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DENTAL SEDATION COURSES FOR DENTISTS*

*Utilize the navigation ribbon at the top of any page to locate the desired type of sedation course.

The sedation permit process and the sedation CE required to maintain a permit can be very confusing.  The information below can be used as a general guide that navigates the sedation permit process in all 50 states.  The state dental boards construct and enforce sedation rules and regulations.  The ADA can only publish guidelines and make national recommendations.  Occasionally, state regulations are less stringent than the ADA national recommendations.  In some cases, like the state of Illinois, the state regulations are more stringent.  Most states parallel their regulations with the ADA guidelines.  Dentists should be compliant with both entities to avoid dental legal liability.  It is the responsibility of the dentist to ensure they know their state training requirements.  The ADMA can ensure the CONTENT of training is state compliant.  The ADMA requires the trainee to be responsible for the LENGTH of training.

Below we will review three types of permits.  The certification process to obtain a permit and the sedation CE process to maintain a permit will be outlined.

  • Minimal oral (enteral) conscious sedation permit, typically 16-30 training hours required; Adult and Minor
  • Moderate oral (enteral) conscious sedation permit, typically 60 hrs required, ADMA has a 2 module course, module I 30 hrs + module II 30 hrs = 60 hrs; Adult 
  • Moderate IV (parenteral) conscious sedation permit, 60-75 training hours; Adult and Minor

PERMIT CERTIFICATION

Upon completion of any sedation training, the training entity certifies completion of the course.  This certification packet is then mailed to the dental board with the states requested application.  The state reviews the application and issues a permit.  In most states (except for minimal sedation), a site inspection is necessary within a year at the beginning of the dentists sedation career.  Some states do not issue a temporary permit prior to the first site inspection.  Typically, the site inspection is repeated every 5 years.

Minimal oral (enteral) conscious sedation permit; Adult and Minor

The ADMA protocols that this course teaches include traditional halcion (triazolam) protocols with titration (sequential dosing), combination protocols with titration (sequential dosing) and combination triazolam / inhalational N2O protocols.  Patients are not dosed to deeper moderate conscious sedation levels with these protocols.  The dosing levels remain safe, effective, and patients are able to be discharged home with their caregiver without significant concerns.  Amnesia and comfort are readily achieved with these protocols without pushing safe oral dosing limits.  The ADMA limits the total oral exposure doses due to the prolonged clinical effects of halcion (triazolam) metabolites.  The metabolites cause safety issues while the patient recovers at home.  This is why the ADMA trains all of their dentist to remain in the minimal oral conscious sedation spectrum when they administer orally.

ADA Recommendations:

  • A minimum of 16 hours
  • Clinically-oriented experiences during which competency in oral minimal sedation techniques is demonstrated.
  • Minor (sedation training for children 13 and younger) requires additional course content and clinical learning experience specific for children.

ADMA Oral Conscious Sedation Course:

  • 30 hours of didactics
  • Individual monitoring to include capnography & ECG, and airway management training
  • Live cases
  • 17 sedation simulations with emergency response challenges
  • ACLS review
  • Pediatric course: This course includes pediatric anatomy and physiology, pediatric airway management, and live pediatric simulated emergency response.

Moderate oral (enteral) conscious sedation permit; Adult and Minor

Most states are adapting the 60 hr + 20 cases regulation for oral moderate sedation.  The ADMA oral combination protocols can achieve moderate sedation safely.  However, we recommend that if a dentist wants to deliver consistent and safe sedation at this depth, IV (parenteral) techniques are used.  The key point is the patient’s status upon discharge.  Typically, if traditional halcion protocols are used to maintain moderate sedation for longer that 2 hours, patients are at risk from high secondary benzodiazepine metabolites after discharge.  ADMA combination protocols avoid this risk by using non benzodiazepine sedatives to lower halcion doses while achieving a moderate sedative state.

Typical State Regulations / ADA Future Recommendations:

  • A minimum of 60 hours of sedation didactics
  • 20 clinical cases during which competency in oral moderate sedation techniques are demonstrated.
  • Minor (sedation training for children 13 and younger) requires additional course content and clinical learning experience specific for children.

ADMA Moderate Oral Conscious Sedation Course:

  • 60 hours of didactics
  • Individual monitoring to include capnography & ECG, and airway management training
  • 25 live cases
  • 17 sedation simulations with emergency response challenges
  • ACLS review
  • Pediatric course: This course includes pediatric anatomy and physiology, pediatric airway management, and live pediatric simulated emergency response.

Moderate IV (parenteral) conscious sedation permit; Adult and Minor

The ADMA / RMS is proud to offer an IV sedation training as a nationally recognized ADA CERP CE Provider.   Each dentist sedates their own patients with one on one instruction from a board certified anesthesiologist.

Typical State Regulations / ADA Recommendations:

  • A minimum of 60 hours of sedation didactics
  • 3 Dentists to 1 Patient ratio allowed for 20 clinical cases during which competency in IV(parenteral) moderate sedation techniques are demonstrated.
  • Minor (sedation training for children 13 and younger) requires additional course content and clinical learning experience specific for children.
  • ACLS/PALS or emergency response course equivalent recommended

ADMA Moderate Oral Conscious Sedation Course:

  • 75 hours of didactics
  • Individual monitoring to include capnography & ECG, and airway management training
  • 25 live cases: 1 Dentist to 1 Patient & 1 Instructor to 1 Dentist
  • 15 sedation simulations with emergency response challenges
  • ACLS certification
  • Pediatric course: This course includes pediatric anatomy and physiology, pediatric airway management, and live pediatric simulated emergency response.  25 pediatric live dental sedation cases are required.

PERMIT MAINTENANCE ∇ SEDATION CE

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