Sedation and Anesthesia

 All submissions to the Facility Inspection Program (FIP) department must be sent via email, to sedation@rcdso.org, for processing. We do not accept applications or submissions by mail or facsimile. Cheques and money orders are accepted by mail.

Items emailed to FIP must be:

  • PDF format

Clear (not faded) and legible

  • Complete (with no pertinent information cut off)
  • Unaltered

Sedation and anesthesia related items should be emailed to sedation@rcdso.org.

If you no longer require your Member Authorization or Facility Permit and wish to cancel it, you can submit a cancellation request by email to sedation@rcdso.org or through the RCDSO Member Resource Centre. Cancellation requests cannot be processed over the phone..

RCDSO Sedation and Anesthesia Standard

The RCDSO is committed to continuous improvement in every area of clinical practice. The Standard of Practice on the Use of Sedation and General Anesthesia in Dental Practice sets enhanced requirements and standards. Recent advancements in training, technology, and knowledge are represented in this version of the Standard.

Applying for a Facility Permit

Every dental facility/office intending to provide sedation above the minimal level must have a facility permit from the College and must adhere to the Standard of Practice on the Use of Sedation and General Anesthesia in Dental Practice. The College inspects facilities to ensure compliance with the Standard. There are two types of facility permits: Type A and Type B. It is possible to hold both types.

Dentists can access a list of approved dentists or physicians by logging in to their RCDSO Portal account.

All permits expire on March 31st of each calendar year, regardless of when in the year they were initially issued.

Facility permits are non-transferable. If the ownership of the practice changes or the practice moves, the facility permit will be cancelled effective on the date of sale. The sale of a practice that holds a facility permit should be reported to FIP to ensure the former owners do not receive correspondence regarding renewals or re-inspections.

The processing times for facility permit applications vary depending on the number of applications received by the College around that time. Dentists and physicians should not book any procedures that require the administration of sedation until they receive the required facility permit.

Frequently Asked Questions

I’m moving/selling/buying a practice with a Facility Permit, can I transfer the Facility Permit to the new location/owner?

Facility Permits are non-transferrable if there is a complete change in practice ownership. If the sale involves a partial change in practice ownership (i.e. the original Facility Permit Holder is remaining as a co-owner of the facility), we may be able to update the permit without a new application or inspection. Please submit information regarding the change in ownership structure to the Facility Inspection Program at sedation@rcdso.org.

How do I expedite my application?

Applications are processed in the order received. Processing times may vary depending on the volume of applications in process and the number of facilities with deficiencies.

The best way to ensure your permit application is processed in a timely manner is to verify your application is complete prior to submission and ensure you are prepared for the initial inspection.

If you application relates to a full practice sale or change of location you can submit the new facility permit application in advance and clearly indicate the date the sale/relocation will be completed. We will try to schedule an inspection soon after the date of sale/relocation. However, we cannot guarantee there will be no disruption of services at the facility so we strongly advise against pre-booking patients who require sedation.

Can you email all of the dentists/physicians at my practice about file updates?

We only communicate with the Facility Permit Holder as they are the responsible individual..

Applying for Authorization to Administer

Dentists and physicians are not permitted to administer any level of sedation in a dental office unless they have the required authorization issued by the College. The processing times for authorization applications varies depending on the number of applications received by the College. Dentists and physicians should not pre-book any procedures that require the administration of sedation.

Dentists

For information on applying for authorization to administer minimal sedation, visit the Minimal Sedation page.

To apply for authorization to administer sedation above the minimal level, apply to the College using this form. Dentists applying to administer sedation above the minimal level must select either Member authorization (i.e. non-visiting) or Visiting Member authorization. . The authorization must be compatible with the permit type of the facility.

  • Member authorizations are for dentists who will be using sedation equipment and emergency drugs that are kept onsite. This corresponds to a type A facility permit.
  • Visiting Member authorizations are for dentists who bring all the necessary sedation equipment and emergency drugs approved by the College to a facility. This corresponds to a type B facility permit. Dentists with a visiting member authorization can also administer sedation in a type A facility, but are restricted to the level of sedation of the type A facility permit and they can only use the facility’s sedation equipment and emergency drugs maintained on-site.

Physicians

A physician who wishes to administer sedation above the minimal level in a dental office must apply to the College for authorization using the following form: Application for a physician to administer sedation and general anesthesia in a dental office.

Physicians can apply for two types of privileges.

  • Physician authorizations are for physicians who will be using the sedation equipment and emergency drugs on site. This corresponds to a type A facility permit.
  • Visiting physician authorizations are for physicians who bring all the necessary sedation equipment and emergency drugs approved by the College to a facility. This corresponds to a type B facility permit. Visiting physicians can also administer sedation in a type A facility, but are restricted to the level of sedation outlined on the type A facility permit and they can only use the facility’s sedation equipment and emergency drugs maintained on-site.

Provisional Authorization

If a dentist’s application to administer oral moderate sedation or parenteral conscious sedation or deep sedation and/or general anesthesia is approved, the dentist will be issued a three-month provisional member authorization. During this time, the dentist will be required to submit five sedation records for review to the College. Instructions on how to submit sedation records will be provided when the provisional member authorization is issued.

If the sedation records submitted to the College are complete and in compliance with the Standard of Practice, an annual authorization will be issued to the dentist. If the cases are not in compliance with the Standard the College, a one-time 3-month extension may be requested. During this time, the dentists must submit additional cases for review. If the dentist is unable to submit cases in compliance with the Standard by the expiry of the extended provisional authorization, then the dentist will not be issued an annual authorization. However, they will have the option to re-apply in the future.

Reporting a Tier 1 /Tier 2 Event

Tier 1 Events

Serious adverse events must be reported to the RCDSO in writing within 24 hours of knowledge of the event.

  • Death of a patient within the facility.
  • Death of a patient within 10 days of a procedure performed at the facility.
  • Transfer of a patient from the facility directly to a hospital for care.

Tier 2 Events

Other incidents must be reported to the RCDSO in writing within 10 days of knowledge of the event.

  • Unscheduled treatment of a patient in a hospital within 10 days of a procedure performed with sedation or general anesthesia.
  • Any use of a benzodiazepine or opioid antagonist.
  • Any serious cardiac or respiratory adverse event requiring administration of a medication for its management.

CE, Life Support Training and Minimum case requirements related to the Standard  

The Standard sets out the life support training that must be maintained at all times, the minimum number of continuing education (CE) points related to sedation and anesthesia that must be completed in a 3-year period, and the annual minimum cases that an authorized dentist must complete in a year.

 
Patient Population
Current *
Basic*/Advanced*  Life Support Training Required
CE Requirements*
Minimum #of Cases Required Per Year
Minimal Sedation - N2O Only

Pediatric Patients

Adult Patients

BLS

None 

5 cases
(if patients are under 12 years old, all cases should be pediatric) 

Minimal Sedation - Oral Sedation Only

If Pediatric Patients – MUST authorize and train for Oral Moderate Sedation

Adult Patients

BLS

None 

5 cases
(if patients are under 12 years old, all cases should be pediatric) 

Oral Moderate Conscious Sedation

Pediatric Patients
(>3 years OR >15 kg)

Adult Patients

PALS
BLS

6 CE points over a 3 year period

5 cases
(if patients are under 12 years old, all cases should be pediatric)  

Parenteral Moderate Conscious Sedation


Adult Patients Only

BLS
ACLS

12 CE points over a 3 year period

10 adult cases

Deep and/or General Anesthesia

Pediatric Patients

BLS
PALS
ACLS

12 CE points over a 3 year period

10 cases
(if patients are under 12 years old, all cases should be pediatric) 




Adult Patients


BLS
ACLS

 

12 CE points over a 3 year period

Current*

  • For the purposes of fulfilling this requirement, “current” is defined as within two years.

Basic Life Support (BLS) Training*

  • CPR at the Level of Health Care Practitioner or its equivalent with training that includes a hands on component.

Advance Life Support Training*

Adult Patients

  • Advanced Cardiac Life Support (PALS) with training that includes a hands on component

Pediatric Patients

  • Pediatric Advanced Life Support (PALS) with training that includes a hands on component OR
  • Pediatric Emergency Assessment Recognition (PEARS) with training that includes a hands on component

Continuing Education*

  • This 3-year period for sedation and anesthesia related CE will match your general CE cycle.
  • CE points for sedation and anesthesia can be acquired in any category.
  • Log your CE points for sedation and anesthesia in your e-Portfolio in the appropriate category.
  • For the purposes of fulfilling this requirement, courses in the management of medical emergencies are accepted. Courses to acquire or maintain life-support certification (BLS, ACLS, PALS and PEARS) are NOT accepted.
  • By December 14, 2022, all CE cycles will require the sedation CE points as set out by the Standard.
  • As with all other CE activities, you must keep your original CE documents. These documents must be retained for five years from the end of each three-year CE cycle and submitted to the College on request.

Minimum Number of Cases Required

  • For the purposes of fulfilling this requirement, the calendar year during which the minimum number of cases is completed is the year of your authorization approval i.e. March 31, 2019 – August 31, 2020.

Questions?

Email: sedation@rcdso.org
Phone: 416-934-4331