Nitrous oxide in Dentistry

Nitrous oxide was discovered in 1772, but its use was limited to recreational use, with the purpose to cause euphoria and slight hallucinations, in British upper class in 1799, known as “laughing gas parties”. People found that inhaling a little of the gas would make you laugh (hence the name) and that inhaling a little more would knock you unconscious.

It was not until 1844 when a dentist in Harford, Conn., named Horace Wells came upon the idea of using this gas for medical use. Wells had the idea after witnessing a friend who was high on the gas at a party fell and suffered a deep cut in his leg. Despite the serious injury is friend had no idea he was injured until someone pointed out the injury to him.

To test the use of nitrous oxide in dentistry Wells used himself as a guinea pig. He knocked himself out by inhaling a large dose of nitrous oxide, and then had a dentist extract one of his teeth. When Wells came to, this tooth had been extracted painlessly.

In the following weeks, Wells treated the first 12-15 patients with nitrous oxide and according to his own record only failed in two cases. In January 1845 Wells set out to share his medical discovery by performing a demonstration with a willing patient in the amphitheatre at Massachusetts General Hospital. Unfortunately, Wells had not completely mastered the administration technique and he attempted to extract the patient’s tooth prematurely causing the patient to scream out in pain. The failure of the demonstration left the medical crowd doubtful of the efficacy and safety of nitrous oxide. Wells was disgraced and soon left the profession of dentistry to become a traveling salesman.

A couple of years later Wells began experimenting with chloroform and ether. After constant experimental chloroform use, Wells became increasingly deranged. In a delirious state of mind, Wells ran into the street and poured sulfuric acid over the clothing of two women. While in prison the influence of the drugs waned and Wells realized what he had done. Wells committed suicide by cutting an artery in his leg after inhaling chloroform to block the pain.

Nitrous oxide did not gain general use until 1863, when Gardner Quincy Colton successfully started to use it in all his dental clinics. Over the following three years, Colton and his associates successfully administered nitrous oxide to more than 25, 000 patients. With its efficacy and safety now demonstrated by large numbers, the usage of nitrous oxide rapidly became the preferred anesthetic method in dentistry. Because the gas is mild enough to keep a patient in a conscious and conversational state, and yet in most cases strong enough to suppress the pain caused by dental work, it remains the preferred gas anesthetic in today’s dentistry.

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