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Important update on the use of nitrous oxide by itself and in combination with an enteral sedative type drug:

Previously, we sent out a notice to all members via email to alert them to this change in the regulations.  The regulation is 18VAC60-21-280 (Administration of minimal sedation- anxiolysis or inhalation analgesia).
The current regulations state that if you use nitrous by itself you are held to the equipment and monitoring requirements as stated in the regulation.  At the last Board of Dentistry meeting,  VDA members Carl Atkins, Nick Lombardozzi, Teg Brickhouse and Rob Strauss presented compelling testimony about this regulation.  In the words of Dr. Atkins "the current guidelines of the AAPD state that children who receive minimal sedation generally will not require more than observation and intermittent assessment of their level of sedation. He described how the current Board requirements for minimal sedation significantly increase the cost of treatment. He also questioned the requirement for recording vital signs prior to discharge."
The feeling among all four who testified was that the current regulations, in regards to the practitioner just using nitrous, was an 'over regulation' that was not required.  They did agree that if an enteral sedative was 'added', the regulations may be more appropriate.  
Dr. Charles Gaskins, the president of the Board, then formed a special committee (with Dr.'s Brickhouse and Strauss) to reconsider the language in this regulation and report their recommendations back to the board at their next meeting in June.  This will be done via the 'fast track' mechanism to hopefully get this change done within 4-5 months.  However, all licensees are held to the current regulation as it reads.

Please read the entire regulation and make sure you are in compliance with it.  If you have questions or concerns please contact Laura Givens at the VDA office (804-523-2185) or send your comments to her at and we will pass them along to Dr.'s Brickhouse and Strauss.  We will also make an update to this notice after the April 27th committee meeting which will be held at 2 PM at the Department's office.  You are certainly welcome to attend that meeting.