One needn’t be a meteorologist to recognize the regulatory forecast for general dentists who provide oral sedation to their fearful and anxious patients. A severe storm is headed your way, if it hasn’t already arrived.
Sedation dentists in Louisiana, West Virginia, and New Mexico have already been instructed: “Get an IV sedation permit or quit providing your patients the most common minimal and moderate enteral sedation protocols.”
The Virginia Board of Dentistry stands poised to drop the hammer on oral sedation dentists in that state as well.
[Editor’s Note: There is a silver lining to these clouds, which we’ll explain below.]
The seed of this sea change dates back to October 2016, when the American Dental Association’s House of Delegates – urged on by oral surgeons and other specialists – approved new guidelines governing the use of oral sedation. Resolution 37, as it was dubbed, calls for all general dentists to obtain an IV permit before providing their patients with most forms of minimal and moderate sedation, regardless of the route of administration.
Translated, Resolution 37 requires that even dentists who have safely and effectively administered oral sedatives to their patients for years, even decades, return to the classroom and obtain their IV sedation certification if they wish to continue providing enteral (oral) sedation as they have.
DOCS Education and many respected dental groups and researchers strongly opposed Resolution 37 as baseless scientifically. Moreover, millions of safe and effective clinical experiences using oral sedatives argued against the need to update the ADA’s existing guidelines – which had protected patients for nearly a decade without requiring general dentists to be certified in IV sedation.
No Sugar-Coating This
Despite all the efforts to derail Resolution 37, it was passed. In its aftermath – like dominoes – one state after another has begun encoding into law the basic ADA sedation guidelines.
There is no sugar-coating this.
Like it or not, the reality is that Resolution 37-like guidelines are being considered by a growing number of dental boards. Even if your state is not one that plans to embrace the IV certification requirement anytime soon, the guidelines are rapidly becoming the standard of care nationally.
If you continue to provide minimal or moderate oral sedation, in the event one of your patients ever brings a legal action against you claiming harm, your defense may be weakened considerably if you must acknowledge that you were not in compliance with the ADA’s recommendations and nationwide standard of care.
It’s a “gotcha.”
Moreover, unless as an oral sedation dentist you take prompt and deliberate action, all of the patients who currently rely on you to calm their nerves using oral sedation may be left to fend for themselves. Some patients will simply quit seeking oral care, especially those located in rural areas where specialists are few and far between. Other patients will have no choice but to turn to an expensive oral surgeon whose IV permit allows the doctor to continue to provide both parenteral and enteral sedation.
“No one opposed the ADA’s recommendation that all sedation dentists obtain an IV sedation permit more than we did,” says Michael D. Silverman, DMD, president and founder of DOCS Education. “But we have to accept the reality that we have an obligation to the tens of millions of patients who look to general dentists for sedation care to do whatever we must to continue providing it.”
To aid dentists who are committed to providing their patients with safe and effective sedation – regardless of the brewing regulatory storm – DOCS Education, in concert with Oregon Health & Science University School of Dentistry, has developed a CODA-accredited curriculum – offered chiefly from the convenience of your home or office – that will comply with the new, stricter standard of care nationwide.
Moreover, the OHSU/DOCS Education curriculum is the only program in the nation that teaches proven and safe protocols that combine oral and IV sedatives.
Dr. Anthony S. Feck, Dean of the DOCS Education faculty and one of the most respected oral sedation educators in the nation, obtained his IV sedation permit long ago and regularly uses it in his practice. Dr. Feck praises the value – to both dentists and their patients – of having the ability to combine oral and IV sedation; what he describes as “the best of both worlds.”
Best of Both Worlds
“Combining oral and IV sedation will improve your efficiency,” Dr. Feck explains. It allows dentists to treat medically complex patients, as well as to better serve those patients who are difficult to treat with oral sedation alone.
Dr. Feck, along with distinguished DOCS Education faculty members Leslie Fang, MD, PhD; Jerome Wellbrock, DMD; and James Bovia, EMT-P, are the primary instructors for IV Sedation Certification, which consists of 50 hours of didactic, study-at-home training, combined with 40 hours of in-person, live patient training that is held over a single, extended weekend at a state-of-the-art clinic in Lexington, KY.
“Our IV Sedation Certification program is designed from the ground up to be as convenient and expedient as possible,” says Dr. Silverman. “Not only will it bullet-proof our graduates from the turbulence of ever-changing dental regulations, but it will also allow them to safely and confidently treat medically complex cases and refer out fewer patients.”
One cautionary note Dr. Silverman offers to dentists who recognize the wisdom of getting their IV certification: Each DOCS Education IV Sedation program has a maximum clinical class size of six doctors.
“Dentists who don’t secure their seat early on may have to wait – literally – years to receive the required certification,” says Dr. Silverman. “Demand for IV certification training far outstrips the supply.”