Pediatric Minimal Sedation Permit - Licensed Dentists

On January 1, 2022, Senate Bill (SB) 501 (Glazer, Chapter 929, Statutes of 2018) repealed the authority of the Dental Board of California (Board) to issue Oral Conscious Sedations for Minors (OCS-M) permits. Effective January 1, 2022, the Board will no longer renew existing OCS-M permits or issue new OCS-M permits. The OCS-M permit has now been replaced with the new Pediatric Minimal Sedation (PMS) permit, which will be required for a dentist to administer or order the administration of minimal sedation on a patient under the age of 13.

“Minimal Sedation” means “a drug-induced state during which patients respond normally to verbal commands. Although cognitive function and coordination may be impaired, airway reflexes, ventilatory, and cardiovascular functions are unaffected.” (Business and Professions Code (BPC), § 1647.30, subd. (a).) In addition, “[t]he drugs and techniques used in minimal sedation shall have a margin of safety wide enough to render unintended loss of consciousness unlikely. Further, patients who require tactile stimulation to elicit a response to verbal commands shall not be considered to be in a state of minimal sedation.” (BPC, § 1647.30, subd. (b).) “For the very young or developmentally delayed individual, incapable of the usually expected verbal response, a minimally depressed level of consciousness should be maintained.” (BPC), § 1647.30, subd. (c).)

Pediatric Minimal Sedation permits are “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. ((BPC), § 1647.32, subd. (d))

The following provide specific information regarding PMS permits:

Business and Professions Code, Division 2, Chapter 4, Article 2.87 (commencing with section 1647.30)

Business and Professions Code, Section 1680(z)

California Code of Regulations (CCR), Title 16, Division 10, Chapter 2, Article 5.1 (commencing with Section 1043.9)

Applying for Pediatric Minimal Sedation Permit

The requirements for a permit to administer or order the administration of pediatric minimal sedation on an outpatient basis for pediatric dental patients under 13 years of age include:

  1. A completed online application via www.breeze.ca.gov or Application for Pediatric Minimal Sedation Permit (PMSP-1) form. (BPC, § 1647.32; CCR, tit. 16, § 1043.9.1, subs. (b).)
  2. A non-refundable application fee of $459.00. (CCR, tit. 16, § 1021, subs. (r).) Check or money order made payable to the Dental Board of California.
  3. A current, active license to practice dentistry in this state, or a current permit issued pursuant to BPC section 1638 or 1640. (BPC, § 1647.31, subd. (a).)
  4. Provide documentation of one of the following (BPC, § 1647.32, subd. (c)):
    1. Successful completion of at least 24 hours of pediatric minimal sedation instruction in addition to one clinical case. Instruction shall include training in pediatric monitoring, airway management, and resuscitation and patient rescue from moderate sedation. Applicant must have their educational institution complete Question 4 of the Certification of Pediatric Minimal Sedation (PMSP-2) form.
    2. Successful completion of a Commission on Dental Accreditation (CODA) approved residency in pediatric dentistry. Applicant must have their educational institution complete Question 4 of the Certification of Pediatric Minimal Sedation (PMSP-2) form.

The completed Application for Pediatric Minimal Sedation Permit (PMSP-1) form, non-refundable application fee, and the Certification of Pediatric Minimal Sedation Training (PMSP-2) form must be submitted by online application or by mail to:

Dental Board of California/Anesthesia Unit
2005 Evergreen St., Suite 1550
Sacramento, CA 95815

New Monitoring Requirements for Pediatric Minimal Sedation Permits issued after 01/01/2022 for Patients Under 13 Years of Age

SB 501 also enacted patient monitoring requirements for the administration of pediatric minimal sedation to patients under 13 years of age as follows:

  • A dentist who administers or order the administration of pediatric minimal sedation shall be physically present in the treatment facility while the patient is sedated. (BPC, § 31, subd. (b).)
  • 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. (BPC, § 32, subd. (a).)

Renewal of Pediatric Minimal Sedation Permit

The PMS permit is renewed biennially, and the renewal fee is $182.00. (CCR, tit. 16, § 1021, subs. (t).) The renewal application and fee submitted online through the BreEZe system at www.breeze.ca.gov, and will be available approximately 90 days prior to the expiration date. If you do not have a BreEZe account, you can register as a new user to create an account. If you have an existing BreEZe account but do not know your username or password, you can follow the Forgot Password?, or Forgot Username? prompts.

Your first renewal may not be valid for a full two years. Your expiration date is based on your birth month and birth year. If you were born in an even year, your permit will expire in an even year. If you were born in an odd year, your permit will expire in an odd year. From the issuance of your permit, your first permit will expire on the last day of your birth month, in the first odd or even year corresponding with your birth year.

After your first renewal, your permit will expire every two years on the last day of your birth month, either in an odd or even numbered year (as based on the year of your birth).

You are exempt from the continuing education requirements for your first PMS permit renewal. Beginning with your second PMS permit renewal, you are required to complete seven units of approved courses related to pediatric minimal sedation.

PMS permit holders will complete a self-certification to certify completion of the required continuing education courses at the time of renewal. Permit holders are required to retain for certificates of course completions for at least three renewal periods.