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Coping with Dental Fears in Looming Nitrous Oxide Shortage

When a deadly explosion tore through an Airgas nitrous oxide plant in Cantonment, Florida in August of 2016, the last thing anyone was thinking about was their teeth. But after the dust settled and the victim was laid to rest, both the medical and food industries were left with the startling realization that a nitrous oxide shortage was a very real possibility.  Unfortunately, despite Airgas’ attempts to shift manufacturing of their laughing gas to other plants, they are still falling short on production nearly a year later. As a result, they have cut back shipments to foodservice companies who typically use the gas as an aerosol to create things like whipped cream. Despite these efforts however, the medical community is still feeling the pinch of the shortage, and patients around the US who have come to rely on laughing gas to get them through anxiety-ridden dental procedures are now faced with the reality of having to attend their dental visit without the aid of this popular relaxer. Dr. Michele Simpson of Wilmington, North Carolina understands what the nitrous oxide shortage means to practices like hers. She's also aware of how it can impact her patients, however, there are things patients can do to help get them through their dental anxiety without the help of laughing gas.

Though production of nitrous oxide has been hampered since August, when the FDA announced that nitrous oxide supplies were depleting to record lows back in January, they assured Americans the supply would be restored by the end of February. Unfortunately, their estimates were off and the shortage continues. Many dental practices around the US are using their last tanks, and some are already out. So, what does this mean for patients who grapple with the very real fear of the dentist, or odontophobia?

Simpson, who provides nitrous oxide for sedation in her practice says patients who rely on laughing gas to get them through their appointment shouldn’t be dissuaded from keeping their appointments.

"Part of the fear patients face when visiting the dentist is the fear of the unknown," Simpson said. "Because you can’t see your teeth as well as a dentist can, it’s hard to know if there are undiagnosed problems in your mouth. That’s one of the reasons your dentist does x-rays and exams. When you put off going to the dentist out fear, if there are problems, waiting to treat them will only make them worse."

If that’s not sufficient motivation to keep your cleaning appointment, Simpson says there are other ways around the nitrous shortage, like prescription sedatives such as Ativan or Valium.  

"The downside to taking sedatives is that the patient cannot drive themselves to and from the appointment so they must have a caregiver on hand for their entire procedure for a dentist to treat them," Simpson said. "The patient also has to request them ahead of the appointment, and fill the prescription on their own." 

Unfortunately, many people aren’t aware that nitrous oxide is scarce right now and may not know to arrange for other options ahead of time.

For patients who aren’t interested in taking a sedative, there are still plenty of options to consider. Simpson suggests creating a playlist of relaxing songs and wearing headphones during your their or loading a tablet with a favorite show or movie. Other ideas include practicing deep breathing or meditation techniques, diffusing relaxing aromatherapy oils in a portable diffuser, or simply rescheduling your procedure if you really are feeling overwhelmed with anxiety.

"I recommend calling ahead and seeing if your dentist has nitrous available," Simpson said. "If they don’t, and that’s a deal breaker for you, ask to have the practice call you to reschedule when more nitrous oxide is available." 

For patients with serious problems that need immediate attention, Simpson suggests asking your dentist for a referral or calling around to see if any local practices have nitrous oxide on hand and can fit you in quickly.

"Your dentist doesn’t want to lose you as a patient, but we want you to be comfortable and healthy," Simpson said. "We’d much rather you go to a trusted colleague for a procedure if they can accommodate you sooner than keep you waiting in pain indefinitely because of a sedative shortage."

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