Okla. Admin. Code § 195:20-1-4

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

Section 195:20-1-4 - Conscious sedation utilizing parenteral methods

(a)Required training. Every dentist who administers conscious sedation using parenteral methods (includes intramuscular (IM), intravenous (IV), intranasal (IN), submucusal (SM), subcutaneous (SC), or intraocular) for dental patients must satisfy at least one of the following requirements:

(1) Has accrued a minimum of sixty (60) hours training in parenteral 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.

(2) Currently hold a permit in the State of Oklahoma to provide general anesthesia (to include deep sedation).

(3) Completion of an American Dental Association Commission on Dental Accreditation approved advanced dental education program which includes at least sixty (60) hours of comprehensive and appropriate training necessary to administer and manage parenteral conscious sedation.

(b)Permits for dentists. No dentist shall administer conscious sedation using parenteral methods for dental patients, unless such dentist possesses a permit or authorization issued by the Oklahoma Dental Board for the administration of conscious sedation using parenteral 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 parenteral conscious sedation shall satisfy all of the following:

(1) Current certification in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) by the American Heart Association.

(2) Two (2) assistants 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, anesthesia or medical emergencies in the dental office. These six (6) hours are in addition to those accrued completing certification or re-certification in BLS and ACLS or PALS.

(d)Facility permit inspections. Each facility of every dentist who authorizes or directly supervises the administration of parenteral conscious sedation in his or her office 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 available to the applicant for review prior to a request for an inspection. A written list of all monitors, emergency equipment, drugs, and other materials which the mobile or portable anesthesia provider agrees to have available at all times while administering parenteral conscious sedation in this facility will be required at the time of inspection. The dentist holding a facility permit can work with or employ:

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

(2) A dentist holding a valid general anesthesia provider permit.

(3) 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 195:20-1-4(f).

(e)Provider permit inspections. The knowledge, techniques, procedures, facilities, drugs, equipment and personnel utilization of every dentist who administers parenteral conscious sedation 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 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 permit applicants will be required to demonstrate the administration of parenteral conscious sedation to a patient in the presence of an evaluation team. 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 parenteral conscious sedation is administered. At least fifty percent (50%) of the inspection team shall be composed of a like trained dentist, unless the dentist to be inspected waives the provision.

(f)Direct supervision of a Certified Registered Nurse Anesthetist (CRNA). A dentist is permitted to directly supervise the administration of parenteral conscious sedation to patients by a CRNA provided the following requirements are satisfied:

(1) Current certification in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) by the American Heart Association.

(2) Complete every three (3) years at least eighteen (18) hours of courses related to the administration of anesthesia, sedation or medical emergencies in the dental office. Hours accrued completing certification or re-certification in BLS and ACLS or PALS shall be accepted towards completion of this eighteen (18) hour requirement.

(3) Hold a valid facility permit as described in 195:20-1-4(d).

(g)Restrictions. No dentist providing parenteral conscious sedation 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 as stated in section 195:20-1-2.

Okla. Admin. Code § 195:20-1-4

Amended at 14 Ok Reg 1547, eff 7-1-97¹; Amended at 16 Ok Reg 3273, eff 5-10-99 (emergency); Amended at 17 Ok Reg 1873, eff 7-1-00

¹On 4-6-99, subsection (d) of the rule promulgated at this cite was declared void and unenforceable by the Oklahoma Court of Civil Appeals, affirming a decision of the District Court of Oklahoma. [See Joseph Seay, D.D.S. v. The Board of Dentistry of the State of Oklahoma, Case No. CJ-97-4607, 12-16-97, Judge Niles Jackson, District Court of Oklahoma County; 70 OBJ 1086] The rule was later amended by emergency rulemaking, effective 5-10-99, and followed by permanent rulemaking, effective 7-1-00.