Dental Sedation and Anesthesia Permits by State

A dental license lets you practice dentistry. It does not let you sedate patients beyond the lightest levels. Every state we have checked runs a separate permit system for sedation and general anesthesia, and the permit belongs to the state that issued it. When you move or start practicing in more than one state, each sedation permit has to be earned again under that state's rules, even if you have held the same level of permit for twenty years somewhere else.

The Dentist and Dental Hygienist Compact does not change this. Its FAQ says that if a state "requires additional testing, training, or permits/certifications to perform certain procedures (e.g., sedation/anesthesia permits for dentists, or administration of local anesthesia for dental hygienists), practitioners would be required to complete those requirements." The compact is also not issuing privileges yet; see our compact hub for its status.

Do states divide sedation into the same permit levels?

Most states sort permits by depth of sedation and route of administration, and some add an age split for children. The labels differ, which is the first trap for anyone comparing states.

• Texas requires a permit for five separate categories: nitrous oxide/oxygen inhalation sedation; Level 1 minimal sedation; Level 2 moderate sedation limited to enteral routes; Level 3 moderate sedation that includes parenteral routes; and Level 4 deep sedation or general anesthesia (22 Tex. Admin. Code § 110.2).
• California issues a General Anesthesia permit, a Moderate Sedation permit, a Pediatric Minimal Sedation permit and an adult Oral Conscious Sedation certificate, plus Pediatric Endorsements that sit on top of the general anesthesia and moderate sedation permits (Dental Board of California permit pages; 16 CCR § 1021).
• New York has five dental anesthesia certificates: General Anesthesia; Parenteral Conscious (Moderate) Sedation for patients 13 and older; Parenteral for patients 12 and younger; Enteral Conscious (Moderate) Sedation for 13 and older; and Enteral for 12 and younger (NYSED dental anesthesia/sedation certification page).
• Illinois issues Permit A for moderate (conscious) sedation and Permit B for deep sedation and general anesthesia (68 Ill. Admin. Code §§ 1220.510 and 1220.520).
• Georgia does not require a permit when the intent is minimal sedation, but moderate sedation requires a Moderate Enteral or Moderate Parenteral Conscious Sedation permit "based on a credentials review" (Ga. Comp. R. & Regs. 150-13-.01).

So a dentist with an Illinois Permit A who is moving to Texas has to work out whether the procedures they actually perform fall under Level 2 or Level 3, and a dentist moving to New York has to decide whether they need the 12-and-younger certificate as well as the adult one.

Which training does each level require?

Training rules are where files most often fail, because a course that satisfied one board may not match another board's hours or case count.

Nitrous and minimal sedation

Texas requires at least 14 hours of nitrous oxide training with a clinical component for the nitrous permit (22 TAC § 110.3) and at least 16 hours of didactic training for a Level 1 minimal sedation permit (§ 110.4), in both cases consistent with the ADA's Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students. New York's statute, by contrast, says nothing in its certificate law limits a dentist's use of nitrous oxide (N.Y. Educ. Law § 6605-a).

Moderate sedation

Illinois Permit A calls for an anesthesiology training program of at least 75 hours of didactic and clinical study with supervised experience sedating 20 or more patients, completed within one calendar year, plus current ACLS or PALS (68 IAC § 1220.510). California's Moderate Sedation permit requires training that includes at least 20 cases of the applicant's own administration of moderate sedation and certification of competence in rescuing patients from deeper sedation (Dental Board of California, Moderate Sedation Permits). New York's parenteral certificate for patients 13 and older requires a formal course of at least 60 clock hours plus intravenous sedation of at least 20 live dental patients, one doctor per patient. Georgia's adult enteral permit can rest on a board-approved course of at least 24 didactic hours, 8 of them in person, plus management of at least 10 adult patient experiences, which may include simulated cases (150-13-.01(6)).

Deep sedation and general anesthesia

At this level states lean on formal residency training. Texas requires a CODA-accredited advanced education program that covers deep sedation or general anesthesia, plus BLS and either ACLS or PALS, and PALS for anyone treating children 12 or younger (22 TAC § 110.6). California requires completion of a CODA-accredited residency in general anesthesia or in oral and maxillofacial surgery, plus ACLS. Illinois Permit B requires two years of advanced anesthesiology training, diplomate status or an active application with the American Board of Oral and Maxillofacial Surgery, or an Illinois OMS specialty license. New York requires three years of post-doctoral anesthesia education (for programs completed from January 1, 2019) or a graduate program in oral and maxillofacial surgery, plus ACLS, and PALS for general anesthesia on patients 12 and younger.

Where does the board inspect the office?

Facility review is part of the permit in several states, and it adds calendar time you cannot control.

• Texas may require a facility inspection or further review of credentials before issuing a sedation or anesthesia permit. If it does, you must arrange the inspection within 180 days of the notice, with at most a 90-day extension (22 TAC § 110.2(b)(3)).
• California conducts an onsite inspection and evaluation of a general anesthesia permit holder's facility, equipment, personnel and procedures within one year of the initial permit and every five years after that. The fee is $2,000, and refusing the inspection means automatic denial or revocation (Dental Board of California, citing Bus. & Prof. Code § 1646.4 and 16 CCR § 1021(u)).
• Illinois may require more documentation or an on-site evaluation of facilities, equipment and personnel if the submitted documents raise questions (68 IAC § 1220.510(f)).
• Arizona's statute directs the board to require a permit for general anesthesia and sedation, to collect a fee of not more than $300, and to conduct inspections to ensure compliance (Ariz. Rev. Stat. § 32-1207(E)).

How much do sedation permits cost?

These are the figures in the rules and board pages we read in October 2026. Fees change, so confirm the current amount with the board before paying.

• California: $524 to apply for a General Anesthesia or Moderate Sedation permit, $325 renewal, $459 for a Pediatric Minimal Sedation permit, $459 for adult oral conscious sedation, $532 for each Pediatric Endorsement, and $2,000 for the general anesthesia or moderate sedation onsite inspection and evaluation (16 CCR § 1021).
• Illinois: $300 to apply for a sedation permit and $300 to renew it, which the rule describes as $100 per year (68 IAC § 1220.415).
• New York: $100 for a dental anesthesia certificate, paid every three years at renewal (N.Y. Educ. Law § 6605-a).
• Arizona: a statutory cap of $300 for the permit fee (A.R.S. § 32-1207(E)).

Does a sedation permit carry extra jurisprudence or reporting duties?

Often, yes. Texas requires a sedation permit applicant to have passed the Chapter 110 (Sedation and Anesthesia) component of its jurisprudence examination within one year before applying (22 TAC § 110.2(b)(5)). Florida's statute requires a dentist to notify the board in writing by certified mail within 48 hours after an adverse incident in the dentist's outpatient facility and to file a complete written report within 30 days, and it defines adverse incidents to include injuries requiring hospitalization during or as a result of general anesthesia, any level of sedation, nitrous oxide or local anesthesia (Fla. Stat. § 466.017). Illinois requires 9 hours of sedation technique continuing education per renewal cycle for permit holders, separate from BLS (68 IAC §§ 1220.510 and 1220.520). Our jurisprudence exam guide covers the exams themselves.

Which documents go into a sedation permit file?

1. Proof of the underlying license. Most states issue sedation permits only to dentists already licensed there, so the permit application usually follows the license. California, for example, requires a current, active California license in good standing (or a permit under Bus. & Prof. Code §§ 1638 or 1640).
2. Training certificates that match the state's hours. Course completion certificates, residency certificates and, where required, a signed training form from the program.
3. Case documentation. California and New York ask for case counts and, for pediatric endorsements or endorsement of an out-of-state certificate, redacted patient records.
4. Life support cards. BLS, ACLS and PALS as the level requires, current on the date the board reviews the file.
5. Facility and team attestations. Illinois requires a signed affidavit about facility equipment and an anesthesia team that includes trained hygienists or assistants.
6. Inspection scheduling where the state inspects.

Our post on moving your sedation permit to a new state walks through the out-of-state version of this file.

Can we handle the sedation permit paperwork for you?

We can prepare it. Our Sedation & Anesthesia Permit service is $699 per permit. We read the state's rule, map your training and cases against it, build the document set and the case logs, give you a question-by-question guide to the application, schedule any inspection and track the file with the board. You complete and sign the application, pay the board and submit it, because permit applications, like license applications, carry your own attestations. Board, inspection and course fees are separate. Start with the state index to see each state's licensing rules, including Texas, California and New York.