According to the survey, 80% of patients have phobia of tooth extraction, which can lead to patients not cooperating well with the doctor’s operation during the extraction, especially for children and elderly patients with a history of hypertension and coronary heart disease who need tooth extraction, the patient’s fear often makes the doctor helpless. Recently, the technique of tooth extraction under laughing gas anesthesia was introduced to our oral and maxillofacial surgery, which can effectively solve this problem. The technique of laughing gas inhalation sedation is a safe and effective anesthetic technique that can preserve consciousness by giving the patient an appropriate volume fraction of laughing gas-oxygen mixture to achieve anxiolytic or sedative effects. It is a safe and effective technique that preserves consciousness. Not only does it enable the patient to stabilize and cooperate well with the surgeon, but it also improves the effectiveness of local anesthesia and makes the experience of tooth extraction less painful. For elderly patients with a history of hypertension and coronary heart disease, the patient’s vital signs are monitored with ECG monitoring while undergoing laughing gas anesthesia, making the extraction procedure more comfortable and safe. Liu Gangli of the Department of Oral and Maxillofacial Surgery of Shandong University Stomatology Hospital received an elderly female patient yesterday afternoon who complained of biting pain in the left lower posterior teeth with a history of hypertension and coronary heart disease, and was found to have 37 loosening II°. X-ray examination showed that the left mandibular wisdom tooth was horizontally low obstructed and the crown of the wisdom tooth was compressing the 37 compressed root. However, considering that the wisdom tooth extraction was traumatic and time-consuming, and that the patient had a history of hypertension, coronary heart disease and fear of tooth extraction, it was recommended to perform a painless and comfortable extraction under cardiac monitoring using laughing gas anesthesia. The procedure went smoothly and the patient’s blood pressure fluctuated slightly during the operation, but all other vital signs were stable. After the operation, the patient reported that he had no obvious fear and felt comfortable during the extraction. In order to reduce the fear of patients, to stop turning away patients with heart disease and hypertension, to make the extraction safer and to expand the indications for extraction, we will continue to actively carry out the mature technique of laughing gas extraction so that more patients can benefit from it.