Course Description:

More children are coming to our practices with more cavities than ever before.

Parents are juggling jobs, kids, school work, appointments—they're stressed.

The last thing they want to hear is that their child has cavities and needs to come in for multiple appointments.

But more often than not, that's the reality. And it doesn't get any easier: parents want to minimize the amount of time they have to take off work and take their kids out of school, so appointments are scheduled after school. Kids come to your office tired from a full day at school and not happy about being at the dentist; parents come in stressed and annoyed; you're taking the brunt of it all. Something needs to change.

Learn about the course from instructor Dr. Sanger himself by listening here:

What's the game changer in pediatric dentistry? Change the way you treat pediatric patients using minimal conscious sedation with an orally administered sedative and amnesic (no memory) drug with N2O analgesia.

Transform these multiple appointments and difficult cases into a single "no memory" appointment.

What makes the Pediatric Sedation Dentistry (PSD) course better than other pediatric sedation courses?

  1. Some courses give you a shopping list of drugs you can use. PSD gives you one drug that's been proven to be one of the safest and most effective in medicine.
  2. PSD is taught by renowned practicing pediatric dentists and physicians: Roger Sanger, DDS, MS (pediatric dentist), Leslie Fang, MD, PhD (internist and nephrologist), and James Bovia, EMT-P.
  3. Instruction is focused on clinically-relevant information that you can put to use immediately in your practice.
  4. You will learn Advanced Pediatric Airway Management (APAM)* using high-fidelity human simulators and animal cadaver material so you can be prepared should an emergency arise.

With pediatric sedation, you can complete a child's dental treatment in one single appointment, of which the child will have no memory. Reduced chair time means more time for you to treat other cases, and less time patients and their parents have to spend at appointments. Less stress for everyone involved; increased patient and parent satisfaction; more productivity for you. Stop dreading afternoon appointments.

What You'll Learn

In this 2-day course (including pre-course web-based instruction) totaling 25 CE you will develop a foundational skill set that will allow you to safely and confidently use sedation on pediatric patients. You will learn how to determine which child and parent are good candidates for pediatric oral sedation; pediatric anatomy, physiology and physical evaluation; what equipment, supplies, and management techniques are necessary to start sedation procedures in your office.

You will engage in intensive study of pediatric sedation dentistry: from case selection to the science of sedation to safety to implementation.

Get Started

Live Patient Experience Requirements: If you are licensed in a state that requires one (CA) or three (ID, ME, MO, ND, TX) live patient experiences, DOCS Members enjoy access to our Mentor Program, which assists in completing those requirements. In our Mentor Program, we will connect you with an experienced DOCS Member sedation dentist where you can observe your three live cases. (CA dentists are automatically registered for the single live patient experience at each West Coast seminar). If you are licensed or intend to obtain a license in one of those states, consider becoming a DOCS Member to take advantage of this and other great member benefits.

Bring Your Team! Successful implementation of new skills depends not just on an intelligent doctor—but an intelligent team. Provide them with the confidence, skills, and preparation to ensure pediatric sedation is implemented safely and efficiently in your practice. Read more in "Why should I bring my team?" below.

Completing Your Pediatric Sedation Dentistry Education

By learning Advanced Pediatric Airway Management (APAM)* you’ll complete your permitting requirement in many states. When practicing pediatric sedation dentistry, advanced airway management skills are critical to keep you and your patients safe. In this hands-on, practical course, through repetition, you will become proficient at different techniques for airway management and resuscitation. 

Check with DOCS Education’s Regulatory Counsel for your specific state requirements.

Clinician Testimonial

I would like to thank the DOCS Education team for facilitating the best pediatric sedation course that I have ever attended. As a pediatric dentist we are constantly training to provide our young patients with the safest sedation modalities available. The DOCS Education pediatric sedation course not only provides a pediatric dentist with that training but it also gives you the know-how to implement what you have learned in a practical way. I highly recommend this course for any general dentist interested in sedation and any pediatric dentist with experience in sedation looking to strengthen his or her knowledge.
Frederick Ballard, DDS
Kool Koala Pediatric and Adolescent Dentistry

Financing available to qualified applicants. Call for more information. 

Scientific support and additional resources are available here.

Upon completion of a competency course in minimal sedation, the dentist must be able to:  

  1. Describe pediatric anatomy and physiology of the respiratory, cardiovascular and central nervous systems, as they relate to sedation.  

  1. Describe the pharmacological effects of drugs.  

  1. Describe the methods of obtaining a medical history and conduct an appropriate physical examination.  

  1. Apply these methods clinically in order to obtain an accurate evaluation.  

  1. Use this information clinically for ASA classification and risk assessment.  

  1. Choose the most appropriate technique for the individual patient.  

  1. Use appropriate physiologic monitoring equipment.  

  1. Describe the physiologic responses that are consistent with minimal sedation.  

  1. Understand the sedation/general anesthesia continuum.  

  1. List and discuss the advantages and disadvantages of enteral and/or combination inhalation-enteral minimal sedation (combined minimal sedation).  

  1. List and discuss the indications and contraindications for the use of enteral and/or combination inhalation-enteral minimal sedation (combined minimal sedation).  

  1. List the complications associated with enteral and/or combination inhalation-enteral minimal sedation (combined minimal sedation).  

  1. Discuss the prevention, recognition and management of these complications.  

  1. Comprehend how oral sedative drugs produce their effect in the oral cavity, esophagus, stomach, small intestine, liver, cardiovascular system, and into the brain.  

  1. Discuss how other drugs and common medical conditions can influence the effect(s) of the sedative drug(s). 

  1. Review of drug regimens 

  1. Identify and adjust for the complicated patient 

  1. Understand the metabolism of drugs and drug-drug interaction 

  1. Recognize and respond to pediatric emergencies 

  1. Discuss the pharmacology of the enteral and inhalation drugs selected for administration.  

  1. Discuss the precautions, contraindications and adverse reactions associated with the enteral and inhalation drugs selected.  

  1. Describe a protocol for management of emergencies in the dental office and list and discuss the emergency drugs and equipment required for management of life-threatening situations.  

  1. Demonstrate the ability to manage life-threatening emergency situations,  

  1. Determine appropriate cases for treatment 

  1. Confidently communicate with both patient and parent 

  1. Select appropriate drug/s, dosage and delivery method 

  1. Observe live patient video feed of sedated pediatric patient 

  1. Identify the guidelines for monitoring, stabilization and staff support  

  1. Prepare consent forms and appropriate documentation 

  1. Discuss and recommend treatment for actual cases and review results 

  1. Identify considerations for treatment planning 

  1. Learn intricacies of local anesthesia use 

  1. Integrate nitrous oxide/oxygen sedation with and without other sedatives 

  1. Review the legal and regulatory issues surrounding sedation 

  1. Recognize and fulfill staff support and training requirements 

  1. Complete the hands-on portion of the PALS or PALS Recertification (Add On, additional tuition)

  1. Test emergency skills on High Fidelity Human Simulation in 6 emergency scenarios 


Scientific support and additional resources are available here. 

Advanced Pediatric Airway Management (APAM) with High-Fidelity Human Simulation Module

A pediatric emergency could occur on any patient in your practice. If this situation arises, you are the first responder. Are you prepared? Can you recognize pediatric emergencies and manage successful outcomes? Are your “hands-on” life support skills current?

APAM stands for Advanced Pediatric Airway Management and the simulator used in teaching is a replica of a pediatric patient. By perfectly mimicking real patient behavior, the module helps in the training process to provide doctors with the skills for safe and effective airway management.

James Bovia brings his 30 years of experience in emergency medical services in order to lead attendees through six emergency scenarios.

These six scenarios will be programmed into the high-fidelity human simulators that have direct application for pediatric dentists who sedate children in their office. These scenarios include:

  • Asthma: A patient may experience an attack while under sedation, thus causing an airway emergency.

  • Excess of local anesthetic: A patient could experience an overdose (toxicity) of local anesthesia causing a biphasic (excitation then depression) reaction.

  • Allergic reaction: This could result in first a cutaneous reaction progressing to anaphylaxis with airway emergency.

  • Sinus Tachycardia (ST) or Supra Ventricular Tachycardia (SVT): Possibly from elevated temp, stress, etc. during sedation requiring initial vagal stimulation.

  • Foreign body introduction: Gauze, tooth, crown, bur, etc. in oropharyngeal area during sedation causing an airway emergency.

  • Diabetes: Patient could experience an episode of hypoglycemia during sedation.

Note: DOCS Education strongly encourages dentists to enroll in the American Heart Association’s HeartCode PALS Part 1 prior to enrolling in Pediatric Sedation Dentistry. If you successfully complete HeartCode PALS Part 1, you have the opportunity to become PALS-certified or re-certified by attending Pediatric Sedation Dentistry, which fulfills Parts 2 and 3. (Add On, additional tuition) This also applies to completing the APAM course in conjunction with Safe and Effective Pediatric sedation Dentistry (((Live))) Event.

However, spaces for recertification testing will be limited. If you are interested in becoming certified or recertified, please inquire with your Customer Service Representative to learn more.

DOCS Education considers the dental team a vital part of good patient care and urges every dentist to bring at least one staff member to courses. Whether assisting the doctor during the actual appointment or tending to the practical concerns of appointment scheduling and recordkeeping, a doctor cannot perform pediatric sedation without the help of his or her team. Thus, it's imperative your team members be knowledgeable about the pediatric sedation process to better serve the patient and the dentist.

"I brought some of the team with me, including two hygienists and our assistant manager—all of whom are extremely reluctant to try new things. I sat at lunch today listening with amazement as they told me what we need to do to implement this in our practice! Your enthusiasm is infectious, and I will be sending the rest of the team to this course!"

- Karen Harriman, DDS

States differ in their sedation regulations. Visit to learn more.

Dr. Roger Sanger is DOCS Education's lead instructor for Pediatric Sedation Dentistry and has personally performed over 13,000 pediatric sedation cases. He explains why, if performed by a skilled and responsible doctor, sedation dentistry is a safe, dependable and important method of treatment for children with anxiety:

I am a believer that with the proper training and regulatory guidance, a general dentist can perform safe and effective sedation to aid in the dental treatment of children and teens. Proper training must include (among many other subjects) the selection of proper drug(s) and their safe use, and MOST IMPORTANTLY, the proper selection of the child or teen.

Minimal oral conscious sedation performed by trained GPs provides children with a much more pleasant dental experience, thus making them better patients for the rest of their lives.

For the majority of cases a general dentist will encounter in practice where oral conscious minimal sedation will be beneficial, the use of one drug (midazolam is the most popular) given at or below the maximum recommended therapeutic dose (MRTD) with nitrous oxide, oxygen inhalation, analgesia and injectable local anesthesia will suffice. Cases requiring a higher degree of sedation because of patient selection or length of treatment can be referred to the pediatric specialist who may want to achieve moderate sedation.

If one drug is sufficient, why use nitrous oxide or local anesthesia? Nitrous oxide is the safest drug we have to achieve analgesia. Along with injectable local anesthesia, nitrous oxide analgesia will reduce pain sensation thus allowing for a lesser amount of the sedative drug to achieve a better and safer level of minimal sedation.

Why do some states allow a GP to administer a second sedative drug? The second sedative drug (hydroxyzine is the most commonly used) will be synergistic to the first drug thus allowing a lower dose of the first. The second sedative drug is usually for great working time and antiemetic, antihistaminic, antisialologue properties.

I believe that allowing a GP to administer one sedative drug without nitrous would not allow the child or teen to whom the sedation is intended to receive the most comfortable dental treatment. I also believe many states are correct in establishing educational requirements for its regs. I also know that in a child it is AIRWAY, AIRWAY, AIRWAY. Therefore, I encourage states to establish a requirement that any dentist sedating a child be certified by the AHA in PALS (Pediatric Advanced Life Support) and recertified every two years by the AHA. I also feel strongly that the dentist should have a CE requirement for recertification of the sedation regulations by a state.

The four major reasons for complications during dentist administered oral sedation are as follows:

  1. They picked the wrong patient due to physical, mental, medical, drug, etc. compromising conditions. (EDUCATION)
  2. They used an overdose of the sedative drug(s). (EDUCATION)
  3. They used an overdose of the local anesthetic drug(s). (EDUCATION)
  4. They allowed a foreign body to go down the throat by not protecting the airway (no rubber dam or suitable isolation). (EDUCATION)

All these topics should be educational requirements established by the regulations.

Many dental insurance carriers will pay for sedation. Again, there is wide variability in this area.

25 participation  

1 live case  

10 video cases  

(Hours - AGD Code - Definition

1 - 010 Basic Science: Anatomy

2 - 010 Basic Science: Pharmacotherapeutics

1 - 010 Basic Science: Physiology

7.5 - 142 Electives:  Emergency Training / CPR

6 - 340 Anesthesia & Pain Management

0.5 - 432 Pediatric Dentistry: Prevention/Diet/Nutrition

3.5 - 433 Pediatric Dentistry: Behavior Management

3.5 - 434 Pediatric Dentistry: Management of Child Patient

TOTAL: 25 hours (participation)  


"The DOCS Pediatric Sedation Course provides a simple straight forward approach to oral sedation for children. I completed the course just after graduating from my pediatric dental residency program and found all the material helped to solidify all the concepts that I had just learned in my program. The small but valuable variations in the protocol and the extra hints and tricks they provide make the course well worth the investment for a recent graduate or someone interested in providing pediatric oral sedation in their clinic."

    Daniel Dupuis

    I believe that attendance at the DOCS Pediatric Sedation course is a “must” for any resident or recent graduate who plans to incorporate oral conscious sedation in his practice. The practical content of this course is a thorough and comprehensive overview of the subject. The workbook is an excellent reference on airway management and emergency preparedness and is far better than any text book or other publication on the subject. 

    Ray E Stewart
    DMD, MS Clinical Professor UCSF School of Dentistry Chair, Division of Pediatric Dentistry

    The presentations were very detailed and organized. The case presentations were most valuable.

    Valerie Turner

    Very thorough, comprehensive course. I enjoyed it very much. Gave me all the tools to get started. Very knowledgeable Faculty, well-organized, and fun. Even if I never do any sedation cases, the course was still very valuable and informational.

    Ken Legault

    Value: good review, good opportunity to hear others, and good opportunity to be more enlightened. Always take home pearls.

    Betsy Barcroft

    Entire course was valuable. Enjoyed case review. Great, organized presentation for Pediatric Dentistry.

    Ronald Singer

    Greatly enjoyed. Instilled a fear/respect for the subject and motivated me to look into it further. Provided clarity of what the real issues are in both care/needs and protection of patient.

    Fred Kapple

    PSD Faculty


    How can I meet my state’s requirements?

    To learn more about how DOCS Education’s full range of courses can satisfy your state’s regulatory requirements, visit This unique online resource is kept up-to-date with the latest in sedation legislation by DOCS Education’s fulltime regulatory counsel. Contact one of our course advisers with any questions or visit our course listings to see upcoming classes and locations.

    DOCS Education courses carry the AGD PACE certification

    DOCS Education is the nation’s premier provider of safe sedation and advanced dentistry education, having trained almost 24,000 dentists. Since 2000, our courses have been accepted by the AGD for Fellowship/Mastership and membership maintenance credit. We offer extensive CE opportunities, both in-person and online, that meet your needs.

    What is DOCS Education?

    DOCS Education is an exclusive community of professionals serving at the forefront of dentistry. We offer world-class courses on safe sedation and advanced dentistry, relying on instructors who are consistently ranked among the very best in the nation. We also are a supportive network of members who guide one another to be better, more confident, more successful dentists.