Article 2.87 - Use of Pediatric Minimal Sedation

California Business and Professions Code — §§ 1647.30-1647.38

Sections (10)

Amended by Stats. 2024, Ch. 483, Sec. 19. (SB 1453) Effective January 1, 2025.

(a)A dentist who desires to administer or to order the administration of moderate sedation shall possess a dentist license or a permit under Section 1638 or 1640 issued by the board that is in good standing and apply to the board on an application form prescribed by the board. The dentist shall submit an application fee and produce evidence showing that the dentist has successfully completed training in moderate sedation that meets the requirements of subdivision (c).
(b)The application for a permit shall include documentation that equipment and drugs required by the board are on the premises.
(c)Training in the administration of moderate sedation shall be acceptable if it meets all of the

following as approved by the board:

(1)Consists of at least 60 hours of instruction.
(2)Requires satisfactory completion of at least 20 cases of administration of moderate sedation for a variety of dental procedures.
(3)Complies with the requirements of the Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students of the American Dental Association, including, but not limited to, certification of competence in rescuing patients from a deeper level of sedation than intended, and managing the airway, intravascular or intraosseous access, and reversal medications.
(d)A dentist may apply for a pediatric endorsement for a moderate sedation permit by confirming all of the following:
(1)Successful completion of residency in pediatric dentistry accredited by the Commission on Dental Accreditation (CODA) or the equivalent training in pediatric moderate sedation, as determined by the board.
(2)Successful completion of at least 20 cases of moderate sedation to patients under 13 years of age to establish competency in pediatric moderate sedation, both at the time of the initial application and at renewal. The applicant or permitholder shall maintain and shall provide proof of these cases upon request by the board for up to three permit renewal periods.
(3)In order to provide moderate sedation to children under seven years of age, a dentist shall establish and maintain current competency for this pediatric population by completing 20 cases of moderate sedation for children under seven years of age in the

24-month period immediately preceding application for the pediatric endorsement and for each permit renewal period.

(4)Current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8.
(e)A moderate sedation permitholder with a pediatric endorsement shall maintain current and continuous certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8, for the duration of the permit.
(f)Applicants for a pediatric endorsement who otherwise qualify for the pediatric endorsement but lack sufficient cases of moderate sedation to patients under 13 years of

age may administer moderate sedation to patients under 13 years of age under the direct supervision of a general anesthesia or moderate sedation permitholder who possesses a pediatric endorsement. The applicant may count these cases toward the 20 required in order to qualify for the applicant’s pediatric endorsement.

(g)Moderate sedation permitholders with a pediatric endorsement seeking to provide moderate sedation to children under seven years of age, but who lack sufficient cases of moderate sedation to patients under seven years of age pursuant to paragraph (3) of subdivision (d), may administer moderate sedation to patients under seven years of age under the direct supervision of a general anesthesia or moderate sedation permitholder who possesses a pediatric endorsement to administer general anesthesia or moderate sedation to patients under seven years of age.
(h)Patient

records submitted to the board pursuant to paragraph (2) of subdivision (c) and paragraphs (2) and (3) of subdivision (d) shall be confidential and shall not be disclosed pursuant to any state law, including, but not limited to, the California Public Records Act (Division 10 (commencing with Section 7920.000) of the Government Code), except for disclosure pursuant to a lawfully issued subpoena or a written request from a government agency responsible for either enforcement of civil or criminal laws or the professional licensing of individuals that is conducting an investigation about the applicant.

(i)If the procedures under paragraph (2) of subdivision (c) or paragraph (3) of subdivision (d) are performed in a dental office located in this state, the following shall apply:
(1)All office facility, equipment, and staff requirements for moderate sedation permitholders shall be

met.

(2)The procedures shall be performed under the direct supervision of a California-licensed dentist who holds a board-issued general anesthesia or moderate sedation permit.
(3)For procedures performed under paragraph (3) of subdivision (d), the procedures shall be performed under the direct supervision of a California-licensed dentist who holds a board-issued general anesthesia or moderate sedation permit with a pediatric endorsement issued by the board.
(4)The procedures shall be supervised in compliance with subdivision (a) of Section 1682.
(j)For purposes of this section, “good standing” means the license or permit is active and unrestricted by disciplinary action taken pursuant to Chapter 5 (commencing with Section 11500) of Part 1 of

Division 3 of Title 2 of the Government Code, is not the subject of an unresolved complaint or review procedure, and is not the subject of any unresolved disciplinary proceeding.

Amended by Stats. 2024, Ch. 483, Sec. 25. (SB 1453) Effective January 1, 2025.

As used in this article, the following definitions apply:

(a)“Minimal sedation” means a drug-induced state during which patients respond normally to verbal commands, and conforms to all of the following:
(1)Although cognitive function and coordination may be impaired, airway reflexes, ventilatory, and cardiovascular functions are unaffected.
(2)The drugs and techniques used in minimal sedation shall have a margin of safety wide enough to render unintended loss of consciousness unlikely.
(3)Patients who require tactile stimulation to elicit a response to verbal commands shall not be

considered to be in a state of minimal sedation.

(4)For the very young or developmentally delayed individual, incapable of the usually expected verbal response, a minimally depressed level of consciousness should be maintained.
(b)“Good standing” means the license or permit is active and unrestricted by disciplinary action taken pursuant to Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, is not the subject of an unresolved complaint or review procedure, and is not the subject of any unresolved disciplinary proceeding.

Amended by Stats. 2024, Ch. 483, Sec. 26. (SB 1453) Effective January 1, 2025.

(a)A dentist may administer or order the administration of pediatric minimal sedation on an outpatient basis for pediatric dental patients under 13 years of age, if the dentist possesses an active dentist license or permit under Section 1630 or 1640 issued by the board and an active general anesthesia permit, moderate sedation permit with a pediatric endorsement, or a pediatric minimal sedation permit.
(b)A dentist who administers or orders the administration of pediatric minimal sedation shall be physically present in the treatment facility while the patient is sedated.
(c)A dentist with a pediatric minimal sedation permit shall possess the training, equipment, and supplies to rescue a patient

from an unintended deeper level of sedation.

(d)This article does not apply to the administration of local anesthesia, moderate sedation, deep sedation, or general anesthesia.

Amended by Stats. 2024, Ch. 483, Sec. 27. (SB 1453) Effective January 1, 2025.

(a)A dentist who desires to administer or order the administration of pediatric minimal sedation shall apply to the board on an application form prescribed by the board. The dentist shall possess a dentist license or permit under Section 1638 or 1640 in good standing, submit an application fee, and produce evidence showing that the dentist has successfully completed training in pediatric minimal sedation that meets the requirements of subdivision (c).
(b)The application for a permit shall include documentation that equipment and drugs required by the board are on the premises.
(c)Training in the administration of pediatric minimal sedation shall be acceptable if it meets either of the following as

approved by the board:

(1)Consists of at least 24 hours of pediatric minimal sedation instruction in addition to one clinical case. The pediatric minimal sedation instruction shall include training in pediatric monitoring, airway management, and resuscitation and patient rescue from moderate sedation.
(2)Completion of a residency accredited by the Commission on Dental Accreditation (CODA) in pediatric dentistry.
(d)A dentist shall be limited to administering a single drug whose primary purpose is sedative via the oral route, either singly or in divided doses, not to exceed the manufacturer’s maximum recommended dose, plus a mix of nitrous oxide and oxygen and adjunctive agents such that the drugs either singly or in combination are unlikely to produce a state of unintended moderate sedation. This section shall not

be construed to restrict the administration of adjunctive medication intended to relieve pain, affect the onset or duration of the primary sedative agent, or to reduce the side effects of sedation, including nausea or emesis.

(e)The operating dentist and a minimum of one additional personnel who are both trained in the monitoring and resuscitation of pediatric patients, as approved by the board, shall be present during the administration of minimal sedation.

Added by Stats. 2018, Ch. 929, Sec. 9. (SB 501) Effective January 1, 2019. Operative January 1, 2022, pursuant to Section 1647.36.

(a)The application fee for a pediatric minimal sedation permit or renewal under this article shall not exceed the amount prescribed in Section 1724.
(b)It is the intent of the Legislature that the board hire sufficient staff to administer the program and that the fees established pursuant to this section be equivalent to administration and enforcement costs incurred by the board in carrying out this article.

Added by Stats. 2018, Ch. 929, Sec. 9. (SB 501) Effective January 1, 2019. Operative January 1, 2022, pursuant to Section 1647.36.

A violation of any provision of this article constitutes unprofessional conduct and is grounds for the revocation or suspension of the dentist’s permit or license, or both. The proceedings under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein.

Repealed and added by Stats. 2024, Ch. 483, Sec. 29. (SB 1453) Effective January 1, 2025.

A pediatric minimal sedation permitholder shall be required to complete a minimum of seven hours of approved courses of study related to pediatric minimal sedation as a condition of renewal of the permit. Those courses of study shall be credited toward the total continuing education required by the board pursuant to Section 1645.

Repealed and added by Stats. 2024, Ch. 483, Sec. 31. (SB 1453) Effective January 1, 2025.

(a)A physical evaluation and medical history shall be taken before the administration of pediatric minimal sedation.
(b)Records of the physical evaluation, medical history, and pediatric minimal sedation procedures used shall be maintained as required by board regulations.

Added by Stats. 2024, Ch. 483, Sec. 32. (SB 1453) Effective January 1, 2025.

A pediatric minimal sedation permit shall expire on the date specified in Section 1715 that next occurs after its issuance, unless it is renewed as provided in this article.

Added by Stats. 2024, Ch. 483, Sec. 33. (SB 1453) Effective January 1, 2025.

An oral conscious sedation for minor patients permitholder who has a permit that was issued before January 1, 2022, that authorized the permitholder to administer or order the administration of oral conscious sedation for minor patients under prior Article 2.85 (commencing with Section 1647.10) may follow the terms of that existing permit until it expires. Any pediatric minimal sedation permit issued or renewed pursuant to this article on or after January 1, 2022, shall require the permitholder to follow the requirements of this article.