Royal College of
Dental Surgeons of Ontario
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RCDSO Sedation and Anesthesia Standard: What’s New?

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

November 15, 2018 – Standard is approved by the College

Changes effective immediately

  • Minimal sedation is now defined as the use of nitrous oxide and oxygen sedation or oral minimal sedation.
  • The administration of any combination of an oral sedative with nitrous oxide and oxygen, regardless of dosing, now requires that the care provided meet all requirements for oral moderate sedation, including applying for authorization and a facility permit.
  • The administration of oral sedatives to children under 12, regardless of dosing, now requires that the care provided meet all requirements for oral moderate sedation, including applying for authorization and a facility permit.
  • The Standard has new requirements for all IV and deep/GA providers, including:
    • Training for providers and team members
    • Dosing restrictions
    • Drugs and equipment
    • Recovery/monitoring
  • Parenteral moderate sedation for children under 12 is only permitted by those with additional training as outlined in the Standard.
  • Tier 1 and Tier 2 events are reportable effective November 15, 2018.

Changes effective April 1, 2019

  • All dentists using a combination of an oral sedative with nitrous oxide and oxygen, regardless of dosing, must have applied for and received authorization to administer oral moderate sedation, even if the dosing is minimal, as outlined in the Standard.
  • All dentists, including pediatric dentists, must have applied for and received authorization to administer oral moderate sedation to children under 12, even if the dosing is minimal, as outlined in the Standard

Changes effective July 1, 2019

  • All dentists using a combination of an oral sedative with nitrous oxide and oxygen, regardless of dosing, must have applied for and received a facility permit to administer oral moderate sedation, even if the dosing is minimal.
  • All dentists, including pediatric dentists, must have applied for and received a facility permit to administer oral moderate sedation to children under 12, even if the dosing is minimal.
  • Additional training requirements for members and team members, including ACLS, PALS, and PEARS, must be met.

April 1, 2020 – Authorization required for minimal sedation providers

  • All dentists providing minimal sedation must be authorized by the College.
  • Dentists currently providing minimal sedation will be issued authorization based on history of use.
  • All offices providing minimal sedation will be subject to inspections.
If you have questions about the implementation of the Standard, contact the College.