State Oral Conscious Sedation Guidelines

Oral conscious sedation regulations vary by state, with requirements set by individual state dental boards. Most states follow guidelines provided by the American Dental Association (ADA), which outline training, monitoring, and safety protocols for sedation dentistry. Below is a breakdown of state-specific sedation permit requirements.

Table of Contents

• General Guidelines for Oral Conscious Sedation
• State-Specific Sedation Regulations
  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
• Frequently Asked Questions

General Guidelines for Oral Conscious Sedation

Although each state sets its own specific sedation permit requirements, most states follow the American Dental Association (ADA) Guidelines for the Use of Sedation and General Anesthesia by Dentists. Key components of these guidelines include:

• Dentists must complete an approved sedation training program, often requiring clinical hands-on experience.
• Most states require a moderate sedation permit in addition to a general dental license.
• Emergency preparedness is essential, including Advanced Cardiac Life Support (ACLS) certification.
• Continuous monitoring of heart rate, blood pressure, oxygen saturation, and consciousness levels is required during sedation.
• Thorough medical history review and risk assessment are mandatory before administering sedation.

State-Specific Sedation Regulations

Alabama

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of didactic instruction, management of 20 patients
• Certification: ACLS required (PALS for pediatric patients)
• Facility Requirements: Emergency equipment, drugs, and protocols
• Monitoring: Continuous clinical observation and pulse oximetry
• Additional: Facility inspection, 12 hours CE every 2 years

Alaska

• Permit Type: Moderate Sedation Permit
• Education: 60 hours didactic and clinical, 20 patient experiences
• Certification: ACLS (PALS if treating patients under 13)
• Facility Requirements: Specific equipment and emergency drugs
• Monitoring: Continuous clinical and mechanical monitoring
• Additional: 4 hours CE annually, staff must be BLS certified

Arizona

• Permit Type: 1301 Permit (Conscious Sedation)
• Education: 60 hours training, 20 patient experiences
• Certification: ACLS
• Facility Requirements: Emergency equipment and drugs
• Monitoring: Continuous monitoring of vital signs
• Additional: On-site evaluation, 6 hours CE annually

Arkansas

• Permit Type: Moderate Conscious Sedation Permit
• Education: 60 hours training, 20 clinical cases
• Certification: ACLS and PALS
• Facility Requirements: Emergency equipment and drugs
• Monitoring: Continuous monitoring of vital signs
• Additional: Facility inspection, 6 hours CE biennially

California

• Permit Type: Conscious Sedation Permit
• Education: 60 hours of instruction, 20 patient cases
• Certification: ACLS
• Facility Requirements: Emergency equipment and drugs
• Monitoring: Continuous monitoring of vital signs
• Additional: On-site inspection, 15 hours CE every 2 years

Colorado

• Permit Type: Moderate Sedation Privileges
• Education: 60 hours of Board-approved coursework
• Certification: ACLS or PALS
• Facility Requirements: Emergency equipment, monitoring devices
• Monitoring: Continuous monitoring of vital signs
• Additional: Clinical on-site inspection, 5 hours CE annually

Connecticut

• Permit Type: Conscious Sedation Permit
• Education: 60 hours didactic, 20 patient cases
• Certification: ACLS
• Facility Requirements: Emergency equipment and drugs
• Monitoring: Continuous monitoring of vital signs
• Additional: On-site evaluation, 4 hours CE annually

Delaware

• Permit Type: Restricted Permit I (Conscious Sedation)
• Education: 60 hours training, 20 patient cases
• Certification: ACLS
• Facility Requirements: Emergency equipment and drugs
• Monitoring: Continuous monitoring of vital signs
• Additional: Office inspection, 12 hours CE every 2 years

Florida

• Permit Type: Moderate Sedation Permit
• Education: 60 hours training, 20 patient cases
• Certification: ACLS (PALS for pediatric patients)
• Facility Requirements: Emergency equipment and drugs
• Monitoring: Continuous monitoring of vital signs
• Additional: Facility inspection, 4 hours CE biennially

Georgia

• Permit Type: Conscious Sedation Permit
• Education: 60 hours training, 20 patient experiences
• Certification: ACLS (PALS for pediatric patients)
• Facility Requirements: Emergency equipment and drugs
• Monitoring: Continuous monitoring of vital signs
• Additional: On-site evaluation, 4 hours CE biennially

Hawaii

• Permit Type: Moderate Sedation Permit
• Education: 60 hours instruction, 20 patient cases
• Certification: ACLS or PALS
• Facility Requirements: Properly equipped facility
• Monitoring: Continuous monitoring of vital signs
• Additional: Facility inspection, CE requirements

Idaho

• Permit Type: Moderate Sedation Permit
• Education: Board-approved training within 5 years
• Certification: ACLS or PALS
• Facility Requirements: Specific emergency equipment
• Monitoring: Continuous monitoring of vital signs
• Additional: 25 CE hours in sedation every 5 years

Illinois

• Permit Type: Moderate Sedation Permit
• Education: 60 hours training, 20 patient cases
• Certification: ACLS (PALS for pediatric patients)
• Facility Requirements: Emergency equipment and drugs
• Monitoring: Continuous monitoring of vital signs
• Additional: On-site evaluation, 12 hours CE every 3 years

Indiana

• Permit Type: Light Parenteral Conscious Sedation Permit
• Education: 60 hours didactic, 20 patient experiences
• Certification: ACLS
• Facility Requirements: Specific emergency equipment
• Monitoring: Continuous monitoring of vital signs
• Additional: On-site evaluation, 5 hours CE biennially

Iowa

• Permit Type: Moderate Sedation Permit
• Education: 60 hours instruction, 20 patient cases
• Certification: ACLS or PALS
• Facility Requirements: Specific emergency equipment
• Monitoring: Continuous monitoring of vital signs
• Additional: Facility inspection, 6 hours CE biennially

Kansas

• Permit Type: Level I Permit (Enteral/Combination Inhalation-Enteral)
• Education: Board-approved course
• Certification: ACLS or PALS
• Facility Requirements: Emergency equipment and drugs
• Monitoring: Continuous monitoring of vital signs
• Additional: 6 hours CE biennially

Kentucky

• Permit Type: Moderate Sedation Permit
• Education: Comprehensive training program (CODA-approved or ADA Guidelines)
• Certification: BLS and ACLS (PALS for pediatric patients)
• Facility Requirements: Sedation Facility Certificate required
• Monitoring: Continuous monitoring of vital signs
• Additional: Facility self-attestation, CE requirements

Louisiana

• Permit Type: Moderate Sedation Permit
• Education: 60 hours didactic training, management of at least 20 patients
• Certification: ACLS required
• Facility Requirements: Emergency equipment and drugs
• Monitoring: Continuous monitoring of vital signs
• Additional: Facility inspection, 12 hours CE every 2 years

Maine

• Permit Type: Moderate Sedation Permit
• Education: 60-hour training program, 20 supervised cases
• Certification: ACLS
• Facility Requirements: On-site evaluation and emergency protocols
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 5 years with 40 hours of CE

Maryland

• Permit Type: Class II Moderate Sedation Permit
• Education: 60 hours didactic and clinical training
• Certification: ACLS
• Facility Requirements: Emergency equipment and facility inspection
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 2 years with 16 hours of CE

Massachusetts

• Permit Type: Facility and Individual Moderate Sedation Permit
• Education: 60 hours of didactic and clinical training
• Certification: ACLS
• Facility Requirements: On-site inspection required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 2 years with CE requirement

Michigan

• Permit Type: Moderate Intravenous Conscious Sedation Permit
• Education: 60 hours of training, including 40 hours of supervised clinical instruction
• Certification: ACLS
• Facility Requirements: Emergency equipment and monitoring systems
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal annually

Minnesota

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of didactic and clinical training
• Certification: ACLS
• Facility Requirements: Emergency equipment and monitoring systems
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 2 years with CE requirement

Mississippi

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and 20 supervised cases
• Certification: ACLS
• Facility Requirements: Must meet emergency equipment standards
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal annually with 4 hours of CE

Missouri

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and 20 supervised cases
• Certification: ACLS
• Facility Requirements: On-site evaluation required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 5 years with 25 hours of CE

Montana

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and 20 supervised cases
• Certification: ACLS
• Facility Requirements: Emergency equipment and monitoring systems
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 3 years with CE requirement

Nebraska

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and 20 supervised cases
• Certification: ACLS
• Facility Requirements: On-site evaluation required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal annually with 6 hours of CE

Nevada

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and management of 20 cases
• Certification: ACLS
• Facility Requirements: Site inspection required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal annually with 6 hours of CE

New Hampshire

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and 20 supervised cases
• Certification: ACLS
• Facility Requirements: Facility must meet emergency preparedness standards
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 2 years with CE requirement

New Jersey

• Permit Type: Parenteral Conscious Sedation Permit
• Education: Minimum 40 hours didactic and 40 hours clinical training
• Certification: ACLS
• Facility Requirements: Inspection every 5 years
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 2 years with 20 hours of CE

New Mexico

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and management of 20 patients
• Certification: ACLS
• Facility Requirements: Facility inspection may be required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit valid for 6 years, renewal requires CE

New York

• Permit Type: Conscious Sedation Certificate
• Education: 60 hours of didactic instruction and clinical training
• Certification: ACLS
• Facility Requirements: On-site evaluation required
• Monitoring: Continuous monitoring of vital signs
• Additional: Certificate renewal every 3 years with 12 hours CE

North Carolina

• Permit Type: Moderate Conscious Sedation Permit
• Education: 60 hours of training and management of 20 cases
• Certification: ACLS
• Facility Requirements: Emergency equipment and facility inspection
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal annually with 6 hours of CE

North Dakota

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and 20 supervised cases
• Certification: ACLS
• Facility Requirements: Emergency equipment and facility inspection
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 5 years with CE requirement

Ohio

• Permit Type: Conscious Sedation Permit
• Education: 60 hours of training and 20 supervised cases
• Certification: ACLS
• Facility Requirements: On-site evaluation required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal biennially with 20 hours of CE

Oklahoma

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and management of 20 cases
• Certification: ACLS
• Facility Requirements: Facility inspection required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal annually with CE requirement

Oregon

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and 20 supervised cases
• Certification: ACLS
• Facility Requirements: On-site evaluation of facilities
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 2 years with 14 hours of CE

Pennsylvania

• Permit Type: Conscious Sedation Permit
• Education: 60 hours of training and management of 20 cases
• Certification: ACLS
• Facility Requirements: Office inspection and clinical evaluation required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 4 years with 15 hours of CE

Rhode Island

• Permit Type: Moderate Sedation Permit
• Education: Completion of an approved residency or a 60-hour course
• Certification: ACLS
• Facility Requirements: Facility inspection required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 2 years with CE requirement

South Carolina

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and 20 supervised cases
• Certification: ACLS
• Facility Requirements: Facility inspection may be required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 2 years with CE requirement

South Dakota

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and management of 20 cases
• Certification: ACLS
• Facility Requirements: Facility inspection required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal annually with CE requirement

Tennessee

• Permit Type: Conscious Sedation Permit
• Education: 60 hours of training and 20 supervised cases
• Certification: ACLS
• Facility Requirements: Facility inspection every 5 years
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 2 years with CE requirement

Texas

• Permit Type: Level 2 Moderate Sedation Permit
• Education: 60 hours of training and management of 20 cases
• Certification: ACLS
• Facility Requirements: Office inspection required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 2 years with 8 hours of CE

Utah

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and 20 supervised cases
• Certification: ACLS
• Facility Requirements: Facility inspection may be required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 2 years with CE requirement

Vermont

• Permit Type: Conscious Sedation Endorsement
• Education: 60 hours of training and management of 20 cases
• Certification: ACLS
• Facility Requirements: Facility must meet equipment requirements
• Monitoring: Continuous monitoring of vital signs
• Additional: Endorsement renewal with license renewal

Virginia

• Permit Type: Conscious/Moderate Sedation Permit
• Education: 60 hours of training and management of 20 cases
• Certification: ACLS
• Facility Requirements: Facility inspection required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal annually with 15 hours of CE

Washington

• Permit Type: Moderate Sedation Permit
• Education: Minimum 60 hours of training
• Certification: ACLS
• Facility Requirements: On-site inspection may be required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 3 years with 7 hours of CE

West Virginia

• Permit Type: Class 3 Anesthesia Permit for Moderate Sedation
• Education: 60 hours of training and management of 20 cases
• Certification: ACLS
• Facility Requirements: Facility inspection required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal with license renewal

Wisconsin

• Permit Type: Class II Permit for Moderate Sedation
• Education: 60 hours of training and 20 supervised cases
• Certification: ACLS
• Facility Requirements: Facility inspection may be required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal every 2 years with CE requirement

Wyoming

• Permit Type: Moderate Sedation Permit
• Education: 60 hours of training and management of 20 cases
• Certification: ACLS
• Facility Requirements: Facility inspection required
• Monitoring: Continuous monitoring of vital signs
• Additional: Permit renewal annually with CE requirement

Frequently Asked Questions

What is the difference between minimal and moderate sedation?

Minimal sedation keeps the patient awake but relaxed, while moderate sedation (oral conscious sedation) induces a deeper state of relaxation where the patient may feel drowsy but remains responsive to verbal commands.

Which states require live patient observation for a sedation permit?

Several states, including Texas, Idaho, Missouri, Maine, and Massachusetts, require dentists to observe or administer sedation to live patients under supervision before obtaining a permit.

How often do sedation permits need to be renewed?

Most states require sedation permit renewal every 1-3 years, with mandatory continuing education (CE) credits in sedation dentistry.

What are the CE requirements for maintaining a sedation permit?

CE requirements vary by state, but most states require 4-15 hours of sedation-specific CE credits per renewal cycle. Some states also require annual ACLS (Advanced Cardiac Life Support) certification.

Do sedation permits apply to pediatric patients?

Some states require additional certifications, such as PALS (Pediatric Advanced Life Support), for dentists who sedate pediatric patients. Check with your state dental board for specific requirements.

What emergency preparedness is required for moderate sedation?

Most states require dentists to have emergency drugs, monitoring equipment, oxygen supply, and defibrillators on-site. Dentists must also be trained in emergency response and airway management.

Where can I find specific sedation requirements for my state?

The best sources for up-to-date regulations are your state dental board’s website, the American Dental Association (ADA), and DOCS Education.

What equipment is required for in-office sedation procedures?

States typically require:

• Pulse oximeter
• Blood pressure monitor
• Oxygen delivery system
• Emergency drug kit
• Defibrillator (AED)
• Capnography (CO2 monitoring) in some states

What happens if a dentist performs sedation without a permit?

Practicing sedation without a valid permit can result in fines, suspension, or loss of a dental license. States take sedation regulations seriously due to patient safety risks.

Can dentists from another state transfer their sedation permit?

Some states allow permit reciprocity if the dentist has equivalent training and experience. However, many states require reapplication and compliance with state-specific requirements.

Are there restrictions on the drugs used for oral sedation?

Yes, each state regulates which sedative medications can be used. Common drugs include:

• Benzodiazepines (e.g., Diazepam, Triazolam, Lorazepam)
• Antihistamines (e.g., Hydroxyzine)
• Nitrous oxide (in combination with oral sedation in some states)

Always check state guidelines for approved sedation medications and dosages.