The State Board of Dental Examiners adopts amendments to §108.7, Minimum Standard of Care, General with changes to the proposed text published in the July 20, 2001, issue of the Texas Register (26 TexReg 5330). Changes to §108.7(6) were made.

The amendments to §108.7 results from an effort by the Board and several interested entities, including the three Texas dental schools, the Health and Human Services Commission, and the Texas Department of Health to develop standards for the contents of records required to be maintained by dentists in Texas pertaining to the dental services rendered to patients. The language of paragraph (1) has been modified to drop references to required records, and to refer to §108.8, Records of the Dentist, where specifics are shown. Paragraph (6) has been changed to add the words "...treatment plans and..." as well as "...treatment plans or..." to clarify the requirement for informed consent.

The following entity, Texas Dental Association ("TDA") furnished written comments on the proposed amendments to §108.7(6). Section 108.7(6) provides that each dentist shall conduct his/her practice in a manner consistent with that of a reasonable and prudent dentist under the same or similar circumstance and that each dentist should maintain a written informed consent signed by the patient, or a parent or legal guardian of the patient if the patient has been adjudicated incompetent to manage the patient's personal affairs. Further §108.7(6) provides that such consent is required for all treatment plans and procedures where a reasonable possibility of complications from the treatment plan or procedure exists, and such consent should disclose risks or hazards that could influence a reasonable person in making a decision to give or withhold consent. TDA asks whether this rule requires written informed consent for administration of nitrous oxide and whether a dentist must obtain written informed consent when administering nitrous oxide while performing a Class 1 Amalgam commenting that it can be concluded that a written informed consent for nitrous oxide is recommended but not required in light of comparisons to §108.32(6) (Minimum Standard of Care, Anesthesia) and §108.34 (Permit Requirements and Clinical Provisions). In response to TDA's questions, written informed consent is required where a reasonable possibility of complications from the treatment plan or procedure exists. No changes were made.

TDA further commented that the term "treatment plan" when used for a second time under §108.7(6) should be changed to "treatment planned" to avoid confusion and the term "procedures" when employed a second time should be singular for sentence consistency.

The Board agrees and amends §108.7(6) to read:

(6)...Such consent is required for all treatment plans and procedures where a reasonable possibility of complications from the treatment planned or a procedure exists, and such consent should disclose risks or hazards that could influence a reasonable person in making a decision to give or withhold consent.

The amended rule is adopted under Texas Government Code §2001.021 et. seq; Texas Civil Statutes, the Occupations Code §254.001 which provides the State Board of Dental Examiners with the authority to adopt and enforce rules necessary for it to perform its duties, and to ensure compliance with laws relating to the practice of dentistry.