Sedation Frequently Asked Questions

All dentists and certified specialists administering minimal, moderate or deep sedation, or general anesthesia must comply with BCCOHP’s standards or guidelines for that modality.

The sedation spectrum ranges from minimal sedation to general anesthesia.

Below are some frequently asked questions about sedation.

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Minimal sedation

No. Minimal sedation providers and minimal sedation facility owners are not required to complete a self-assessment.

This depends on your course provider. If your certificate is valid for one year, annual
retraining is required. If your certificate is valid for two years, retraining every two years is permitted.

Currently, registration is not required for minimal sedation. Registrants may provide minimal sedation services as long as they are in full compliance with the Minimal and Moderate Sedation Standards & Guidelines (e.g. education, training, staff, equipment, drugs, and protocols).

Currently, registration for minimal sedation facility is not required. Registrants may provide minimal sedation services as long as they are in full compliance with the Minimal and Moderate Sedation Standards & Guidelines.

Yes, one vial of flumazenil is required if benzodiazepines are used.

Yes, all clinical sedation and/or general anesthesia staff are required to have current BLS designed for healthcare professionals, and the course must contain all of the following:

    • Bag-valve-mask
    • Hands-on component
    • Certification no longer than 24 months

CPR-Level C is not acceptable for sedation. If by chance the course you took met all of the requirements above, it is beneficial to obtain written confirmation from course provider to keep on file for record.

It is best practice for staff whose role is purely administrative to have current BLS, but it is not mandatory.

Moderate sedation

If you own a dental office and intend to administer moderate sedation to your patients, you must first register your qualifications with BCCOHP.

If you own a dental office and administer parenteral (IV) moderate sedation, you must inform the College by contacting us to be added to the register of facilities administering parenteral (IV) moderate sedation.

You are responsible for ensuring that any visiting dentist or physician who administers sedation in your office has the appropriate qualifications.

If you own a dental office, and intend to have another dentist or physician administer parenteral (IV) moderate sedation, you must inform the College by contacting us to be added to the register of facilities that administer parenteral (IV) moderate sedation.

If you intend to administer moderate sedation to patients in other dentists’ offices, you must have your qualifications registered with the College.

According to the Minimal and Moderate Sedation in Dentistry Standards and Guidelines, moderate sedation is defined as a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is rarely compromised.

The drugs and/or technique used in moderate sedation should carry a margin of safety wide enough to render unintended loss of consciousness unlikely. Repeated dosing of an agent before the effects of previous dosing can be fully appreciated may result in a greater alteration of the state of consciousness than is the intent of the dentist. Further, a patient whose only response is reflex withdrawal from a painful stimulus is not considered to be in a state of moderate sedation but, rather, deep sedation.

The usual modalities of moderate sedation are one of the following:

  • Oral (enteral) administration of multiple sedative drugs, with or without nitrous oxide and oxygen;
  • Parenteral administration of benzodiazepine drugs (intravenous, intramuscular, subcutaneous, submucosal or intranasal); or
  • Parenteral administration of benzodiazepine and narcotic drugs (intravenous, intramuscular, subcutaneous, submucosal or intranasal).

Registrants must first be authorized and registered with BCCOHP through the Sedation & General Anesthesia Committee before providing moderate sedation services.

Requirements vary depending on the level of sedation CDAs assist and the roles they function on the clinical team. Please refer to Sedation and General Anesthesia Standards and Guidelines for details.

CDAs who function as moderate sedation assistants or recovery supervisors must have current BLS and DAANCE, OMAAP, or CDAAC.

CDAs who function as operative assistants are required to have current BLS.

Regulated professionals who provide and/or assist with sedation services should ensure they are in full compliance with BCCOHP standards and guidelines. All sedation providers, operating dentists (i.e., non-sedation providers treating sedated patients) and support staff will be assessed with the BCCOHP’s Minimal and Moderate Sedation in Dentistry Standards & Guidelines, including assessment of each team member’s credentials.

Yes, all clinical sedation and general anesthesia staff are required to have current BLS designed for health professionals, and the course must contain all of the following components:

  • Bag-valve-mask
  • Hands-on components
  • Certification no longer than 24 months

All moderate sedation providers who sedate patients 13 years of age and over are required to have current ACLS.

This depends on your course provider. If your certificate is valid for one year, annual
retraining is required. If your certificate is valid for two years, retraining every two years is permitted.

ACLS must be renewed every two years or as recommended by course provider, whichever is more frequent.

The assessment cycle for moderate sedation facilities will be four years, one of which will require an in-office assessment by College-appointed sedation assessors:

  • In the first year of the cycle (2022-23), all moderate sedation facilities will complete a self-assessment.
  • Between years two and four of the cycle, each moderate sedation facility will be visited and assessed once by a College-appointed assessment team. Depending on the findings, additional assessments may be required. Annual self-assessments will be required in the years other than the year when an in-office facility assessment is conducted.
  • The four-year cycle is repeated until moderate sedation services are no longer provided in the facility.

Accepted payment methods include cheque (by mail), Mastercard and Visa credit cards, and Interac for RBC Royal Bank, TD Bank, First Nations Bank of Canada, Scotiabank, and most BC credit unions. Mastercard/Visa debit cards are not accepted.

BCCOHP does not accept payments by telephone, in cash, or those delivered in person.

Mastercard and Visa credit cards are accepted, but Mastercard/Visa debit cards are not. Interac for RBC Royal Bank, TD Bank, First Nations Bank of Canada, Scotiabank, and most BC credit unions are accepted.

If you receive an error message while paying, please contact your bank to ensure there are no issues on their end before making another attempt with payment using the same credit card. If the issue is not banking-related, try another payment method or contact us via our form.

No, each facility is required to submit only one initial self-assessment. All owners of the facility should be listed in the package.

No, only the following may function as moderate sedation and/or recovery supervisors:

  • A registered nurse (RN)
  • A CDA with Dental Anesthesia Assistant National Certification (DAANCE), Oral and Maxillofacial Anesthesia Assistants Program (OMAAP), or Canadian Dental Anaesthesia Assistant Certification (CDAAC)

A dental hygienist with DAANCE, OMAAP, or CDAAC

All clinical sedation and/or general anesthesia staff are required to have current BLS designed for healthcare professionals, and the course must contain all of the following:

  • Bag-valve-mask
  • Hands-on component
  • Certification no longer than 24 months

CPR-Level C is not acceptable for sedation. If by chance the course you took met all of the requirements above, it is beneficial to obtain written confirmation from course provider to keep on file for record.

It is best practice for staff whose role is purely administrative to have current BLS, but not mandatory.

Physicians are required to submit a copy of their current Certificate of Professional Conduct (CPC) and a copy of their current hospital privileges (or current BLS, Advanced Cardiovascular Life Support (ACLS), and/or Pediatric Advanced Life Support (PALS), and difficult airway course).

Both enteral (oral) and parenteral (IV) moderate sedation facilities are being assessed.

Registrants may only administer moderate sedation sedation to patients who are 12 years of age and under in out-of-hospital dental facilities when they are qualified and authorized to provide deep sedation and/or GA, or have completed training in a formal postgraduate program in pediatric dentistry that meets BCCOHP Standards. Practitioners who do not fall under these categories cannot provide moderate sedation services to patients 12 years of age and younger.

Deep sedation and general anesthesia

Do you:

If you own a dental office and intend to administer deep sedation or general anesthesia to your patients, you must register your qualifications with BCCOHP and must apply to have your facility inspected by BCCOHP.

  • To register your qualifications, please complete the Application for Registration of Qualifications (PDF) and submit it to BCCOHP with the applicable fee (C$150). Please allow 2-3 months for your application to be processed.
  • To apply for facility authorization, please complete the Application for Facility Authorization (PDF) and submit it to BCCOHP with the applicable fee (C$4,500). Facility inspection and authorization typically takes 6-8 months.

If you own a dental office, and intend for another dentist or physician to administer deep sedation or general anesthesia, you must have your facility inspected by BCCOHP. Please be aware that you are responsible for ensuring that any visiting dentist or physician who provides sedation in your office has the appropriate qualifications.

  • To apply for facility authorization, please complete the Application for Facility Authorization (PDF) and submit it to BCCOHP with the applicable fee (C$4,500). Facility inspection and authorization typically takes 6-8 months.

If you intend to administer deep sedation or general anesthesia to patients in dental offices approved to do so by BCCOHP, you must have your qualifications registered with BCCOHP.

For dentists

No. Any dentist who holds practising status is authorized to provide minimal sedation provided they feel competent in this modality.

This is considered moderate sedation. In order to provide moderate sedation, you must first meet the educational requirements set out in the Standards and then register with, and have your qualifications approved, by BCCOHP.

No, CDAs cannot give medications to patients. Only dentists, physicians, or registered nurses acting under orders and direct supervision of a dentist/physician may give medications to patients.

Your letter from BCCOHP approving your qualifications is your sedation permit.

For certified dental assistants

No, CDAs cannot give medications to patients. Only dentists, physicians, or registered nurses acting under orders and direct supervision of a dentist/physician may give medications to patients.

No. DAANCE is an online self-study course that participants work through at their own pace over a period of six months. The final exam can be taken at one of seven testing centres throughout B.C. To find out more, visit www.aaoms.org or call 1-800-822-6637.

Yes. Canadian Dental Anaesthesia Assistant Course is an accepted alternative to DAANCE for CDAs assisting with moderate sedation.

OMAAP is the Oral and Maxillofacial Surgery Anesthesia Assistants Program. This program was previously offered by the American Association of Oral and Maxillofacial Surgeons and was replaced by DAANCE.

*Dental Anesthesia Assistant National Certification Examination offered by the American Association of Oral and Maxillofacial Surgeons.

Questions?

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