Moderate Conscious Sedation Permit Number 160460

When it comes to sedation dentistry, there are actually a variety of methods that can be used to achieve sedation.  Understanding the differences, the associated risks, and the qualification requirements that the North Carolina State Board of Dental Examiners now places on those practicing sedation dentistry – all these should help you to make a more informed choice about the sedation dentistry options available to you.

Recently, the North Carolina State Board of Dental Examiners has implemented new policies with respect to sedation dentistry, in an effort to ensure patient safety. Effective in July 2009, new permits, backed by validation of recent experience and training by the board, will be required for general dentists who practice sedation dentistry. With growing demand for sedation dentistry – because both dentists and patients realize it makes good sense in so many cases – the Board has wisely taken appropriate action.

Special permits are required for the type of sedation dentistry that lets you have more invasive or lengthy procedures performed while comfortably sedated. Some patients also need this level of sedation to be comfortable with lesser procedures. This accreditation is referred to as limited moderate conscious sedation dentistry, or oral conscious sedation dentistry.

•     This is the level of sedation dentistry accreditation held by Dr. Williamson.
•     Only six dentists in Raleigh, and 96 of the general dentists in North Carolina, have been accredited to perform this level of sedation dentistry (June 2009)
•     This form of sedation dentistry permits the administration of multiple doses of sedatives, either alone or in conjunction with inhaled sedation techniques (e.g., nitrous oxide).
•     The new accreditation helps to ensure your safety because it confirms that your dentist is qualified to practice the level of sedation dentistry most appropriate for some comprehensive dentistry services and for some patients’ degree of dental phobia.
•     This type of sedation dentistry can be used in conjunction with “traditional” non-sedating anesthetics that create numbness, as appropriate for a specific procedure or patient need.
•     Your dentist must have many hours of specialized training and experience in this technique before he or she can be certified to practice sedation dentistry.
•     In addition, dental staff members also receive special sedation dentistry training that helps them know what to do in the rare event of emergency.
•     There is less risk with this limited, certified form of sedation dentistry because you remain conscious and able to respond to commands, even though you’re unaware of what is happening or how much time has elapsed. Other levels of sedation dentistry require the use of a back-up ventilators and artificial airways because of an increased risk of needing to be resuscitated.

Without a special sedation dentistry accreditation by the Board, a dentist in North Carolina can only administer a single dose of an oral sedative, possibly in combination with nitrous oxide, to patients prior to beginning a treatment.

• This single-dose practice does not fall under the new guidelines developed for sedation dentistry in North Carolina, and effective July 2009.
• This practice may be sufficient to manage the anxiety that some patients experience about minor, fairly routine procedures (cleaning, fillings).
• While not actually a form of sedation dentistry per se, this method can also be used in conjunction with “traditional” non-sedating anesthetics.
• For Dr. Williamson’s practice of sedation dentistry, he will advise and administer either this level or the higher, accredited level of sedation, depending on what best fits the patient’s needs as well as the specific procedure(s) being performed.

Beyond limited moderate conscious sedation dentistry, there is an additional level of conscious sedation dentistry permit that involves the administration of sedation intravenously (with an IV needle). IV administration carries additional risk and requires more resuscitation equipment and personnel training because of that higher risk. Oral surgeons, for example, may offer this added level of sedation dentistry, even though more limited means of sedation (i.e., oral conscious sedation dentistry) make most patients completely comfortable for procedures such as wisdom teeth extractions. The North Carolina Dental Board refers to the level of sedation dentistry involving the use of IVs as moderate conscious sedation dentistry, because it is not “limited” to oral administration of sedation.

Additionally, there is a general anesthesia option, which renders the patient unconscious and is typically performed in a hospital setting. It is performed in that setting because of the expensive equipment needed to provide an artificial airway by insertion of a tube, so that artificial resuscitation can be instantly administered in the event of an overdose.