Levels of Sedation

Definitions of sedation and guidelines are published by several dental professional organizations, notably the American Academy of Pediatric Dentistry, the American Association of Oral Maxillofacial Surgeons, and the American Dental Association (ADA). Information on the guidelines can be found on their respective websites.^23-27 The ADA’s guidelines also include the educational requirements needed to qualify a dentist to provide sedation in their office as well as guidelines for teaching sedation to dentists and dental students.²⁷ Although most state dental boards base their requirements on the ADA guidelines, dentists should contact their respective state board for specific information.

Sedation is defined as the use of a drug or a combination of drugs to depress the central nervous system (CNS), thus reducing the awareness of the patient to their surroundings. Depending on the degree of CNS suppression, the sedation may be conscious, deep, or general. Sedation does not control pain and, consequently, does not eliminate the need for the use of local anesthetics.

Conscious sedation is a controlled, pharmacologically induced, minimally depressed level of consciousness that retains the patient’s ability to maintain a patent airway independently and continuously and respond appropriately to physical and/or verbal commands. The drugs used should have a wide margin of safety to prevent loss of consciousness.

The followings levels of sedation, as well as the education requirement, are promulgated in the ADA guidelines.^26,27