If you’re living with type 1 diabetes (T1D), you’re probably used to almost constant management of your blood sugar.
But trying to manage blood sugar levels during hospital stays, surgeries, outpatient procedures, and even a visit to the dentist can cause concern and require extra planning.
This article will outline the effects of getting the common anesthetic nitrous oxide – otherwise known as laughing gas – from the dentist, as well as what it can mean for you and your blood sugar.
Nitrous oxide is an effective and safe sedative agent. When mixed with oxygen, it can help people relax during medical procedures. It is especially useful for people who suffer from anxiety.
It is delivered through a small mask that fits tightly over your nose. It’s different from anesthesia, where you basically fall asleep for a procedure. Laughing gas simply gives you a feeling of calm and relaxation, with no residual effects once it wears off.
Although people may sometimes feel sleepy when taking nitrous oxide, they will still be able to respond to the dentist.
If you are anxious before a dental procedure, nitrous oxide may be a great option for you.
Dentists prefer to use it because:
- The amount of sedation can quickly be increased or decreased.
- It acts extremely quickly (takes effect after a few minutes).
- It is extremely safe for the brain, heart, liver, lungs and kidneys.
It is useful for the very young, as well as for people with severe anxiety or disabilities, including diabetes.
The drug is simple and easy to administer through a face mask. Plus, there are no lasting side effects. However, nitrous oxide has short-term side effects and drawbacks.
Nitrous oxide is safe and effective for adults and children with type 1 and type 2 diabetes, according to research 2020.
Before recommending treatment with nitrous oxide, a person should discuss average blood sugar levels and A1C levels with their endocrinologist or diabetes care team. They should also discuss medications and treatment options to make sure nitrous oxide is appropriate.
It is especially important to know how to prevent hypoglycemia during any dental procedure requiring nitrous oxide.
The use of nitrous oxide generally requires fasting for several hours, usually about 6 hours before the visit to the dentist. This means that scheduling a morning appointment (with an overnight fast) may be easier for someone with diabetes. Blood sugar is often higher in the morning, which can be helpful in preventing hypoglycemia.
For children with diabetes, a dentist may not be able to treat a child if their blood sugar level is 250 mg/dL or higher at the time of a dental appointment, depending on the Louisiana State University School of Dentistry.
Although there is no scientific research focused on laughing gas and its effect on glucose levels, anecdotal evidence from the online diabetes community indicates that it does not raise or lower it. significantly during the procedure.
Some people say any fluctuation is more likely caused by anxiety and stress, both of which raise glucose levels in people with diabetes.
For people with diabetes, nitrous oxide can be somewhat tricky, as you may not experience hypoglycemia as effectively if you are lightly sedated:
- Most importantly, make sure your dental team knows you have diabetes and what to do in case of severe hypoglycemia.
- It is important to use a temporary basal (if you are using an insulin pump).
- Wear a continuous blood glucose monitor (CGM) with low alerts enabled to ensure your dentist can hear if you drop during a procedure.
- Always carry weak snacks (especially glucose gel which can be quickly absorbed by your gums without the need to chew!) when you go to the dentist.
- Most dentists will ask you to fast for at least 6 hours before receiving nitrous oxide, which can be difficult with diabetes if you frequently suffer from low blood sugar.
- Drinking clear liquids is generally acceptable about 2 hours before a treatment, so managing hypoglycemia with clear juice should suffice. That said, having an empty stomach when taking nitrous oxide can help prevent nausea and vomiting. This is something you should discuss with your dentist if you have any concerns about the strength of nitrous oxide and experience lower blood sugar, especially before a procedure.
- Try to avoid making dental appointments after strenuous exercise or during a meal that you usually rely on for carbohydrates. It can also increase the likelihood of hypoglycemia during a procedure. Work with your doctor to lower your insulin dose on the day of a procedure or use a temporary basal setting on your insulin pump to help prevent hypoglycemia. Always carry weak snacks and activate your hypoglycemic alerts if you wear a CGM, so that your dentist can intervene in the event of a hypoglycemic episode.
Good dental health is extremely important for people with diabetes. According to American Dental Associationthis condition means you are more prone to cavities, gum disease, and tooth decay.
It’s crucial to incorporate regular dental visits into your diabetes care, but sometimes dental procedures can get quite complicated and scary. This may require mild sedation to help you cope, such as nitrous oxide.
Although side effects are possible from laughing gas, these are not usually common.
Common short-term side effects include:
- excessive sweating
- feel like sleeping
Some people also experience hallucinations or sound distortion after inhaling nitrous oxide.
People should be given more oxygen after stopping nitrous oxide to help prevent some of these side effects. You should only go home after the side effects have subsided.
If you are using nitrous oxide for long term use, take a vitamin B12 to prevent anemia.
With time and care taken to prepare properly before a dental visit, using nitrous oxide can be an effective way to manage dental anxiety without wreaking havoc on blood sugar.