First, thank you for listening to my comments.  As a practicing general dentist who includes sedation dentistry as a part of my practice to help those in fear of the dentist, I implore you to reconsider the restrictions being proposed for MINIMAL sedation.  Having a fear of the dentist is like having a fear of snakes.  Could you imagine being in a den of slithering snakes and you hate snakes? That is what patients have described as the heart-pounding experience they have even from simply picking up the phone to call our office.  These patients are dying inside from their lack of oral care and all is compounded by systemic disease working in synergy to their early demise.  They need our help to SAFELY and EASILY gain access to care through sedation.  

Your proposal would require IV sedation equivalent training for perhaps only a quadrant of dentistry. I am a fan of continual learning, but it has to make sense.  Oral sedation is already proven to be the most safe method for helping phobic patients.  If the ADA guidelines are not this restrictive, why are Virginia's?  The best way to increase patient safety is not with arbitrary regulation and dosage requirements, but with adequate training, equipment, and patient monitoring.  How does IV sedation training equate to safer oral sedation administration?  My goal is minimal sedation if at all possible, but the patient has to be comfortable.  Nitrous oxide in addition to the sedative is key to realizing lower dosages of medications.   However, some patients just will need more than this proposal allows, and that is bad for the patient if this regulation passes. 

Tooth pain is real and so is the fear of the dentist.  Please do not pass these restrictions that will make it even harder for patients to receive and afford these services to improve their health. If dentists are required to attend these expensive courses for additional, unnecessary training, the cost is passed along to the patients.  Patients can be safe and healthy WITHOUT these hefty restrictions and extra fees.  My colleagues should be able to perform minimal sedation including nitrous oxide safely to improve access to care without arbitrary dose requirements.  Please reconsider, and thank you for your time.