ADA Rules Guide Sedation

Guidelines from the American Dental Association (ADA) outline the training that dentists need to administer different levels of sedation. Dentists must also comply with the rules of the states where they practice.

You should feel free to ask about your dentist's training and experience with these generally very safe sedation methods. Ask your dentist if he or she follows the ADA guidelines, and whether he or she needs a state permit for the type of sedation/anesthesia being recommended for your treatment.³

The ADA guidelines explain each level of pain control:

• Analgesia (relief for minor pain) with medications such as aspirin, ibuprofen, and acetaminophen¹

• Local anesthesia using topical gels and injectable numbing drugs such as lidocaine¹

• Minimal sedation using standard doses of oral antianxiety medication, nitrous oxide, and the like¹

• Moderate sedation for patients with a higher degree of fear or for a more complex procedure. The dentist may use a higher dose of oral antianxiety medication or intravenous (IV) medication.¹ The dentist must have had 24 hours of classroom training, CPR certification, a course in managing emergencies, and experience with at least 10 patients to provide oral moderate sedation. ADA guidelines for IV moderate sedation require 60 hours of classroom training, CPR certification, a course in managing emergencies, and at least 20 supervised IV infusions of patients.²

• Deep sedation or general anesthesia for patients with the highest levels of anxiety or an inability to cooperate, or for extensive or complex procedures.¹ ADA guidelines require the dentist to complete an accredited oral surgery or dentist-anesthesiologist residency.²

¹ "Anesthesia." American Dental Association. http://www.ada.org/public/topics/anesthesia_faq.asp. Accessed 2009.

² "Guidelines for the Use of Sedation and General Anesthesia by Dentists: As adopted by the October 2007 ADA House of Delegates." The American Dental Association. http://www.ada.org/prof/resources/positions/statements/anesthesia_guidelines.pdf. Accessed 2009.

³ "Know Your Sedation Options to Receive the Best Treatment." Academy of General Dentistry. http://www.agd.org/support/articles/?ArtID=2989. Accessed 2009.