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.
According to the Minimal and Moderate Sedation Standards and Guidelines, minimal sedation is defined as a minimally depressed level of consciousness produced by a pharmacological method, in which the patient retains the ability to independently and continuously maintain an airway and respond normally to tactile stimulation and verbal command. Although cognitive function and co-ordination may be modestly impaired, ventilator and cardiovascular functions are unaffected.)
Minimal sedation is nitrous oxide/oxygen or single oral sedative drug (within MRD), with or without nitrous oxide/oxygen.
Please be reminded that although minimal sedation is defined as a single oral sedative, within MRD, with or without nitrous oxide or oxygen, or nitrous oxide/oxygen alone, it is ultimately the patients’ response and level of consciousness that determine the level of sedation provided. As sedation is a continuum, the level of sedation provided is not solely dependent on drugs or route of administration. Any single agent can produce a greater effect, if given enough. As such, if minimal sedation is the intended level, the patient’s level of consciousness and response must remain in the state of minimal sedation.
No. Minimal sedation providers and minimal sedation facility owners are not required to complete a compliance 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. Licensees 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. Licensees 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:
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.
According to the Minimal and Moderate Sedation 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:
Licensees must first be authorized and registered with BCCOHP before providing moderate sedation services.
If you own a dental office and intend to administer moderate sedation to your patients, you must first register your qualifications with BCCOHP.
Facilities that intend to provide moderate sedation services in their facility must inform BCCOHP and complete an initial compliance assessment.
You are responsible for ensuring that any visiting dentist or physician who administers sedation in your office has the appropriate qualifications.
Facilities that intend to provide moderate sedation services in their facility must inform BCCOHP and complete an initial compliance assessment.
If you intend to administer moderate sedation to patients in other dentists’ offices, you must have your qualifications registered with the College.
To register your qualifications, please complete the Application for Registration of Qualifications (PDF) and submit it to BCCOHP.
No. BCCOHP does not recommend sedation courses. Please refer to Minimal and Moderate Sedation Services in Dentistry Standards and Guidelines for education/training requirements
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, CDAAC or the University of Alberta’s Sedation Training Assistant Certificate Program (Sedation Assistant Certificate).
All 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.
Both enteral (oral) and parenteral (IV) moderate sedation facilities are being assessed.
The accreditation cycle for moderate sedation facilities will be five years.
The cycle will continue to repeat every five years as long as the facility offers moderate sedation services.
Yes, while assessment is ongoing, licensees may provide moderate sedation services as long as they are in full compliance with the Minimal and Moderate Sedation Standards & Guidelines and related sedation updates, unless directed otherwise.
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:
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.
Accepted payment methods include cheque (by mail), Mastercard and Visa credit cards. Mastercard/Visa/Interac 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.
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.
Yes, all registrants who own facilities that provide moderate sedation services are required to complete the initial Sedation & General Anesthesia Compliance Assessment.
No, each facility is required to submit only one initial compliance assessment. All owners of the facility should be listed in the package.
Please review the Minimal and Moderate Sedation Standards & Guidelines and Sedation/GA News.
No, only the following may function as moderate sedation and/or recovery supervisors:
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:
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 not permitted to function in any capacity within BCCOHP-regulated moderate sedation facilities until the facility has completed its initial accreditation inspection (completed by the dentist/RN inspector, biomed inspector, and anesthesiologist inspector) and has been accredited by BCCOHP through the Accreditation Committee.
Licensees 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.
According to the Deep Sedation Standards and Guidelines, deep sedation is defined as a controlled state of depressed consciousness accompanied by partial loss of protective reflexes including the inability to respond purposefully to verbal command, produced by a pharmacologic or non-pharmacologic method or a combination thereof.
Licensees must first be authorized and registered with BCCOHP before providing deep sedation services.
According to the General Anesthesia Standards and Guidelines, general anesthesia is defined as a controlled state of unconsciousness accompanied by loss of protective reflexes, including an inability to maintain an airway independently and to respond purposefully to physical stimulation or verbal command. This state therefore applies to any technique which has depressed the patient beyond deep sedation.
Licensees must first be authorized and registered with BCCOHP before providing general anesthesia services.
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.
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 accreditation, please complete the Application for Facility Accreditation to Provide Deep Sedation/GA Services in Dentistry and submit it to BCCOHP
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.
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, LDAs 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.
ACLS and PALS courses must have a hands-on component. Courses entirely online are not appropriate. The Heart and Stroke Foundation states that, “substantial hands-on practice is needed to meet psychomotor and nontechnical/leadership skill performance objectives.”
Yes. BCCOHP recognizes the following programs and certificates for licensed dental hygienists who successfully complete them to assist with moderate sedation:
Please note that dental hygienists who wish to function as sedation assistants or recovery supervisors for deep sedation and/or general anesthesia must have DAANCE or OMAAP.
No, LDAs 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. BCCOHP recognizes the following programs and certificates for LDAs who successfully complete them to assist with moderate sedation:
Please note that LDAs who wish to function as sedation assistants or recovery supervisors for deep sedation and/or general anesthesia must have DAANCE or OMAAP.
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.
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