Royal College of
Dental Surgeons of Ontario
Contact Us info@rcdso.org RCDSO Portal Login
Filter
Search Filter Options

Sedation and Anesthesia

The Facility Inspection Program (FIP) will no longer be accepting mail items effective March 1, 2021. All submissions to the FIP department must be sent via email for processing. With the exception of cheques and money orders, items mailed to the department after March 1, 2021 will not be processed and must be resubmitted via email.

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

Items emailed to FIP must be:

  • PDF format
  • Clear (not faded)
  • Legible
  • Complete (with pertinent information cut off)
  • Unaltered
For information on minimal sedation, visit the Minimal Sedation page. If you no longer require your Member Authorization or Facility Permit and wish to cancel it, please request the cancellation by email to sedation@rcdso.org. Cancellation requests must be received in writing via email to sedation@rcdso.org, and cannot be processed over the phone.

RCDSO Sedation and Anesthesia Standard

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. 

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 our 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 B. It is possible to hold both types.

Dentists can access a list of approved dentists or physicians by logging in to their member resource centre account.

Facility permits are non-transferable. If the ownership of the practice changes or the practice moves, the facility permit will be cancelled.

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

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?

If the sale involves a complete change in practice ownership: Due to College By-Laws, we cannot transfer the Facility Permit. However, we do try to accommodate practices in this category to minimize disruption to services.

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): Please submit information regarding the change in ownership structure to the Facility Inspection Program at sedation@rcdso.org, as we may be able to update the permit in such cases without a new application/inspection.

I have a practice sale that recently occurred in the past, how do I expedite my application?

If the date of practice sale is in the past, in addition to the application, we require the details from the buyer:

  1. Practice location (exact address)
  2. Date of sale
  3. Seller name
  4. A completed application form.

I have a practice sale in the future, how do I expedite my application?

If the date of practice sale is in the future, we require the details from the seller and buyer:

  1. Practice location (exact address)
  2. Date of sale
  3. Seller/buyer name

In addition, an application form needs to be submitted by the buyer after the change in ownership takes place.

I’m moving my practice, how do I expedite my application?

Please submit your completed application form and indicate in your email that it is for an existing practice that is moving locations.

Can you give me the date my permit will be issued?

While the FIP department does its best to prioritize inspections related to changes in ownership/address we cannot guarantee timelines. The processing of a file is contingent on the Facility Inspection Program department AND the full cooperation of the Facility Permit Holder. In cases where we do not receive the required information/documentation in an organized and timely manner from the Facility Permit Holder or deficiencies exist our ability to expedite a file is limited. 

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

For efficiency, we may only communicate with the Facility Permit Holder or their designate. 

Applying for Authorization to Administer

Any dentist or physician who wishes to administer sedation above the minimal level in a dental office must apply to the College to have their training reviewed and approved.

Dentists

There are two types of 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 in a type A facility. 
  • Visiting member authorizations are for dentists who bring all the necessary sedation equipment and emergency drugs approved by the College to a facility that holds a type B permit.
  • Dentists with a visiting member authorization can also administer in a type A facility, but are restricted to the level of sedation of the type A facility permit. They can only use the facility’s sedation equipment and emergency drugs maintained on-site.
Application for member authorization to administer sedation and general anesthesia.

Physicians

Physicians can apply for two types of privileges.

  • “Physician” applies to physicians who use the sedation equipment and emergency drugs provided by a type A facility.
  • “Visiting physician” applies to physicians who bring all the necessary sedation equipment and emergency drugs Visiting physicians can also administer in a type A facility, but are restricted to the level of sedation outlined on the type A facility permit.
Application for a physician to administer sedation and general anesthesia in a dental office.

Submitting my Sedation Records to the RCDSO

When your application to administer oral moderate sedation or parenteral conscious sedation or deep sedation and/or general anesthesia is approved, you will be issued a three-month provisional member authorization, which can be extended for an additional three months (six months total). During this time, you will be required to submit five sedation records for review to the College, and provided they are complete and in compliance with the Standard of Practice, your annual authorization will then be issued.

Your sedation records must be submitted via email according to RCDSO criteria

Until a member holds a College-issued member authorization, they are not permitted to offer any oral moderate sedation or parenteral conscious sedation or deep sedation and/or general anesthesia services, and no such cases should be pre-booked.

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 requirements related to the Standard 

  • The Standard sets out the minimum number of CE points related to sedation and anesthesia that must be completed in a 3-year period. This 3-year period will match  your 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.
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

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 If patients < 12

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*

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.

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 about the Standard?

Email: spatodia@rcdso.org 
Phone: 416-961-6555 ext 4309

General or application specific questions?

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