Making it more difficult to provide minimal sedation will harm the patients who need it the most. We have many patients whose finances are tight, and who are terrified of the dentist. The cheapest method of sedation available is for them to pickup a valium at the local pharmacy and take it a few hours before their appointment. Many of these patients arrive still very fearful and need something further. This leaves us with 2 options. Option 1 is to add some nitrous, which allows us to quickly titrate them to a precise mild sedation level. It's safe, effective, fast, and expelled from the body quickly. Option 2 is to add more pills, which is harder to titrate, slow, and requires significant post op observation time. It also carries an increased risk of oversedation that is much more difficult to correct. This increases the overall cost of the visit, which eliminates dental care for many of the needy. Making mild sedation more expensive and difficult will decrease the overall publics oral health, increase dental ER visits, and reduce access to care. Please do not make VA the most difficult state in the US to offer minimal sedation.