Moderate Parenteral & Enteral Sedation

Education Requirements | Permits | Satellite Office | Site Evaluation

Moderate Sedation: 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 usually maintained. 

Educational Requirements 

A dentist who wishes to administer moderate parenteral or enteral sedation in the dental office should be familiar with the ADA Guidelines for the Use of Sedation and General Anesthesia by Dentists and the requirements of the NDBDE. A dentist must complete and submit the permit application and fee. The application is reviewed and approved by the Anesthesia Committee. A site evaluation is required within 90 days of submitting the application. An evaluation fee is payable directly to the site evaluator. The Anesthesia Committee will notify the permit applicant once the completed site evaluation form has been reviewed by the Board. If you have questions after you have reviewed the permit application and/or site evaluation forms, please contact the Board.

Administration of moderate sedation by another qualified dentist or independently practicing qualified anesthesia healthcare provider requires the operating dentist and his/her clinical staff to maintain current certification in Basic Life Support for Healthcare Providers.

Moderate Enteral Sedation Education Requirements 

  • Current certification in Advanced Cardiac Life Support.
  • Current certification in Basic Life Support.  
  • A comprehensive training program with a minimum of 24 hours in moderate enteral sedation that satisfies the requirements as prescribed in the ADA Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students and ADA Guidelines for the Use of Sedation and General Anesthesia by Dentists. The NDBDE requires 20 managed adult clinically-oriented patient experiences by the enteral and/or enteral-nitrous oxide/oxygen route. The cases must include 10 live patient clinical dental experiences.  The course should be directed by a dentist or physician qualified by experience and training. This individual should have had at least three years of experience, including formal post doctoral training in anxiety and pain control.  The application must include documentation of the cases. 

Moderate Parenteral Sedation Education Requirements 

  • Current certification in Advanced Cardiac Life Support.
  • Current certification in Basic Life Support.  
  • A comprehensive training program with a minimum of 60 hours in moderate parenteral sedation that satisfies the requirements as prescribed in the ADA Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students and ADA Guidelines for the Use of Sedation and General Anesthesia by Dentists. The NDBDE requires management of 20 adult live patient clinical case experiences by the intravenous route. Additional supervised clinical experience is required to manage children and medically compromised adults. The course should be directed by a dentist or physician qualified by experience and training. This individual should have had at least three years of experience, including formal postdoctoral training in anxiety and pain control. Applicants must provide documentation of cases. 

Renewal of Permit 

  • Both the sedation permit and the inspection are subject to expiration and renewal.
  • The sedation/anesthesia permit must be renewed biennially, concurrent with the dentist’s license renewal. 
  • Four hours of the 32 hour CE requirement for renewal of license must pertain to sedation. 

Non-renewal of Permit

  • Late renewals result in the permit expiring.
  • Once a permit has expired, sedation privileges are suspended until a reinstatement is completed and formally approved by the Board’s Anesthesia Committee. It is unlawful to provide sedation without the appropriate permit. A late fee is incurred when the permit renewal is postmarked after the December 31st deadline of odd numbered years.

Satellite Office

  • All offices where sedation services are provided must comply with the minimum standards established by the Board. Anesthesia or sedation permit holders providing services at satellite clinics are responsible for ensuring that each office location has been evaluated.

Site Evaluations

  • The purpose of the evaluation is to assess the patient’s anesthetic risk and assess a sites ability to provide emergency care; therefore, the site evaluation emphasizes recognition and management of emergencies and complications associated with office administration of sedation.
  • It is the applicants responsibility to schedule and complete the initial site evaluation within 60 days of submitting the permit application. It is the applicants responsibility to schedule office re-evaluations with the Board's designated evaluator. Pursuant to N.D.A.C. 20-02-01-05(4), all site re-evaluations are conducted within five years of anniversary of the previous site evaluation. 
  • It is the Anesthesia Committee’s prerogative to suspend privileges if the sedation permit holder’s site evaluation is overdue.

Moderate Sedation Permit - Initial Application

  Moderate Sedation - Site Evaluation