In addition to their extensive training, Oral and Maxillofacial Surgeons that provide moderate anesthesia or greater are required to obtain a certificate from the state of Hawaii.  Among other things, the Education Department regulations require extensive anesthesia training, certification in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS), and a defibrillator in each office in case of emergencies.   Other equipment is required to monitor patient vital signs and ensure proper airway management.

Each member must also participate in the American Association of Oral and Maxillofacial Surgeon's Office Anesthesia Evaluation.