(a) A dentist licensed to practice in Texas who desires to
use enteral conscious sedation either, must have a parenteral conscious sedation
anesthesia permit or a deep/general sedation anesthesia permit issued pursuant
to board rule or must obtain an enteral conscious sedation permit from the
State Board of Dental Examiners. A permit is not required for administration
of Schedule II drugs prescribed for pain control.
(1) A permit may be obtained by completing an application form
approved by the State Board of Dental Examiners, a copy of which may be obtained
from the SBDE.
(2) The application form must be filled out completely and
appropriate fees paid.
(3) Prior to issuance of a sedation/anesthesia permit the Board
may require that the applicant undergo a facility inspection or further review
of credentials. The SBDE may direct an Anesthesia Consultant, appointed pursuant
to board rule to assist in this inspection or review. The applicant will be
notified in writing if an inspection is required and provided with the name
of an Anesthesia Consultant who will coordinate the inspection. The applicant
must make arrangements for completion of the inspection within 180 days of
the date the notice is mailed. An extension of no more than 90 days may be
granted if the designated Anesthesia Consultant requests one.
(4) An applicant for a sedation/anesthesia permit must be licensed
and in good standing with the State Board of Dental Examiners. For purposes
of these rules "good standing" means that a licensee is not suspended, whether
or not the suspension is probated. Applications from licensees who are not
in good standing will not be approved.
(b) The Board may consider a request by a dentist for an on-site
inspection. The Board may, in its discretion and on payment of a fee in an
amount established by the Board, conduct the inspection and issue an advisory
opinion.
(1) An advisory opinion issued by the Board under this section
is not binding on the Board, and the Board, except as provided by paragraph
(2) may take any action in relation to the situation addressed by the advisory
opinion that the Board considers appropriate.
(2) A dentist who requests and relies on an advisory opinion
of the Board may use the opinion as mitigating evidence in an action or proceeding
to impose an administrative penalty. The Board, as appropriate, shall take
proof of reliance on an advisory opinion into consideration and mitigate the
imposition of administrative penalties accordingly.
(c) Once a permit is issued, the State Board of Dental Examiners
upon payment of required fees shall automatically renew the permit annually
unless after notice and opportunity for hearing the Board finds the permit
holder has, or is likely to provide anesthesia/sedation services in a manner
that does not meet the minimum standard of care. At such hearing the Board
shall consider factors including patient complaints, morbidity, mortality,
and anesthesia consultant recommendations.
(d) Annual dental license renewal certificates shall include
the annual permit renewal, except as provided for in subsection (c) of this
section and shall be assessed an annual renewal fee of $5.00 payable with
the license renewal. New permit fees are $28.75 payable with the application
for permit.
(e) Permit Restrictions: the Board may elect to issue a temporary
enteral conscious sedation permit which will expire on a date certain. A full
sedation/anesthesia permit may be issued after the dentist has complied with
requests of the Board which may include, but shall not be limited to, review
of the dentist's anesthetic technique, facility inspection and/or review of
patient records to ascertain that the minimum standard of care is being met.
If a full permit is not issued, the temporary permit will expire on the stated
date, and no further action by the State Board of Dental Examiners will be
required, and no hearing will be conducted.
(f) Educational/Professional Requirements:
(1) To become permitted to administer enteral conscious sedation,
the dentist must satisfy one of the following criteria:
(A) must have completed training consistent with that described
in Part I or Part III of the American Dental Association (ADA) Guidelines
for Teaching the Comprehensive Control of Pain and Anxiety in Dentistry, and
have documented administration of enteral conscious anesthesia/sedation in
a minimum of five cases;
(B) must have completed an ADA accredited post-doctoral training
program which affords comprehensive and appropriate training necessary to
administer and manage enteral conscious sedation;
(C) must have completed the two-day conscious sedation course
in Pediatric Dentistry approved and developed by the American Academy of Pediatric
Dentistry; or
(D) must have completed a two day enteral conscious sedation
course approved by the SBDE.
(2) The following shall apply to the administration of enteral
conscious sedation in the dental office:
(A) the operating dentist must complete at least every three
years appropriate Continuing Education in enteral conscious sedation.
(B) the operating dentist and his/her clinical staff must maintain
current certification in basic cardiopulmonary resuscitation given by the
American Heart Association or the American Red Cross.
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