Many offices chose not to offer nitrous oxide (laughing gas) because, although it is absolutely safe for the patients, long-term exposure to the gas not absorbed by the patient may have negative health changes for the staff. Alternatively, a prescription for a sedative can offer patients a decrease in their anxiety level. We often prescribe a high dose of Ativan, which is very safe and inexpensive. The one drawback is that, unlike nitrous oxide, it cannot be turned off at the end of the appointment and we insist that the patient have an escort home. For patients who require a higher level of sedation, we have specialists to whom we refer depending on the treatment you require.