Most states have implemented a ‘permit’ program and many also have a facility inspection requirement for anesthesia services provided to dental patients.  It is noteworthy that most states have set requirements similar to those in place in Virginia right now (albeit without a permit process).  It would seem prudent to determine to what degree patient safety is greater in those states versus Virginia, a state with similar requirements but without a certificate.  It may, also, be of interest to find out if access is in some amount reduced versus our state.  Safety trumps all else and if there is a measure of gain by having permits, or increasing the requirements needed to provide the various levels of service beyond what is now in place, we should all be for it.  Possibly, this is a place for the proposed “Anesthesia Review Committee” to start to work.  If we believe our current requirements for providing anesthesia services to dental patients are prudent, the objective is reached already. 

The same argument can be used for facility inspections.   If gains in safety can be demonstrated, and without placing onerous barriers to the services, we should proceed.  The proposed “Anesthesia Review Committee” will likely find from other state’s experience, that implementation of state wide inspections by qualified persons, timely and fairly done is a real challenge.  A challenge most states have not been able to meet.