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Is Nitrous Oxide Safe for the Elderly?

My mother is 99 and has dementia. At her last visit, the dentist found a very large cavity in her molar. She suggested a crown, root canal or removal. None of these could be done, while mom is conscious. She was already telling the dentist 'she better not be pulling any teeth,' while she did the cleaning. Could take her to an oral surgeon, but is nitrous oxide safe for someone her age? So far, she's not in pain, but I'm trying to explore my options.
Status: Open    Oct 15, 2015 - 11:06 AM

Other, Senior Health & Nutrition

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Expert Answers

Oct 16, 2015 - 07:49 PM

I applaud you on being inquisitive about the dental options that are available to your mom. Here's the quick answer to your question. Although there are no "age" contraindications for nitrous oxide sedation, quite often geriatric patients have one or more medical conditions which would put them at an increased risk for adverse reactions when using nitrous. A thorough medial history evaluation is in order. Furthermore, in my personal experience nitrous oxide sedation is far more effective when used on a compliant and willing patient. If the tooth truly needs an extraction, I feel that in your case taking your mom to an oral surgeon may be a better course of action.
-Dr Andrei


Oct 19, 2015 - 08:18 AM

I am only a lay person and certainly no expert on this topic but I will share what I have learned through experience. My husband, now 77 years old, has Dementia with Lewy Bodies. Over the past 4-5 years he suffered from greatly increased hallucinations on two separate occasions (more than a year apart) following tooth extractions. After the second incident, I contacted the dentist to find out what anesthetic(s) had been administered. It was a combined lidocaine-epinephrine injection which is typically used in dental procedures because the epinephine enhances and prolongs the anesthetic effect of the lidocaine. He did not receive nitrous oxide nor any other inhaled or injected anesthetic. I suspected the epinephine might have caused his hallucinations only because he had suffered hallucinations after taking Benadryl on a previous occasion (at home). Because of that experience I had come to know that persons with Dementia with Lewy Bodies are highly sensitive to any/all antihistamines and epinephrine is histamine blocker. I also learned that persons with Dementia with Lewy Bodies are highly sensitive to all inhaled anesthetics and that propofol is considered to be the safest injectable GENERAL anesthetic. The next three times my husband needed local anesthesia (removal of a cyst by his dermatologist and multiple tooth extractions), I asked the doctors to exclude the epinephrine and he did just fine. I know this doesn't answer your specific question but if I were you I would certainly do all my homework before subjecting a 99 year old with dementia to any procedure(s) requiring the use of anesthetics unless truly necessary.
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