ADAA View Course


Nitrous oxide and oxygen (N2O/O2) in combination have been used safely and successfully for over 160 years to assist in the management of pain and anxiety. Dr. Horace Wells, a dentist in the early 1800s, dedicated his life to promoting its use for both dental and medical procedures. Because of his persistence in advocating the use of nitrous oxide as a method of pain control, he was posthumously recognized as the “Discoverer of Anesthesia.” Since that time, N2O/O2 has been commonly used in many dental specialties. Other health disciplines have also benefited. In many instances, patients present to medical and dental offices with both pain and anxiety. It is necessary to manage both, since they are interrelated. Nitrous oxide and oxygen sedation can assist patients with their pain and anxiety and can be employed safely and effectively with minimal concerns.

This course will teach about the desirable characteristics of nitrous oxide, indications and contraindications for N2O/O2 use as well as facts and myths surrounding chronic exposure to nitrous oxide, the biologic effects associated with high levels of the gas, and ways to assess and minimize trace gas contamination in an outpatient setting.


Ann Brunick, RDH, MS, is Chairperson and Professor of the Department of Dental Hygiene at the University of South Dakota. She received an A.A. degree from the University of South Dakota, a B.S. degree from the University of Minnesota, and a master’s degree from the University of Missouri-Kansas City, School of Dentistry. She has served on numerous committees at the local, regional and national levels, including the ADHA Institute for Oral Health Scholarship and Research Review Committees, the National Dental Hygiene Board Examination Construction Committee, the International Federation of Dental Hygienists’ editorial board and the ADA Commission on Dental Accreditation as a site visitor. Ms. Brunick has published numerous articles and abstracts. Her most recent work is the third edition of a textbook entitled Handbook of Nitrous Oxide and Oxygen Sedation that she co-authored with Dr. Morris Clark.

Morris S. Clark, DDS, FACD, is a nationally and internationally recognized expert on the subject of nitrous oxide/oxygen therapy. His is a graduate of the University of California School of Dentistry and completed his training in Oral Maxillofacial Surgery at Columbia University. He is a Professor at the University of Colorado School of Dental Medicine and on the faculty of the medical school there as well. He has been President of the American Society for the Advancement of Anesthesia in Dentistry and the American Dental Society of Anesthesia for the states of Colorado, Arizona, Kansas, Utah, Wyoming and New Mexico. Dr. Clark did the original clinical research on Versed (Midazolam) and Romazicon (Flumazenil), the antagonist for all the benzodiazepine class of drugs. He is on the Board of Directors for the American Dental Society of Anesthesia and a member of the American Dental Association Council on Scientific Affairs. He is co-author of the best-selling text Handbook of Nitrous Oxide and Oxygen Sedation, published by Elsevier.


Upon completion of this course, the dental professional should be able to:

• Recognize characteristics of nitrous oxide that make it desirable to use for most patients.
• Evaluate indications and contraindications for the use of N2O/O2 sedation.
• Differentiate between the facts and myths surrounding chronic exposure to nitrous oxide.
• Explain what the NIOSH and ACGIH recommended exposure limits signify.
• Identify biologic effects associated with high levels and/or misuse of nitrous oxide.
• Describe methods for detecting and assessing levels of trace gas in an outpatient setting.
• List methods for minimizing trace levels of nitrous oxide in an outpatient setting.


The ADAA has an obligation to disseminate knowledge in the field of dentistry. Sponsorship of a continuing education program by the ADAA does not necessarily imply endorsement of a particular philosophy, product or technique.

The ADAA cautions participants taking this course on the hazards of using limited knowledge when integrating new techniques into their practices.

Credits earned upon completion of this course may be used to meet DANB’s Recertification Requirements.


If the participant has concerns about the presentation, please contact our Education Department at  If the participant has questions on how to view the presentation, please contact Tech Support at

To proceed with this course please click on the "Register" link.

You need to be logged in to register for a course. Please Click here to log in or create an account
Return to "My Courses"