Plumbed Versus Portable Nitrous Oxide/Oxygen Sedation: Which Is Best?

| 11-16-2022
Plumbed Versus Portable Nitrous Oxide/Oxygen Sedation: Which Is Best?

Want to offer nitrous oxide/oxygen sedation to your dental patients?

Nitrous oxide offers a perfect way to put adults and pediatric patients at ease during procedures. It can also serve as a good revenue generator.

For many dental professionals, the question comes down to which solution makes the most sense.

The two primary delivery mechanisms are through a plumbed central system or a portable solution. Existing practices often think their only option is the latter because they assume the cost of installing a central system won’t be worth it. That’s not necessarily the case.

In this article, we explore why a plumbed central system is best and the options available. We’ll also share what you need to know about portable nitrous solutions if that’s the option you choose.

Let’s start with the reasons why dental practices should seriously consider a plumbed nitrous oxide/oxygen sedation solution.

Plumbed Is Preferred

From long-term cost savings to convenience to greater utilization, there’s no question that a plumbed solution is the best option for any dental practice. This is especially true for new buildouts or practices that are already considering a significant remodel. Here’s why:

Plumbed Systems Tend to Be More Convenient

With portable nitrous oxide/oxygen sedation solutions, dental professionals can fall into the “out of sight, out of mind” trap. Most portable solutions have to be wheeled out of a storage space or closet into the operatory. While today’s portables are compact, they still require extra steps.

On the other hand, a plumbed nitrous oxide/oxygen sedation system offers total convenience because the gas cylinders and most of the delivery mechanism are built into the practice’s physical infrastructure. Everything dental professionals need to administer nitrous sedation is available chairside.

In fact, plumbed systems can be paired with chair-mount kits that locate the tubing and reservoir bag ergonomically attached to the dental chair itself, giving clinicians unrestricted access to the coveted “12 o-clock” and optimal rotation around the patient’s head.

Adec Chairmount

HuFriedyGroup offers Accutron™ RFS™ Remote Flow System Chairmount Kits that can be used with Digital or analog flushmount flowmeters. These can be installed on and even retrofitted to almost any variety of dental chair brands without drilling any holes.

The advantage to Accutron™ Chairmount Kits is that they do not void chair manufacturer warranties because no modifications are made to the chair.

Plumbed Systems Are More Cost Effective

When we look at the cost of plumbed systems versus portable solutions, the difference is significant.

Plumbed systems cost a dental practice around $2 per hour at typical dosages. That’s partly because plumbed systems use large “H” gas cylinders that hold just over 15,000 liters.

Portable systems use “E” cylinders that hold just over 1,500 liters of gas. That disparity translates to five to 15 times higher costs for portables than "H" cylinders and correlates to significantly higher costs per procedure. (Don’t forget that gas prices have and will continue to increase over time, so that gap in cost will continue to expand.)

Accutron digital flushmount

  • Accutron™ Digital Ultra™ Flowmeter
  • Accutron™ Ultra PC™ Flowmeter

Dental practices that use nitrous oxide/oxygen sedation for even just one procedure per day have the potential to clear as much as $20,000 in profit after expenses. The less you pay for gas, the more profit you realize.

And that’s something for existing practices to consider. It’s true that installing a central nitrous system will be more costly on the front end if you’re not already in the process of a remodel. However, in many cases, that cost can be recouped in one to two years, creating the opportunity for additional revenue moving forward. And because central systems are more convenient, they get used more often, creating even more revenue potential.

Accutron™ Digital Newport™ Flowmeter System

  • Accutron™ Digital Newport™ Flowmeter System
  • Accutron™ Newport™ Flowmeter System

If a portable system is still the most viable option for your practice at this time, make sure to choose one that works within the space you have and offers the most flexibility. The Accutron 4-cylinder portables are less than 32" high and can easily move between operatories and store easily.

HuFriedyGroup also offers a unique portable system (Newport) that keeps cylinders out of sight. Plus, the flat surface on these enclosed portables can be used as additional counter space.

Plumbed or portable, technological advancements in this space have improved patient safety.

Digital Technology Improves Patient Safety

When a dental office is considering which nitrous oxide/oxygen sedation solution to implement, the question of digital versus analog will have to be answered — for both the manifold and the flowmeters.

Let’s start with flowmeters.

Choosing Between Analog or Digital Flowmeters

In general, we recommend digital flowmeter technology.  Dental professionals already have enough to focus on during a procedure, so it makes little sense to add managing the balance of gas flow to that list especially when digital flowmeters do that work for them.

With a digital flowmeter, the clinician identifies the patient's tidal volume (aka lung capacity).  Once the tidal volume is determined, the flowmeter will hold this same Total Flow throughout the procedure.  The flowmeter will adjust to keep the constant Total Flow even as you titrate in nitrous.  This key feature eliminates the need to do any math while adjusting your Total Flow and percent nitrous. These flowmeters are easier to use and much more convenient. Plus, since there are no knobs or dials to turn, digital flowmeters lend themselves to superior infection prevention. The only surface is a flat panel touchscreen that can be covered by a reusable barrier strip or disinfected after each use.

HuFriedyGroup offers a range of digital flowmeter packages: The Accutron™ Digital Ultra™ Flowmeter can be used on a stand, slide or wall arm and the Accutron™ Digital Ultra™ Flushmount Flowmeter mounts into the cabinet or wall to save space. All are available with a convenient remote control.

How Auto-switching Digital Manifolds Have Improved Patient Care

Accutron™ Digi-Flo™ Automatic Switching Manifold/Desk Alarm Package A with Pre-Install Kit

Before auto-switching technology, an empty gas cylinder stopped all production. A staff member, usually an assistant, would have to walk to the cylinder closet then manually open and close the cylinder valves to continue with patient treatment.

Luckily, modern flowmeters (even analog) have fail-safe devices preventing them from dispensing 100% nitrous to patients.

With the introduction of auto-switching manifold technology, when an empty gas cylinder is sensed by the system, it automatically switches to the full cylinder. The clinician will receive an alert on the alarm panel that the switch has happened, but it doesn’t interrupt or delay the procedure. An auto-switching manifold keeps the focus on the patient.

  • Accutron™ Digi-Flo™ Systems with Wall Alarm
  • Accutron™ Digi-Flo™ Systems with Desk Alarms

Ready to implement nitrous?

As your practice weighs the pros and cons of plumbed versus portable and digital versus analog, make sure you partner with us early in the process. Our team at Professional Sales Associates (PSA) will make sure you’ve accounted for all of the considerations that go into this type of investment.

Your PSA rep will help you with:

  • Industry experience and insights regarding the most important questions to ask your contractor.
  • Knowledge of state-specific requirements.
  • Space considerations for your practice.
  • How to choose mounting options and examples of what other practices are implementing.

Additionally, if you are building or remodelling, make sure you are working with professionals with dental construction experience. They will also enlist a medical gas plumber. This is required by code when you’re installing a nitrous oxide system.

Accutron Systems are also eligible for a Section 179 Tax Deduction. To qualify, the equipment must be installed before December 31, 2022. Please speak to your tax consultant for more information.

For more information about HuFriedyGroup Accutron™ portable and remote nitrous oxide/oxygen sedation products and to better understand your options, visit