Use Of Pediatric Minimal Sedation - Dentistry - Business & Professions - CA

Section § 1647.30

This section defines key terms related to sedation in a medical setting. 'Minimal sedation' refers to a state induced by medication where a patient can still respond normally to verbal cues, though their cognitive abilities and coordination might be slightly impaired. The condition should not affect breathing, heart function, or airway reflexes. The sedation techniques must ensure that patients don't unintentionally lose consciousness, and specific attention is needed for those who can't respond verbally, like young or developmentally delayed individuals. 'Good standing' for a license or permit means it's active without restrictions from disciplinary actions, unresolved complaints, or reviews.

As used in this article, the following definitions apply:

(a) “Minimal sedation” means a drug-induced state during which patients respond normally to verbal commands, and conforms to all of the following:

(1) Although cognitive function and coordination may be impaired, airway reflexes, ventilatory, and cardiovascular functions are unaffected.

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

(3) Patients who require tactile stimulation to elicit a response to verbal commands shall not be considered to be in a state of minimal sedation.

(4) For the very young or developmentally delayed individual, incapable of the usually expected verbal response, a minimally depressed level of consciousness should be maintained.

(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.

minimal sedation drug-induced state verbal commands response

Section § 1647.31

This law allows dentists to use or arrange pediatric minimal sedation for kids under 13 during dental procedures if they have the right licenses and permits. The dentist must be at the location during sedation. They also need the right training and equipment to handle any unexpected situations where the child goes into a deeper sedation. This law doesn't cover local anesthesia or more intense types of sedation.

(a) A dentist may administer or order the administration of pediatric minimal sedation on an outpatient basis for pediatric dental patients under 13 years of age, if the dentist possesses an active dentist license or permit under Section 1630 or 1640 issued by the board and an active general anesthesia permit, moderate sedation permit with a pediatric endorsement, or a pediatric minimal sedation permit.

(b) A dentist who administers or orders the administration of pediatric minimal sedation shall be physically present in the treatment facility while the patient is sedated.

(c) A dentist with a pediatric minimal sedation permit shall possess the training, equipment, and supplies to rescue a patient from an unintended deeper level of sedation.

(d) This article does not apply to the administration of local anesthesia, moderate sedation, deep sedation, or general anesthesia.

pediatric minimal sedation dentist requirements kids under 13

Section § 1647.32

In California, dentists who want to give minimal sedation to kids must apply for a permit and prove they’ve completed specific training. They need to show they have the right equipment and drugs at their office. The training involves at least 24 hours of learning or completing a recognized residency in pediatric dentistry. Dentists can only use one sedative drug orally, along with a nitrous oxide and oxygen mix, to prevent deeper sedation than intended. Also, a trained assistant must be there to help monitor and respond to the child’s needs.

(a) A dentist who desires to administer or order the administration of pediatric minimal sedation shall apply to the board on an application form prescribed by the board. The dentist shall possess a dentist license or permit under Section 1638 or 1640 in good standing, submit an application fee, and produce evidence showing that the dentist has successfully completed training in pediatric minimal sedation that meets the requirements of subdivision (c).

(b) The application for a permit shall include documentation that equipment and drugs required by the board are on the premises.

(c) Training in the administration of pediatric minimal sedation shall be acceptable if it meets either of the following as approved by the board:

(1) Consists of at least 24 hours of pediatric minimal sedation instruction in addition to one clinical case. The pediatric minimal sedation instruction shall include training in pediatric monitoring, airway management, and resuscitation and patient rescue from moderate sedation.

(2) Completion of a residency accredited by the Commission on Dental Accreditation (CODA) in pediatric dentistry.

(d) A dentist shall be limited to administering a single drug whose primary purpose is sedative via the oral route, either singly or in divided doses, not to exceed the manufacturer’s maximum recommended dose, plus a mix of nitrous oxide and oxygen and adjunctive agents such that the drugs either singly or in combination are unlikely to produce a state of unintended moderate sedation. This section shall not be construed to restrict the administration of adjunctive medication intended to relieve pain, affect the onset or duration of the primary sedative agent, or to reduce the side effects of sedation, including nausea or emesis.

(e) The operating dentist and a minimum of one additional personnel who are both trained in the monitoring and resuscitation of pediatric patients, as approved by the board, shall be present during the administration of minimal sedation.

pediatric minimal sedation dentist permit sedation training

Section § 1647.33

This law states that the fee for applying or renewing a permit for pediatric minimal sedation can’t be more than what's stated in another section. It also mentions that the legislature wants the board to have enough staff to run the program effectively, and the fees collected should cover the board's costs for managing and enforcing this program.

(a) The application fee for a pediatric minimal sedation permit or renewal under this article shall not exceed the amount prescribed in Section 1724.

(b) It is the intent of the Legislature that the board hire sufficient staff to administer the program and that the fees established pursuant to this section be equivalent to administration and enforcement costs incurred by the board in carrying out this article.

pediatric minimal sedation permit application fee permit renewal fee

Section § 1647.34

If a dentist breaks any rules in this article, it counts as bad conduct and can lead to losing or having their permit or license suspended. The process for this follows specific government rules, and the dental board has all the authority given in those rules.

A violation of any provision of this article constitutes unprofessional conduct and is grounds for the revocation or suspension of the dentist’s permit or license, or both. The proceedings under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein.

dentist misconduct license suspension permit revocation

Section § 1647.35

If you have a permit to use minimal sedation on children, you need to complete at least seven hours of special courses about this topic every time you renew your permit. These courses count towards your overall continuing education requirements set by the board.

A pediatric minimal sedation permitholder shall be required to complete a minimum of seven hours of approved courses of study related to pediatric minimal sedation as a condition of renewal of the permit. Those courses of study shall be credited toward the total continuing education required by the board pursuant to Section 1645.

pediatric minimal sedation permit renewal continuing education

Section § 1647.36

Before giving minimal sedation to children, a health professional must first collect their medical history and perform a physical check-up. These details and information about the sedation process need to be recorded according to the board's rules.

(a) A physical evaluation and medical history shall be taken before the administration of pediatric minimal sedation.

(b) Records of the physical evaluation, medical history, and pediatric minimal sedation procedures used shall be maintained as required by board regulations.

pediatric minimal sedation physical evaluation medical history

Section § 1647.37

A permit for minimal sedation in pediatric patients will expire on a specific date set by another section, unless renewed according to the rules mentioned in this article.

A pediatric minimal sedation permit shall expire on the date specified in Section 1715 that next occurs after its issuance, unless it is renewed as provided in this article.

pediatric sedation minimal sedation permit permit expiration

Section § 1647.38

If you have a permit for oral conscious sedation for minor patients that was issued before January 1, 2022, you can keep using it until it runs out. But, starting from January 1, 2022, any new or renewed permits for pediatric minimal sedation must meet the current rules outlined in this new article.

An oral conscious sedation for minor patients permitholder who has a permit that was issued before January 1, 2022, that authorized the permitholder to administer or order the administration of oral conscious sedation for minor patients under prior Article 2.85 (commencing with Section 1647.10) may follow the terms of that existing permit until it expires. Any pediatric minimal sedation permit issued or renewed pursuant to this article on or after January 1, 2022, shall require the permitholder to follow the requirements of this article.

oral conscious sedation minor patients permit holder