Enacts new GS 90-30.3 setting forth dental sedation procedures as follows. Defines adverse event, analgesia, anti-anxiety sedative, anxiolysis, ASA guidelines, BLS-certified, general anesthesia, certified registered nurse anesthetist (CRNA), credentialed surgery center, licensed dentist, and sedation procedure.

Requires licensed dentists to hold an unexpired permit issued by the Board of Dentistry (Board) permitting the dentist to administer general anesthesia, moderate conscious sedation, or moderate pediatric conscious sedation, or supervise a CRNA to administer or an RN employed to deliver anesthesia or moderate sedation. Specifies that, before performing sedation procedures in a facility other than a hospital or credentialed surgery center, the licensed dentist must ensure that the Board has been notified that the licensed dentist intends to administer anesthesia or moderate sedation at the facility and must ensure that the facility has passed a facility inspection by the Board in accordance with the Article.

Sets forth standards for facility equipment in facilities where sedation procedures are performed, including required equipment with yearly maintenance and safety checks, required unexpired drugs that are both present and accessible, written emergency and patient discharge protocols accessible from the operatory and recovery rooms, and any additional facility requirements applicable to the permit level as required by the Article or by the Board.   

Sets forth standards for staffing, education, and training requirements prior to performing a sedation procedure, including emergency response training twice per year, requiring all auxiliaries to be BLS-certified, ensuring that a registered nurse or a BLS-certified auxiliary is dedicated to patient monitoring and recording anesthesia or sedation data throughout the sedation procedure unless the licensed dentist or an additional sedation provider (i.e., a licensed dentist holding the permit described above, anesthesiologist, or anesthetist) is dedicated to patient care and monitoring regarding anesthesia or moderate  sedation throughout the sedation procedure and is not performing the surgery or other dental procedure, and any additional staffing, education, and training requirements applicable to the level of the permit, consistent with the article or rules approved by the Board. Sets forth a required preoperative patient evaluation that is required before a sedation procedure, and requirements for post-operative monitoring and discharge. Requires a dentist to maintain certain information in the patient's treatment records for a period of ten years.

Enacts GS 90-30.4 (pertaining to moderate parenteral and enteral conscious sedation clinical requirements and equipment) as follows. Requires that an unexpired muscle relaxant must be immediately available and be accessible from the operatory and recovery rooms, in addition to the required drugs listed in GS 90-30.3. Sets forth further patient history inquiries and processes. Prohibits a moderate conscious sedation licensed dentist from administering any of the following anesthetic or sedative agents: (1) designed for administering general anesthesia or deep sedation, (2) determined by the manufacturer to be contraindicated for use in moderate conscious sedation, and (3) in an amount exceeding the manufacturer’s maximum recommended doses unless the documents in the sedation record state the clinical reason for exceeding that dosage.

Enacts new GS 90-30.5, pertaining to moderate pediatric conscious sedation as follows. Requires that an unexpired muscle relaxant must be immediately available and be accessible from the operatory and recovery rooms, in addition to the required drugs listed in GS 90-30.3. In addition to the requirements set out in GS 90-30.3, the licensed dentist's emergency manual must include assignments to be performed in the event of emergency by a BLS-certified auxiliary dedicated to patient monitoring. Sets forth additional requirements for preoperative assessment. Sets forth requirements if a patient immobilization device is used including how the device is applied, frequent checking of the patient’s head position and respiratory excursions, exposure of a hand or foot, and that the patient is observed at all times by the dentist or a BLS-auxiliary. Prohibits a moderate conscious sedation licensed dentist from administering any of the following anesthetic or sedative agents: (1) designed for administering general anesthesia or deep sedation, (2) determined by the manufacturer to be contraindicated for use in moderate pediatric conscious sedation, and (3) in an amount exceeding the manufacturer’s maximum recommended doses unless the documents in the sedation record state the clinical reason for exceeding that dosage. Sets forth required information to be given to the parent or guardian prior to sedation. Establishes required competencies that a licensed dentist or applicant must demonstrate during an evaluation, including demonstration of the administration of moderate pediatric conscious sedation on a live patient, including the deployment of an intravenous delivery system for those dentists who use IV sedation and for those that don’t, describing the proper deployment of an IV delivery system along with demonstrating moderate pediatric conscious sedation on a live patient.

Enacts GS 90-30.6, which sets forth reporting requirements of adverse events, including process and timeline. Enacts GS 90-30.7 which sets forth requirements for facility inspections and dentist evaluations including required areas of competency (preoperative patient evaluation and procedures; operative procedures, including IV delivery; post-operative monitoring and discharge; and treatment of clinical emergencies). Requires a written exam and reevaluation once every five years.

Makes conforming changes to GS 90-30.1 (pertaining to standards for general anesthesia and enteral and parenteral sedation).

Effective July 1, 2023.

Directs the NC Policy Collaboratory at UNC (Collaboratory) to conduct a study to determine whether a second health care provider who is qualified to provide anesthesia services is needed when utilizing drugs that can lead to deep sedation, such as propofol. Requires the Collaboratory to submit a report to the specified NCGA committee by April 1, 2024, to include any legislative recommendations.