Okla. Admin. Code § 195:20-1-3.1

Current through Vol. 42, No. 4, November 1, 2024

Section 195:20-1-3.1 - Pediatric conscious sedation utilizing enteral methods (oral, rectal, sublingual)

(a)Required training. Every dentist who administers pediatric conscious sedation using enteral methods (includes oral, rectal, sublingual) or minor tranquilizers in anxiolytic dosages to dental patients ages twelve (12) years and under must satisfy at least one of the following requirements:

(1) Has accrued a minimum of sixteen (16) hours training in enteral conscious sedation techniques given by a faculty member of a recognized teaching institution or hospital, or must have participated in an education program approved by the Board. Didactic and clinical training shall follow the Guidelines for Teaching the Comprehensive Control of Pain and Anxiety in Dentistry, a publication of the American Dental Association. These sixteen (16) hours are in addition to those accrued completing certification or re-certification in Basic Life Support (BLS) for Health Care Providers by the American Heart Association.

(2) Currently holds a provider permit in the state of Oklahoma to administer conscious sedation utilizing parenteral methods or to provide general anesthesia (to include deep sedation).

(3) Satisfactory completion of a postgraduate program in oral and maxillofacial surgery or pediatric dentistry at a dental school approved by either the Commission on Dental Accreditation or a comparable organization approved by the Board.

(4) Satisfactory completion of a general practice residency or other advanced education in a general dentistry program approved by the Board.

(5) Licensed dentists in the state of Oklahoma who have provided pediatric conscious sedation utilizing enteral methods to dental patients ages twelve (12) years and under in a safe, competent, ethical, and effective manner in the past. Such dentists will be grandfathered for one year from the time this rule takes effect on July 1, 2002. The required training ((a) 1,2,3, or 4) shall be completed and/or submitted for permit application prior to July 1, 2003.

(b)Permit for Dentists. No dentist shall administer pediatric conscious sedation using enteral methods (includes oral, rectal, sublingual) or minor tranquilizers in anxiolytic dosages for dental patients ages twelve (12) and under unless such dentist possesses a permit or authorization issued by the Oklahoma Board of Dentistry for the administration of pediatric conscious sedation using enteral methods. Application for such permit will be made to the Board on the prescribed form. A successful credentials review will result in a notification that a formal evaluation can be scheduled. The dentist holding such permit shall be subject to review and such permit must be renewed annually, along with payment of the required fee.

(c)Current training. A dentist who holds a permit for pediatric enteral conscious sedation shall satisfy all of the following:

(1) Current certification in Basic Life Support (BLS).

(2) At least one (1) assistant involved in the procedure currently certified in Basic Life Support for Health Care Providers by the American Heart Association.

(3) Complete every three (3) years at least six (6) hours of courses related to the administration of sedation and medical emergencies. These six (6) hours are in addition to those accrued completing certification or re-certification in BLS.

(d)Facility Permit Inspections. Each facility of every dentist who authorizes the administration of pediatric enteral conscious sedation (includes oral, rectal, sublingual) or minor tranquilizers in anxiolytic dosages in his or her office to dental patients ages twelve (12) years and under shall successfully pass inspection by a consultant or consultants appointed by the Board. This will include an evaluation of the facility's equipment and personnel and will follow the American Dental Association's Guidelines for the Use of Conscious Sedation, Deep Sedation, and General Anesthesia in Dentistry. This evaluation will be on a prescribed form approved by the Board and be available to the applicant for review prior to a request for an inspection. Such dentist is permitted to work with or employ:

(1) A dentist holding a valid pediatric enteral conscious sedation permit.

(2) A dentist holding a valid parenteral conscious sedation permit.

(3) A dentist holding a valid general anesthesia permit.

(4) A Certified Registered Nurse Anesthetist licensed to practice in the State of Oklahoma, provided the dentist who directly supervises the CRNA satisfies the requirements stated in 195:20-1-3(f).

(5) A licensed and trained Allopathic or Osteopathic physician on the anesthesia staff of a hospital accredited by the State of Oklahoma and currently certified in Advanced Cardiac Life Support (ACLS) by the American Heart Association. He or she must personally administer the pediatric conscious sedation using enteral methods and remain on the premises of the dental facility until a full evaluation of the dental patient prior to discharge to a responsible adult is complete.

(e)Provider Permit Inspections. The knowledge, techniques, procedures, facilities, drugs, equipment and personnel utilization of every dentist who administers pediatric enteral conscious sedation or minor tranquilizers in anxiolytic dosages shall successfully pass inspection by a consultant or consultants appointed by the Board. This evaluation will be completed on a prescribed form approved by the Board and be available to the applicant for review prior to an inspection. This form shall follow the American Dental Association Guidelines for the Use of Conscious Sedation Deep Sedation and General Anesthesia in Dentistry. New provider permit applicants will not be required to demonstrate the administration of pediatric enteral conscious sedation to a minor patient in the presence of an evaluation team unless requested to do so at the Board's discretion. In the case of a mobile or portable dentist provider, all inspections of that provider shall be conducted in the office of an Oklahoma licensed dentist where pediatric enteral conscious sedation is administered.

(f)Direct Supervision of a Certified Registered Nurse Anesthetist (CRNA). A dentist is permitted to directly supervise the administration of pediatric enteral conscious sedation or minor tranquilizers in anxiolytic dosages to dental patients by a CRNA provided the following requirements are satisfied:

(1) Hold a valid pediatric conscious sedation by enteral methods provider permit as described in 195:20-1-3(d).

(2) Hold a valid facility permit as described in 195:20-1-3(d).

(g)Restrictions. No dentist providing pediatric enteral conscious sedation or minor tranquilizers in anxiolytic dosages to dental patients ages twelve (12) years and under shall administer or employ any agent(s) which has a narrow margin for maintaining consciousness and would likely render a patient deeply sedated, generally anesthetized or otherwise not meeting the conditions of the definition of conscious sedation stated in section 195:20-1-2. Oral administration of all short acting medications including but not limited to Versed® (Midazalam HCL) and Actiq® (oral transmucosal fentanyl) shall be performed on the dental premise only. Prescriptions for these drug therapies intended for at home pre-medication shall be prohibited.

(h)Exceptions.

(1) The administration of nitrous oxide and oxygen with or without local anesthesia to patients of any age does not require this permit.

(2) A dentist providing enteral conscious sedation or minor tranquilizers in anxiolytic dosages to any dental patients ages thirteen (13) years and older is not required to have an enteral conscious sedation permit. However, the minimum standards for dentists utilizing enteral conscious sedation as described in 195:20-1-7 shall apply.

Okla. Admin. Code § 195:20-1-3.1

Added at 19 Ok Reg 2027, eff 7-1-02