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Moderate Dental Sedation--New State Regulations-Pt. 2

Posted Mar 27 2010 11:57pm

The next pertinent definition changed in the new State of Illinois regulations (April 2010) on dental sedation is:

"Moderate Sedation" or "Conscious Sedation" means a pharmacologically
induced depressed state of consciousness …under which an individual retains
the ability to independently and continuously maintain an airway and respond
appropriately to light tactile physical stimulation and oral verbal commands….
Moderate sedation (conscious sedation) must be administered by an individual
qualified under this Section…. The drugs and/or techniques used must carry a
margin of safety wide enough to render unintended loss of consciousness
unlikely.”

The educational requirements, staffing, equipment, and safety requirement are much more stringent. The dentist must have his Advanced Cardiac Life Support (ACLS) designation, and maintain a log of his training updates. Currently about 1 to 2% of Illinois restorative dentist have this extra sedation Certificate (Sedation Permit A).
The majority of the cases are performed using IV, or intravenous, dental sedation methods. Pills, IM intramuscular medications, or gas is sometimes also used as an adjunct (often for anxiety control prior to starting the IV).

The primary advantages of this over the minimal dental sedation is 1) Fast adjusting of the level of sedation for the patient’s comfort
is possible(30 sec, vs. 30-60 min. with pills)
2) Higher educational requirements
3) Higher safety requirement with monitoring, equipment, and training
4) Greater levels of comfort and amnesia
5) Pain medication in addition to sedative can be administer via the IV in place
6) If needed antiemetics (anti-nausea) medication can be administered via the
IV if needed.

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