The State Board of Dental Examiners (Board) adopts an amendment to 22 TAC §110.13, concerning the Board's requirements for a checklist to be completed by dentists administering nitrous oxide and levels 1 through 4 of sedation/anesthesia. This amendment to the existing rule clarifies the responsibilities and obligations for licensees completing the checklist, and the applicable requirements for each level of sedation/anesthesia permit. This amendment is adopted with changes to the proposed text as published in the January 18, 2019, issue of the Texas Register (44 TexReg 313) and will be republished.

After publication in the Texas Register, Board staff changed the proposed text of the rule to reflect updated references to Texas Occupations Code §258.001(4) in subsection (b), Board rule 22 TAC §108.8 in subsections (a) and (b), and Board rules 22 TAC §§110.3 - 6 in subsection (c) of the amended rule. No other changes were made to the proposed text.

Two comments were received after publication of the proposed rule amendment during the official comment period.

The Texas Dental Association offered a comment in support of the rule as proposed, and notes in part that auscultation is not required to be performed on every patient prior to administering nitrous oxide, and the anesthesia-specific physical examination is specific to the level of sedation/anesthesia being administered, permitting dentists to exercise their judgement when documenting the adequate patient evaluation prior to the delivery of sedation/anesthesia. The Board agrees with this comment and has made no changes to the proposed text as a result of this comment.

The Texas Academy of General Dentistry offered a comment requesting clarification that changes to the rule by the proposed amendment would no longer require providers administering nitrous oxide/oxygen inhalation sedation to auscultate patients. The Board notes that subsection (c)(5) of the rule text as proposed states that a provider must conduct an "anesthesia-specific physical examination including documentation of the following as necessary for the level of sedation/anesthesia administered," but does not require auscultation of all patients. As a result, the Board feels that the text as proposed is clear in permitting patient observation if appropriate under the level of sedation/anesthesia administered, and has made no changes to the proposed text as a result of this comment.

This rule is adopted under Texas Occupations Code §258.153(b)(7) which requires the Board to adopt rules to establish the minimum components required to be included in a preoperative checklist to be used before administering sedation/anesthesia to a patient.

This rule implements the requirements of Texas Occupations Code §258.153(b)(7).