Inhalation sedation vs local anaesthesia: differences and benefits
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April 2, 2026Globally, nearly a third of young children experience anxiety about dental treatment, according to an analysis comparing studies from 2000 to 2023. In adults, recent studies show that approximately 15–20% have high or severe levels of dental anxiety, and up to 40–50% report moderate anxiety when visiting the dentist.
Inhalation sedation and local anaesthesia are methods frequently used in dentistry to manage patients’ discomfort and anxiety.
Inhalation sedation is a form of minimal sedation that induces a state of relaxation without affecting the patient’s consciousness. On the other hand, local anaesthesia involves the administration of an anaesthetic substance to reduce or eliminate the sensation of pain.
What is inhalation sedation?
Inhalation sedation is a method of light sedation achieved by inhaling nitrous oxide (laughing gas) via a nasal mask. The child or adult patient remains conscious and able to communicate throughout the procedure, whilst the induced state of relaxation reduces discomfort.
Inhalation sedation does not put children to sleep, but merely reduces their fear and sensitivity to pain. Laughing gas, used in inhalation sedation for children and adults, has a slightly sweet smell and taste, which makes it pleasant.
“Patients respond positively to inhalation sedation. There are no side effects, either in the short or long term. The effects of nitrous oxide are felt for as long as the mask is held over the nose. Once the mask is removed and the gas supply is stopped, the patient returns to their normal state within just a few minutes.” – Dr. Adina Neagoe, Specialist in Paediatric Dentistry, with expertise in inhalation sedation, at the DENT ESTET 4 KIDS clinics.
When is inhalation sedation recommended?
Inhalation sedation is ideal for anxious or slightly uncooperative children during more complex dental procedures. For example, during appointments involving the treatment of complicated cavities or tooth extractions.
Inhalation sedation can be used to facilitate the administration of local anaesthesia by increasing the young patient’s compliance.
“Pain management during dental procedures is extremely important. There are many situations in which pain can be a factor in neglecting dental care. Therefore, it is important to minimise discomfort and manage painful situations at every visit.” – Dr. Adina Neagoe.
Advantages and limitations of inhalation sedation
Like any medical procedure, this investigation offers significant clinical benefits while also presenting certain limitations that should be carefully considered in relation to the complexity of each case.
Benefits
- Reducing or eliminating anxiety;
- Improved patient communication and cooperation;
- Increasing the pain threshold;
- Increasing tolerance for longer sessions;
- Reducing the gag reflex.
Limitations
- A referral is required for patients with chronic obstructive pulmonary disease (COPD), sleep apnoea, or vitamin B12 deficiency;
- Middle ear conditions, colds, nasal blockages;
- The child’s cooperation is required (to accept the mask);
- Additional costs may apply.
What is local anaesthesia?
Local anaesthesia involves injecting an anaesthetic into the area where a dental procedure is to be carried out. The local anaesthetic temporarily blocks the transmission of pain signals from the nerves to the brain, so that the patient (child or adult) does not feel any pain during treatment.
The patient remains conscious, but the area where the treatment is to be carried out is numb, and the effect lasts for up to 3 hours (depending on the substance used).
When is local anaesthesia recommended
There are several situations in which local anaesthesia is required for dental treatment:
- Treatment of extensive cavities – Local anaesthesia can be used to block pain during the procedure.
- Tooth extraction is a procedure that can be painful and traumatic for children. Local or general anaesthesia can be used to ensure a more comfortable experience.
- Orthodontic treatment – Anaesthesia can be used to reduce discomfort during the fitting of braces or other orthodontic procedures.
- Oral surgery – Anaesthesia ensures a state of deep relaxation during procedures to remove oral cysts or tumours.
Advantages and limitations of local anaesthesia
Benefits
- Effective pain management;
- The child remains conscious;
- Low cost and accessibility;
- Dental anaesthesia can be administered during pregnancy.
Limitations
- Requires the child’s cooperation;
- Does not control anxiety;
- Discomfort on injection;
- Possible allergic reactions in susceptible patients.
Key differences between inhalation sedation and local anaesthesia
Patient condition
- Inhalation sedation – Relaxation and reduction of anxiety (the patient is conscious; the mixture of oxygen and nitrous oxide serves to induce a state of calm and mild euphoria; it cannot eliminate pain, but only makes it more bearable).
- Local anaesthesia – Blocks the sensation of pain (the patient is conscious, and the area being treated is numb).
Duration of effect
- Inhalation sedation – The effect sets in within a few minutes and wears off quickly once the administration of the laughing gas is stopped.
- Local anaesthesia – The numbing effect occurs shortly after the anaesthetic is injected and lasts up to 3 hours (depending on the substance used).
Indications
- Inhalation sedation – Recommended for patients (children or adults) who experience fear of the dentist and dental treatment, to provide added comfort.
- Local anaesthesia – It is recommended for various types of dental treatment to reduce pain.
Safety
- Inhalation sedation – Patients respond well to inhalation sedation; there are no side effects.
- Local anaesthesia - Local anaesthesia is a safe method, but may be associated with discomfort at the injection site and, in rare cases, allergic reactions or reduced effectiveness in acute inflammation.
Benefits of inhalation sedation for children
• Non-invasive method (administered via a nasal mask);
• Safe method due to easy control of the level of sedation (rapid adjustment of gas concentration);
• Rapid onset of effect (within a few minutes of starting inhalation);
• Reduction or elimination of anxiety;
• Improved patient cooperation (the child remains conscious and can respond to simple commands);
• Rapid recovery (the effect wears off once administration stops);
• Reduction in pain and discomfort (does not replace local anaesthesia, but makes it more bearable and the two complement each other very well);
• Reduction in the gag reflex.
Benefits of dental anaesthesia
- Completely blocks the sensation of pain in the treated area;
- Allows procedures to be carried out without discomfort;
- The patient remains conscious throughout the treatment;
- The effect sets in within a few minutes and lasts for 1–2 hours;
- It can be combined with inhalation sedation for an enhanced psychological effect.
Complications and risks
Inhalation sedation and anaesthesia are generally safe procedures, with mild, reversible or no adverse effects, but they require trained staff, appropriate patient selection and close monitoring.
Potential risks of inhalation sedation
- Nausea and vomiting (if the child has not followed the instructions and has eaten a lot before the procedure);
- Dizziness and drowsiness (during the procedure);
- Temporary headache (if insufficient oxygen was administered at the end of the procedure).
Possible risks of local anaesthesia
- Swelling and local inflammation;
- Accidental biting of the lip, cheek or tongue;
- Nerve damage (rare);
- Allergic reactions.
Frequently asked questions about inhalation sedation and local anaesthesia
What is inhalation sedation and how does it differ from local anaesthesia?
Inhalation sedation is a method of relaxation that reduces anxiety, whilst local anaesthesia eliminates pain in the treated area. The two can be used together for optimal comfort.
How long after dental anaesthesia can I eat?
It is advisable to wait until the anaesthetic has worn off to avoid accidentally biting your cheek or tongue.
Is inhalation sedation safe for children?
Yes, it is a safe method, frequently used in paediatric dentistry, provided it is administered by qualified staff.
How long does dental anaesthesia or inhalation sedation last?
Local anaesthesia generally lasts 1–2 hours, and the effects of inhalation sedation wear off quickly, within a few minutes of stopping administration.
Can I have dental anaesthesia whilst pregnant?
Yes, certain types of local anaesthetic can be used safely during pregnancy, on the advice of a doctor.
What complications can arise following dental anaesthesia?
Local discomfort, slight swelling or bruising may occur, and in rare cases, allergic reactions or prolonged numbness.
Bibliography
- McDonald and Avery’s – “Dentistry for Children and Adolescents – Tenth Edition”, 2016
- Prof. Cristina Bica – “Paediatric Dentistry – Diagnosis and Treatment”, University Press, 2013