Revised Sedation and Anesthesia Guidelines Adopted by ADA

At their annual meeting on October 24, the American Dental Association (ADA) House of Delegates voted to make changes to the existing guidelines concerning the use of sedation and anesthesia by dentists. This vote comes amid much controversy and opposition from dental professionals, who expressed concern that revision of the guidelines would double the amount of training that is currently required and limit their ability to administer appropriate treatment options to patients.

The newly adopted revisions include changes to end-tidal CO2 monitoring during moderate to deep sedation and general anesthesia, unless the patient’s condition, the procedure taking place, or the equipment used during the procedure prevents this supervision from occurring. Additionally, the revisions include changes to the duration of educational courses focused on anesthesia and sedation, and other competency standards regarding moderate sedation educational requirements.

Dental professionals have voiced concerns that revisions to the existing guidelines would reduce the number of dentists qualified to administer sedation or anesthesia to patients, thereby making it more difficult for patients to access safe, affordable sedation treatments. Some dentists argue that these revisions will drive up the cost of sedation dentistry substantially, which will drive patients away from dental practices.

Also, before the vote, many dentists worried that guideline revisions would increase the financial burden to dentists and dental students in addition to patients, citing research that estimated a doubling of the required training compared to current educational standards. The additional training was projected to cost as much as $50,000 extra per dentist.

The revised guidelines are extensions of recommendations made in 2015, which were not voted on due to concerns over the proposed changes. In addition to the guidance regarding end-tidal CO2 monitoring and changes to educational course requirements, the suggestions in 2015 included a proposal to make the patient evaluation provisions consistent throughout the patient record, including information related to body mass index and the timing of a medical history review.

The ADA publishes its guidelines to assist dentists in the safe and effective delivery of patient care. State dental boards may use the guidelines when developing their own rules and regulations of the use of sedation and anesthesia in dental practice. First adopted in 1971, the last time the guidelines were revised was in 2012. Read more about the adopted revisions here, and download the 2016 sedation and anesthesia guidelines here.