Texas Register

RULE §110.17Sedation/Anesthesia of Pediatric Patients
ISSUE 03/09/2018
ACTION Proposed
Rule Withdrawn: 06/07/2018
Preamble Texas Admin Code Rule

(a)"Pediatric patient" means a patient younger than 13 years of age.

(b)A permit holder may not administer sedation/anesthesia under a level 2, level 3, or level 4 permit to a pediatric patient unless the permit holder has:

  (1)completed a university or hospital-based residency at least 12 months in length; or

  (2)completed a board-approved education program that includes a minimum of sixteen (16) hours of didactic training and instruction in sedation/anesthesia of pediatric patients. Successful completion of the program must include passing an examination covering the course components. Didactic education must include:

    (A)pre-anesthetic patient assessment/evaluation for pediatric patients;

    (B)physical evaluation and medical history of pediatric patients, including obesity, limited neck mobility, micro/retrognathia, macroglossia, tonsillar obstruction % (Malampatti), and limited oral opening;

    (C)pediatric anatomical and physiological differences;

    (D)pediatric respiratory assessment, including airway anatomy, physiology, and management;

    (E)informed consent by parent, guardian, or care-giver;

    (F)sedation/anesthesia pharmacology;

    (G)sedation/anesthesia management of pediatric patients;

    (H)pediatric patient monitoring;

    (I)peri-operative patient assessment;

    (J)emergency management of pediatric patients including pediatric anesthesia equipment and resuscitation supplies;

    (K)sedation/anesthesia technique;

    (L)sedation/anesthesia record keeping;

    (M)patient recovery and discharge; and

    (N)pediatric case selection and reference behavior scale; and

  (3)completed satisfactory management of sedation/anesthesia in at least fifteen (15) cases involving pediatric patients sedated/anesthetized at the highest level of permit held. The cases must include at least three (3) live cases in which the permit holder is the primary sedation/anesthesia provider, no more than seven (7) cases observed on live patients, and no more than five (5) cases performed as part of a hands-on high-fidelity sedation simulation center or program. All of the cases must be performed and documented under the on-site instruction and direct supervision of a licensed dentist authorized to administer sedation/anesthesia to pediatric patients.

(c)A permit holder is authorized to administer sedation/anesthesia under a level 2, level 3, or level 4 permit to a pediatric patient if they have completed the requirements above. The permit holder must attest to their advanced training in pediatric patients on their initial and/or renewal permit application and they will be required to produce proof of completion as part of a permit inspection or an investigation of a complaint involving sedation/anesthesia of a pediatric patient.

(d)The education hours described in subsection (b)(2) of this section can be applied towards the permit holder’s continuing education requirement for maintaining a sedation/anesthesia permit.

(e)The requirements described in subsection (b)(2) and (3) of this section may not be fulfilled by the same didactic and clinical training used to fulfill the requirements for initial permit issuance.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on February 26, 2018


Tyler Vance

Interim Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: April 8, 2018

For further information, please call: (512) 475-0977

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