.  When fearful patients require treatment a variety of techniques are available - intravenous conscious sedation; intramuscular sedation; oral, rectal, transmucosal, and intranasal sedation; and general anesthesia.  These techniques of drug administration were not available in 1844.  Drugs are available that are able to provide relief from extreme anxiety and fear while the patient retains consciousness; yet these drugs provide amnesia (memory loss) of the entire procedure.  These drugs did not exist in 1844.

 No longer does a patient about to undergo dental implant surgery, tooth extraction, root canal therapy, gum/periodontal therapy, dentures, partials or even fillings face that prospect with utter hopelessness and despair.  Dentistry has long recognized that many persons are frightened of the dental experience, and to our credit, dentists have taken steps to recognize and manage these patients.  In its approach to the management of pain and anxiety, the dental profession has remained in the forfront of all the health professions.

Paul L Caputo, DDS