(a) A dentist may diagnose, treat, operate, or prescribe
for a disease, pain, injury, deficiency, deformity, or physical condition
of the human teeth, oral cavity, alveolar process, gums and jaws,
and provide surgical and adjunctive treatment for directly related
and adjacent masticatory structures.
(b) Screening for Sleep Disorders.
(1) A dentist may screen a dental patient for benign
snoring and obstructive sleep apnea (OSA) by using validated subjective
and objective screening tools. Subjective measures may include but
not are limited to Epworth Sleepiness Scale, Stop-Bang Scoring Tool,
and Apnea Risk Evaluation System. Objective measures may include but
are not limited to evaluation of the oropharyngeal areas, arch forms,
tongue size, neck size, Mallampati classification, other morphometric
measures, and sleep studies. Sleep studies must be interpreted by
a Texas licensed physician.
(2) Any screening shall be for the sole purpose of
identification of contraindications to dental treatment or identification
of benign snoring and OSA in order to refer the patient to a Texas
licensed physician to confirm or rule out OSA, and not be for the
purpose of the dentist diagnosing or ruling out OSA.
(c) Dental Treatment.
(1) A dentist may independently diagnose, treat, and
monitor any dental comorbidity related to benign snoring or OSA. A
dental comorbidity may include, but is not limited to, periodontal
disease, bruxism, occlusal disorders, temporomandibular joint disorders,
and deformities of the soft palate, tongue, and uvula. A dentist should
consider referral to a Texas licensed physician to diagnose or rule
out OSA in accordance with the standard of care.
(2) A dentist may treat and monitor benign snoring,
when no apneic episodes are reported or discovered, with an oral appliance
only after consideration of referral to a Texas licensed physician
in accordance with the standard of care.
(3) A dentist may not treat or monitor OSA without
collaboration with a Texas licensed physician.
(4) An oral appliance shall only be fabricated by a
Texas licensed dentist or by a Texas registered dental lab under a
prescription or work order prepared by a dentist.
(d) A dentist who treats benign snoring or OSA must
provide, on a yearly basis, adequate follow up of the orthotics, stability
and health of occlusion and orofacial musculoskeletal system.
(e) A dentist treating a patient for benign snoring
or OSA shall comply with the Dental Practice Act and Board Rules,
including but not limited to provisions related to fair dealing, standard
of care, records, and business promotion.
(f) A dentist shall maintain records as required by
the Dental Practice Act and Board Rules including, but not limited
to records related to treatment planning, recommendations and options,
informed consent, consultations and recommended referrals, and post
treatment recommendations.
(g) A dentist who treats or monitors benign snoring
or OSA, as described above, shall complete, during the first year
of treating or monitoring benign snoring or OSA, 12 hours of minimum
basic education in sleep-disordered breathing from an educational
venue (a combination of didactic and clinical education). For each
subsequent year that a dentist treats or monitors benign snoring or
OSA, the dentist shall complete 3 hours of education in sleep-disordered
breathing.
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