Use Of Oral Conscious Sedation For Adult Patients - Dentistry - Business & Professions - CA

Section § 1647.18

This section defines key terms about dental practice related to oral conscious sedation. An 'adult patient' is defined as anyone 13 years or older. 'Good standing' refers to a dental professional's license or permit that is active, has no pending complaints, and is not under disciplinary action. 'Oral conscious sedation' is a technique using oral medication to mildly depress consciousness while keeping the patient responsive and able to maintain an airway. This level of sedation should not result in unconsciousness. Special considerations are applied for individuals who cannot respond verbally due to handicaps, ensuring they remain at a minimally depressed consciousness level.

As used in this article, the following terms have the following meanings:

(a) “Adult patient” means a dental patient 13 years of age or older.

(b) “Good standing” means the license or permit is active and unrestricted by disciplinary action taken pursuant to Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, is not the subject of an unresolved complaint or review procedure, and is not the subject of any unresolved disciplinary proceeding.

(c) “Oral conscious sedation” means a minimally depressed level of consciousness produced by oral medication that retains the patient’s ability to maintain independently and continuously an airway, and respond appropriately to physical stimulation or verbal command. “Oral conscious sedation” does not include dosages less than or equal to the single maximum recommended dose that can be prescribed for home use.

(1) The drugs and techniques used in oral conscious sedation shall have a margin of safety wide enough to render unintended loss of consciousness unlikely. Further, patients whose only response is reflex withdrawal from painful stimuli would not be considered to be in a state of oral conscious sedation.

(2) For the handicapped individual, incapable of the usually expected verbal response, a minimally depressed level of consciousness for that individual should be maintained.

oral conscious sedation adult patient good standing

Section § 1647.19

This law allows dentists to give or arrange oral conscious sedation to adult patients in outpatient settings, provided they have the necessary licenses and permits. It specifies that sedation certificates have expiration dates, which need renewal to remain valid. The rule doesn't cover local anesthesia, nitrous oxide with oxygen, or postoperative medication management.

(a) A dentist may administer or order the administration of oral conscious sedation on an outpatient basis to an adult patient if the dentist possesses an active dentist license or permit issued under Section 1638 or 1640 and an active general anesthesia permit, moderate sedation permit, or adult oral conscious sedation certificate pursuant to Section 1647.20.

(b) An adult oral conscious sedation certificate shall expire on the date specified in Section 1715 that next occurs after its issuance, unless it is renewed as provided in this article.

(c) This article shall not apply to the administration of local anesthesia or a mixture of nitrous oxide and oxygen, or to the administration, dispensing, or prescription of postoperative medications.

oral conscious sedation dentist permit outpatient sedation

Section § 1647.20

If a dentist wants to give oral conscious sedation to adult patients and doesn’t have certain permits for general or moderate anesthesia, they must meet specific requirements. They need to apply for a permit, pay a fee, and prove they've completed certain approved educational programs or residencies in dentistry. This could include a program in oral surgery, pediatric dentistry, periodontics, or a specific course on oral sedation.

A dentist who desires to administer, or order the administration of, oral conscious sedation for adult patients, who does not hold a general anesthesia permit, as provided in Sections 1646.1 and 1646.2, or a moderate sedation permit, as provided in Sections 1647.2 and 1647.3, shall possess a dentist license or a permit under Section 1638 or 1640 issued by the board that is in good standing, apply to the board on an application form prescribed by the board, and submit the certification fee and evidence showing that the dentist satisfies any of the following requirements:

(a) Satisfactory completion of a postgraduate program in oral and maxillofacial surgery approved by either the Commission on Dental Accreditation or a comparable organization approved by the board.

(b) Satisfactory completion of a pediatric dental, periodontics, or general practice residency or other advanced education in a general dentistry program approved by the board.

oral conscious sedation adult patients dentist permit

Section § 1647.21

If you hold a certificate to provide oral conscious sedation to adult patients, you must complete at least seven hours of specific training on this topic to renew your certification. These hours can also count towards your other continuing education requirements.

A certificate holder shall be required to complete a minimum of seven hours of approved courses of study related to oral conscious sedation of adult patients as a condition of certification renewal as an oral conscious sedation provider. Those courses of study shall be accredited toward any continuing education required by the board pursuant to Section 1645.

oral conscious sedation adult patients certification renewal

Section § 1647.22

Before a dentist can give oral conscious sedation to an adult, they need to do a medical check-up and take the patient's medical history. They must keep records of these. The dentist has to stay in the clinic while the patient is sedated and until the patient leaves. The drugs used should be safe enough to avoid accidental loss of consciousness.

(a) A physical evaluation and medical history shall be taken before the administration of oral conscious sedation to an adult. Records of the physical evaluation, medical history, and oral conscious sedation procedures used shall be maintained as required by the board regulations.

(b) A dentist who administers, or orders the administration of, oral conscious sedation for an adult patient shall be physically present in the treatment facility while the patient is sedated, and shall be present until discharge of the patient from the facility.

(c) The drugs and techniques used in oral conscious sedation to adults shall have a margin of safety wide enough to render unintended loss of consciousness unlikely.

oral conscious sedation medical history physical evaluation

Section § 1647.23

This law states that the fee charged for getting or renewing a certification must only be enough to cover the costs of managing and enforcing these certifications. If a dentist’s license or permit renewal date changes, the fee may be adjusted accordingly, or prorated.

The fee for an application for initial certification or renewal under this article shall not exceed the amount necessary to cover administration and enforcement costs incurred by the board in carrying out this article. The listed fee may be prorated based upon the date of the renewal of the dentist’s license or permit.

fee for certification renewal fee administration costs

Section § 1647.24

If a dental office performs oral conscious sedation for adults, it must comply with specific equipment and facility standards established by the board, unless another law says otherwise.

Any office in which oral conscious sedation of adult patients is conducted pursuant to this article shall, unless otherwise provided by law, meet the facilities and equipment standards set forth by the board in regulation.

oral conscious sedation adult patients dental office requirements

Section § 1647.25

If a dentist breaks any rule in this article, it's considered bad behavior and could lead to their professional permit, certificate, or license being taken away or temporarily suspended. They might also get a warning or be put on probation. The process to decide these consequences follows specific rules found elsewhere in the Government Code, giving the board authority to act.

A violation of any provision of this article constitutes unprofessional conduct and is grounds for the revocation or suspension of the dentist’s permit, certificate, license, or all three, or the dentist may be reprimanded or placed on probation. The proceedings under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part I of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein.

dentist misconduct permit revocation license suspension

Section § 1647.26

This law allocates $47,000 from the State Dentistry Fund for the Department of Consumer Affairs to handle applications for adult conscious sedation certificates during the 2005–06 fiscal year.

The sum of forty-seven thousand dollars ($47,000) is hereby appropriated for the 2005–06 fiscal year from the State Dentistry Fund to the Department of Consumer Affairs for the purpose of processing applications for adult conscious sedation certificates pursuant to this article.

State Dentistry Fund Department of Consumer Affairs adult conscious sedation