Sedation and Anesthesia

The College has in place a number of requirements to ensure patient safety when sedation and/or general anesthesia is used in a dental office.

There is a Standard of Practice that sets out the general professional responsibilities expected of the dentist and staff. It then addresses specific standards for each modality (level) of sedation and other topics such as patient selection, medical history, consent process, office protocols, equipment, and recovery protocols.

There is also a by-law that sets out the educational requirements needed for those who administer sedation and/or general anesthesia and the need to apply to have the provider’s credentials/training recognized by the College (Member Authorization). The by-law stipulates the need for each office doing sedation procedures to have an initial onsite inspection and then ongoing (every three years) onsite inspections. Offices that pass inspection will be issued a Facility Permit.

Applying for a Facility Permit

Every dental facility where Oral Moderate sedation, Parenteral Conscious sedation, Deep sedation and/or General Anesthesia are administered must have a Facility Permit from the College as required by the Standard of Practice. There are two types of Facility Permits. You may require one or the other or both; note that there is a separate application process for each:

  • Type A Facility Permit is for a dental office or facility that provides and has present at all times all of the sedation equipment and emergency drugs. NOTE: The permit will restrict the level of sedation permitted. The Facility Permit holder may request any or all of the modalities - Oral Moderate, Parenteral Conscious, Deep sedation and/or General Anesthesia - but before proceeding with any level the College must first conduct an inspection and confirm approval.
  • Type B Facility Permit is for a dental office or facility that uses the services of a College approved practitioner (dentist or physician) who brings all the sedation equipment and emergency drugs with them to your office (visiting member or visiting physician).

For a list of approved practitioners (dentists or physicians) click here. Note that this information is maintained in the Member Resource Centre, meaning that only a dentist member of the College can access the list by entering their registration/membership ID and password.

It is important to note that Facility Permits are non-transferable. If the ownership of the practice changes or the practice moves, the Facility Permit will be cancelled. If the office is at a new location then it must be inspected and a new Facility Permit issued. If the office location does not change but there is a new owner then similarly a new Facility Permit needs to be issued and the office must undergo an inspection. The new owner is responsible for applying for a new Facility Permit.

Facility Inspections

Initially, and then every three years, the College must inspect all dental offices wishing to hold a Facility Permit allowing them to offer sedation services. This inspection is required to ensure that the facility is in compliance with the College’s Standard of Practice.

A College inspector will call you to set up a mutually convenient time for this inspection. The dentist owner of the practice should be on site when the inspector is there in order to answer any questions.

There is a checklist of required equipment and emergency drugs (developed from the Standard of Practice) for each level of sedation to help you get ready for the inspector’s visit along with sample sedation records.

Click to view/download Checklists for Inspection


Click here to view/download the sample anesthetic record.

Click here to view/download the sample oral moderate sedation record.

Any deficiencies noted during the inspection relating to inadequate sedation equipment and/or emergency drugs and/or unsatisfactory sedation records will be posted on the public register under the name of the Facility Permit holder. Deficiencies relating to unsatisfactory sedation records will also be posted under the name of the member authorized to administer sedation and/or general anesthesia. Postings will be removed from the public register once the College receives the appropriate documentation that the problems have been corrected.

This transparency is expected by the Ministry of Health and supports the goal shared by all health care regulators that the public has as much information as possible to make informed decisions about the choice of their health care providers.

If you have any questions, please contact Dr. David Harper, Supervising Facility Inspector, at dharper@rcdso.org or by phone at 416-961-6555 ext. 3349 / 1-800-565-4591.

Applying for Authorization to Administer

Any dentist or physician who wishes to administer Oral Moderate sedation, Parenteral Conscious sedation, Deep sedation and/or General Anesthesia in a dental office or facility must apply to the College to have their training reviewed and approved by the College. This is a separate application process and in addition to the office or facility having a Facility Permit to administer.

The authorization expires on March 31st of each calendar year, regardless of when in the year it was initially issued.

For Dentists

  • Member Authorization refers to dentists who will be using the sedation equipment and emergency drugs that are permanently kept onsite in the office/facility where the procedures will be performed. Dentists applying for a Member Authorization will only be permitted to administer sedation and/or general anesthesia in offices holding a Type A Facility Permit. Maintaining the equipment and drugs is the responsibility of the Facility Permit Holder.
  • Visiting Member Authorization refers to dentists who bring with them all the necessary sedation equipment and emergency drugs approved by the College to any office that holds a Type B Facility Permit. Dentists with a Visiting Member Authorization can also administer in a Type A facility, however, if the authorization they hold is for a deeper level of sedation than the Type A Facility Permit allows, the dentists are restricted to the level of sedation outlined on the Type A Facility Permit. He/she can only use the facility’s sedation equipment and emergency drugs maintained on-site. If the visiting dentist prefers to use their own equipment and drugs then he/she must ensure that the office has been issued a Type B Facility Permit.

To see the list of dentists approved to administer sedation and modality click here. Note that this information is maintained in the Member Resource Centre, meaning that only a dentist member of the College can access the list by entering their registration/membership ID and password.

For Physicians

There are two types of privileges physicians can choose to seek from the College:

  • “Physician” applies to those physicians who will be using the sedation equipment and emergency drugs provided by the facility. Physicians applying for physician privileges will only be permitted to administer sedation and/or general anesthesia in offices holding a Type A Facility Permit.
  • “Visiting Physician” applies to those physicians who will be bringing all the necessary sedation equipment and emergency drugs for which they have been granted privileges by the College to any office that holds a Type B Facility Permit. Visiting Physicians can also administer in a Type A facility, however, if the privileges they have are for a deeper level of sedation than the Type A Facility Permit allows, the physicians are restricted to the level of sedation outlined on the Type A Facility Permit. He/she can only use the facility’s sedation equipment and emergency drugs maintained on-site. If the visiting physician prefers to use their own equipment and drugs then he/she must ensure that the office has been issued a Type B Facility Permit,

To see the list of physicians approved to administer sedation and modality click here. Note that this information is maintained in the Member Resource Centre, meaning that only a dentist member of the College can access the list by entering their registration/membership ID and password

Contact Information

If you have any questions or concerns, please contact:

Standard of Practice or Training/Qualifications:

Dr. David Harper

Supervising Facility Inspector
416-961-6555 ext. 3349
1-800-565-4591
dharper@rcdso.org

Application Process:

Email: sedation@rcdso.org

Important Information for Members

The Registrar has the discretion to rescind or restrict a member’s authorization to provide sedation services or cancel a sedation facility permit due to non-compliance with the by-law, standard of practice, or if there is a risk of harm to the public.