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(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.
The agency certifies that legal counsel has reviewed
the adoption and found it to be a valid exercise of the agency's legal
authority.
Filed with the Office
of the Secretary of
State on May 22, 2014
TRD-201402423 Sarah Carnes-Lemp
General Counsel
State Board of Dental Examiners
Effective date: June 11, 2014
Proposal publication date: March 28, 2014
For further information, please call: (512) 475-0977
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