Nitrous Oxide Toolkit: Reducing Waste in NHS Trusts
The above toolkit, published in February 2025 by UCLPartners Health Innovation, outlines methods for reducing waste nitrous oxide.
However, the guidance is largely focused on acute care settings, particularly anaesthetic use. As is often the case, the use of nitrous oxide for analgesia in dentistry has been largely overlooked.
The only reference to dental use appears in Supporting Resource 2, on page 4, within a boxed section titled Mobile Nitrous Oxide Sedation System (Dentistry). This includes a brief description, indications for use, a list of pros and cons, and an equipment list. However, the latter includes some unusual references, such as:
- Connection components and cylinder securing mechanisms
It’s unclear what is meant by “connection components” — possibly items such as Bodok seals or DISS fittings on supply hoses. However, these fittings are typically provided as standard with modern 4-cylinder mobile stands. Similarly, all such stands now include cylinder securing mechanisms, usually in the form of straps to prevent movement while in transit.
The list also includes a cylinder wrench/spanner, which is not routinely used with cylinders on 4-cylinder stands. If needed, a ratchet key is more commonly employed.
Unfortunately, while the other sections of the document are supported with illustrative images, the information relating to dentistry lacks any visual representation.
It is disappointing that, once again, the dental sector appears to be treated as an afterthought. This represents a missed opportunity to provide clear and robust guidance for dental professionals.
On page 9 of the Toolkit, there is also a reference to HTM02-01 (2006), with a note that a revised version is currently in development. We are aware that a section specifically for dentistry has been submitted — this was completed by ourselves following an invitation to contribute. However, the project appears to have stalled, possibly due to recent changes in government, and no publication date has yet been confirmed.
Janet Pickles
March 2025
