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Rule 4715-5-01 | Criteria for admission to dental licensing examination.
The Ohio state dental board will admit to examination only those persons who have graduated from a dental college which was accredited at the time of graduation, or who has received certification from the dean of the accredited dental college stating the applicant will be graduating from the dental college and who have met the requirements set forth in section 4715.10 of the Revised Code. Last updated December 6, 2023 at 1:06 PM Supplemental Information |
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Rule 4715-5-01.1 | Requirements for initial licensure for dentists.
(A) Applicants for licensure to practice dentistry as provided in sections 4715.10, 4715.11 and 4715.12 of the Revised Code, shall furnish satisfactory proof of the following on a form prescribed and provided by the state dental board: (1) Be at least eighteen years of age; and (2) Be of good moral character; and (3) Be a graduate of an accredited dental college, or a graduate of an unaccredited dental college located outside the United States and meets the requirements set forth in rule 4715-18-01 of the Administrative Code; and (4) Has successfully passed all parts of the examination given by the joint commission on national dental examinations; and (5) Provides evidence of successfully passing all components based on a conjunctive scoring method of one of the following regional board examinations: the North east regional board of dental examiners, inc. (NERB), the Central regional dental testing service, inc. (CRDTS), the Southern regional testing agency, inc. (SRTA), or the Western regional examining board (WREB); or (6) Possesses a license in good standing from another state for five years and has actively engaged in the legal and reputable practice of dentistry in another state or in the armed forces of the United States, the United States public health service, or the United States department of veterans' affairs for five years immediately preceding application. (7) Have successfully completed a dental residency program accredited or approved by the commission on dental accreditation and administered by an accredited dental college or hospital, as attested to by the director of the program on a form prescribed and provided by the board. (B) Each applicant shall successfully pass a written jurisprudence examination approved by the state dental board on the statute and rules governing the practice of dentistry in the state of Ohio. Last updated November 30, 2023 at 2:43 PM Supplemental Information |
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Rule 4715-5-02 | Written work authorization.
(A) The Ohio state dental board hereby prescribes that the written work authorization required in division (B) of section 4715.09 of the Revised Code shall be on printed forms for both original and copy and shall contain the following: (1) The name and address of the entity or person to whom the written work authorization is directed, hereinafter referred to as "primary contractor". (2) The patient's name and/or identifying number. In the event such identifying number is used, the name of the patient shall be written upon a copy of such written work authorization retained by the dentist. (3) A description of the work to be done, with diagrams if applicable. (4) A description of the type of the materials to be used. (5) The actual date on which the authorization was written. (6) The original signature in ink by the dentist issuing the said written work authorization, his state dental license number and his office address. (7) A section to be completed by the primary contractor and returned to the issuing dentist that shall disclose all of the following information and certify that the information is accurate by including the signature of a responsible party of the primary contractor: (a) A list of all materials in the composition of the final appliance; (b) The location where the appliance was fabricated, including the name, address, phone number and FDA registration number, if applicable, of the person or entity performing the work; (c) The location, including name, address, phone number and FDA registration number, if applicable, of any sub-contractors utilized to perform some or all of the services relative to the fabrication of the appliance; (d) A description of all disinfection methods used in the fabrication of the appliance. (B) Upon request, the dentist shall provide each patient or authorized patient representative with a duplicate copy of the section of the form described in paragraph (A)(7) of this rule. (C) The dentist shall retain a copy of the written work authorization for two years from its date as a part of the patient record. (D) The primary contractor shall retain the original work authorization for two years from its date. Copies of work authorization forms shall be open for inspection by the Ohio state dental board and its investigators. (E) If the primary contractor receiving a written work authorization from a licensed dentist engages another unlicensed person, partnership, association, or corporation (herein referred to as "sub-contractor") to perform some of the services relative to such work authorization, as provided for in division (C) of section 4715.09 of the Revised Code, he or it shall notify the issuing dentist in advance of the fabrication of the appliance of the name and location of the subcontractor and shall furnish a written sub-work authorization with respect thereto on forms prescribed by the state dental board. The sub-contractor shall retain the sub-work authorization and the primary contractor shall retain a duplicate copy, attached to the work authorization received from the licensed dentist, for inspection by the state dental board or its duly authorized agents, for a period of two years. Copies of work authorization forms shall be open for inspection by the Ohio state dental board and its investigators. (F) The foregoing does not prohibit the inclusion of additional information on the written work authorization when the same is necessary or desirable. (G) "Unlicensed person, partnership, association or corporation" as used in this rule, includes, but is not limited to, dental laboratory or dental laboratory technician. (H) "Appliance" as used in this rule, includes, but is not limited to, any denture, plate, bridge, splint, crown, veneer, or orthodontic or prosthetic dental device. Last updated September 8, 2023 at 1:54 PM Supplemental Information |
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Rule 4715-5-03 | Examination for dentists.
(A) In order to fulfill the requirements of division (D)(1) of section 4715.10 of the Revised Code and paragraph (A)(5) of rule 4715-5-01.1 of the Administrative Code, each applicant for licensure to practice dentistry in the state of Ohio must provide evidence of a passing score on each component of the regional examination as established by the agency for the component. (B) In cases wherein the regional examining agency has not established passing scores for each component of the examination the board requires that each component must be passed by a minimum seventy-five per cent. Last updated September 8, 2023 at 1:54 PM Supplemental Information |
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Rule 4715-5-04 | Specialty designation.
(A) A licensed dentist is recognized as a specialist in Ohio if the dentist meets the standards set forth in paragraph (B) of this rule. Any licensed dentist who does not meet the standards set forth in paragraph (B) of this rule is a general dentist. A general dentist is permitted to render specialty services in Ohio. (B) A licensed dentist must comply with the following requirements before being recognized as a specialist in Ohio: (1) The indicated specialty(s) of dentistry must be those for which there are certifying boards recognized by the American dental association; and (2) The licensed dentist seeking specialty recognition must have successfully completed a post-doctoral education program for each specialty, which post-doctoral education program, at the time of completion, was accredited or held "preliminary provisional approval" or "accreditation eligible status" by the American dental association commission on dental accreditation; or (3) The requirements of paragraph (B)(2) of this rule shall not apply to otherwise qualified specialists who have announced their specialty or designation prior to August 1, 1974. (C) The use of the terms "specialist", "specializes" or the terms "orthodontist", "oral and maxillofacial surgeon", "oral and maxillofacial radiologist", "periodontist", "pediatric dentist", "prosthodontist", "endodontist", "oral pathologist", or "public health dentist" or other similar terms which imply that the dentist is a specialist may only be used by licensed dentists meeting the requirements of paragraph (B) of this rule. (D) All licensed dentists who advertise services must comport with rules 4715-13-01 to 4715-13-05 of the Administrative Code. (E) Rules regarding the advertising of specialty services are specifically set forth in rule 4715-13-05 of the Administrative Code. Supplemental Information |
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Rule 4715-5-05 | Use of general anesthesia and deep sedation.
(A) No dentist shall administer general anesthesia or deep sedation to a patient of any age in the state of Ohio unless such dentist possesses a general anesthesia permit issued by the board or has obtained provisional general anesthesia privileges as set forth in paragraph (C) of this rule. The dentist holding such a permit shall be subject to review and such permit must be renewed biennially. No dentist shall administer or employ any agent(s) with a narrow margin for maintaining consciousness including, but not limited to, potent volatile anesthetic agents, ultra-short acting barbiturates, propofol, ketamine, and similarly acting drugs, or a quantity of agents, or techniques, or any combination thereof that would likely render a patient deeply sedated, generally anesthetized or otherwise not meeting the conditions of the definition of minimal sedation or moderate sedation in paragraph (B) of rule 4715-3-01 of the Administrative Code, unless the dentist holds a valid general anesthesia permit or provisional general anesthesia privileges issued by the board. (B) General anesthesia permit - In order to receive a general anesthesia permit, the dentist must apply on a prescribed application form to the board, submit the application fee, and produce evidence showing that he or she: (1) Has completed one of the following: (a) An advanced dental education program accredited by the commission on dental accreditation which affords appropriate training necessary to competently administer deep sedation and general anesthesia; or (b) A post-doctoral training program in anesthesiology from an approved accredited educational institution or program that affords comprehensive and appropriate training necessary to competently administer and manage deep sedation and general anesthesia commensurate with the American dental association (ADA) "Guidelines for Teaching the Comprehensive Control of Pain and Anxiety at the Advanced Education Level (Part 2)" in effect at the start of their training, if training took place prior to accreditation by the commission on dental accreditation of dental anesthesia residencies (one year training prior to July 1, 1993, and two years thereafter). (2) Has a properly equipped facility(s), whether fixed, mobile, or portable, for the administration of general anesthesia or deep sedation in which the permit holder has available and agrees to utilize adequate monitoring, personnel, emergency equipment and drugs as recommended in the "Guidelines for the Use of Sedation and General Anesthesia by Dentists" as adopted by the October 2016 American dental association house of delegates and/or the American association of oral and maxillofacial surgeon's "Office Anesthesia Evaluation Manual," 9th edition; and (3) At the time of application, maintains successful completion of basic life support for healthcare providers (BLS-HCP) and advanced cardiac life support (ACLS) course(s). (C) Provisional privileges - Prior to the issuance of a general anesthesia permit, if the applicant dentist meets the requirements set forth in paragraph (B) of this rule: (1) The board shall issue to the applicant dentist provisional general anesthesia privileges valid for up to one year pending successful completion of the clinical onsite evaluation; (2) Unless otherwise authorized by the board, a dentist with provisional general anesthesia privileges shall request an extension no later than ninety days before the expiration of their provisional privileges if necessary to complete the onsite evaluation. (D) Onsite clinical evaluation (1) Prior to the issuance of a general anesthesia permit, the board shall require an on-site evaluation of the facility(s) equipment, personnel, anesthetic techniques, and related document(s) to determine if the aforementioned requirements have been met. This evaluation shall be conducted by a qualified consultant appointed by the board and will follow the October 2016 "Guidelines for the Use of Sedation and General Anesthesia by Dentists" as adopted by the American dental association house of delegates and/or the American association of oral and maxillofacial surgeons "Office Anesthesia Evaluation Manual," 9th edition; (2) In the case of a mobile or portable facility, one inspection of that facility shall be conducted in the office of an Ohio licensed dentist where deep sedation or general anesthesia is administered. A written list of all monitors, emergency equipment, and other materials which the mobile anesthesia provider agrees to have available at all times while administering moderate sedation, deep sedation, and general anesthesia in multiple locations shall be provided to the board; (3) The applicant shall be responsible for the cost of this evaluation not to exceed four hundred dollars. (E) Unsatisfactory permit application - In the event the board deems the application or evaluation unsatisfactory, a written explanation documenting deficiencies and suggested remedies shall be forwarded to the applicant. The board may issue a permit based on documentation that deficiencies have been corrected; or the board may require a reevaluation; or the board may issue a notice of opportunity for hearing pursuant to Chapter 119. of the Revised Code to deny the application for a general anesthesia permit. (F) Permit renewal - The board shall without charge renew the general anesthesia permit biennially at the time of dental licensure renewal, provided the permit holder attests to the board that the permit holder: (1) Maintains successful completion of: (a) A basic life support course for healthcare providers (BLS-HCP); (b) A course in advanced cardiac life support (ACLS) and, for anesthetic care of children under eight years of age, pediatric advanced life support (PALS); and (c) A minimum of six hours of board approved continuing education devoted specifically to the management and/or prevention of emergencies which may result from the use of deep sedation and general anesthesia. (2) Has performed emergency drills at least quarterly during the biennium, documenting in a log the date, nature of simulated emergencies and names and roles of all participants. Required simulated emergencies include, at least annually, the following scenarios: (a) Recognition and management of chest pain progressing to cardiac arrest; (b) Hypotensive, hypertensive, bradycardic and tachycardic emergencies; (c) Recognition and management of loss of capnography tracing requiring appropriate management of the airway and of the underlying cause, e.g. anesthetic overdose, secretions, etc. due to: (i) Hypoventilation that progresses to respiratory arrest; (ii) Soft tissue or foreign body obstruction of the airway; (iii) Laryngospasm; and (iv) Bronchospasm. (d) Unexpected decline in level of consciousness, including consideration of multiple possible etiologies, e.g. oversedation, stroke, street drug use, hypoxia, anaphylaxis, etc.; and (e) In offices where deep sedation or general anesthesia is performed less frequently than quarterly, or for the first time, the requirement for emergency drills may be satisfied by performing emergency drills for, at a minimum, all of the above scenarios immediately preceding the administration of deep sedation or general anesthetic for an actual patient. (3) Is in compliance with all requirements of paragraphs (J) and (K) of this rule; (4) Has reviewed the laws and rules governing the administration of deep sedation and general anesthesia; and (5) Verified that all licensed/registered personnel involved in the administration of deep sedation and general anesthesia maintain current, active, licensure or registration. (G) Reciprocity - The board may grant a general anesthesia permit to a dentist who has administered general anesthesia in another state when training as outlined in paragraph (B)(1) of this rule was completed more than two years before the submission of the application and the applicant provides a log of all general anesthesia cases performed during the previous two years. A minimum of twenty cases logged in the preceding two years is required to demonstrate current competency. The board may request complete general anesthesia records of cases selected from this log. (H) Certified registered nurse anesthetist (CRNA) - A dentist holding a general anesthesia permit may supervise a licensed CRNA for any anesthetic procedures for which the dentist is qualified by permit. The permitted dentist must provide direct, personal, on-site supervision of the CRNA throughout the entire anesthesia time. (I) Facility notification - All permit holders shall provide written notification within ten days to the board if anesthesia services are provided at any new facility(s) other than those already listed with the board. (J) Employing general anesthesia provider - A dentist who employs or works with a general anesthesia provider must: (1) Ensure that the general anesthesia provider meets the requirements defined in paragraph (B) of rule 4715-3-01 of the Administrative Code; (2) Ensure that the facility meets the requirements set forth in paragraph (B)(2) of this rule; and (3) Be currently certified in basic life support for healthcare providers (BLS-HCP) and able to assist the general anesthesia provider in an emergency if needed. (K) Anesthetic team - During deep sedation or general anesthesia for a patient eight years of age or over, the following three persons must be physically present in the room and caring exclusively for the patient under anesthesia: (1) A general anesthesia provider; (2) Either of the following: (a) An Ohio-licensed dentist with current BLS-HCP or ACLS certification who can assist the anesthesia provider in an emergency if needed; or (b) An individual currently certified in BLS-HCP who is experienced in patient monitoring and documentation and whose duties are solely dedicated to patient monitoring and documentation and, if needed, assisting the general anesthesia provider in an emergency. (3) One individual whose duties may include assisting with dental procedures. (L) Anesthetic team for very young patients - During deep sedation or general anesthesia for a patient under eight years of age, the following three persons must be physically present in the room and caring exclusively for the patient under anesthesia: (1) Either of the following: (a) A general anesthesia provider with current certification in pediatric advanced life support (PALS) who exclusively administers and monitors the anesthetic and is not otherwise involved with the dental procedure; or (b) A general anesthesia provider with current certification in PALS who is also involved in the dental procedure and who maintains a log of performing deep sedations or general anesthetics for a minimum of twenty cases per year or an aggregate of at least forty cases in children under eight years of age during the preceding twenty-four month period. (2) Either of the following: (a) An Ohio-licensed dentist with current certification in PALS who is able to provide emergency assistance to the general anesthesia provider if needed; or (b) An individual currently certified in BLS-HCP who is experienced in patient monitoring and documentation and, if needed, able to assist the general anesthesia provider in an emergency. (3) One individual whose duties may include assisting with dental procedures. (M) Post-anesthetic monitoring - Once the patient has regained consciousness and responds appropriately to light tactile stimulation or verbal command, the patient's recovery must be monitored by an individual who is experienced in patient monitoring and documentation and is certified in BLS-HCP. (N) Supervision of care - A general anesthesia provider must remain on the premises of the dental facility until any patient given deep sedation or general anesthesia regains consciousness and has been discharged. Once the patient has regained consciousness and responds appropriately to light tactile stimulation or verbal command, further recovery until ready for discharge must be monitored by one person as described in paragraph (J)(1) or (J)(2) of this rule. (O) Reevaluation - The board may, upon informing the permit holder in writing, conduct at any time an evaluation, as described in paragraph (D) of this rule, of the permit holder's facility(s) and/or methods. In determining whether such evaluation is necessary, the board shall consider such factors as it deems pertinent including, but not limited to, patient complaints, reports of adverse occurrences, and random quality assurance audits. Such quality assurance audit(s), may include, but are not limited to, a review of documentation of pre-anesthetic evaluation(s), anesthetic and recovery records, and documentation of appropriateness for discharge, The permit holder shall be responsible for any costs incurred in a formal reevaluation, not to exceed four hundred dollars. (P) Reference materials for paragraphs (B)(1)(b) and (B)(2) of this rule may be found at the following addresses: (1) American dental association: 211 E. Chicago avenue, Chicago, Illinois, 60611-2678; telephone - 312-440-2500; facsimile - 312-4402800; internet website address - www.ada.org. (2) American association of oral and maxillofacial surgeons: 9700 West Bryn Mawr avenue, Rosemont, Illinois, 60018-5701; telephone - 847-678-6200 or 800-822-6637; facsimile - 847-678-6286; internet website address - www.aaoms.org. Last updated April 2, 2024 at 9:00 AM Supplemental Information |
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Rule 4715-5-06 | Reports of adverse occurrences.
(A) All licensees engaged in the practice of dentistry in the state of Ohio must notify the board within seventy-two hours of knowledge of an adverse occurence, and submit a complete written report within thirty days of any adverse occurrence requiring hospital admission within twenty-four hours of patient treatment or any mortality which occurred as a direct result of treatment in a dental facility. (B) Failure to comply with this rule when said mortality or adverse occurrence is related to the use of moderate sedation, deep sedation, or general anesthesia may result in the restriction, suspension, or revocation of such permits as described in rules 4715-5-05 and 4715-5-07 of the Administrative Code and/or other disciplinary action. Last updated April 2, 2024 at 9:00 AM Supplemental Information |
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Rule 4715-5-07 | Use of moderate sedation.
(A) Use of moderate sedation (1) The following may be administered by any dentist, unless otherwise restricted by the board: (a) Patients thirteen years of age or older may receive enteral minimal sedation, limited to a single dose of a single drug at not more than the maximum recommended dose on the FDA-approved labeling indicated for unmonitored home use, with or without nitrous oxide-oxygen minimal sedation and local anesthesia; (b) Patients of any age may receive nitrous oxide-oxygen inhalation for minimal sedation. (2) Notwithstanding paragraph (A)(1) of this rule, no dentist shall administer moderate sedation in the state of Ohio, in accordance with the definition of "moderate sedation", as defined in paragraph (B)(19) of rule 4715-3-01 of the Administrative Code, unless such dentist possesses a moderate sedation permit or provisional moderate sedation privileges as set forth in paragraph (C) of this rule is pending. The dentist holding such permit shall be subject to review and such permit must be renewed biennially. (3) The moderate sedation provider's education, training, experience, and current competence must clinically coincide with the progression of a patient along the anesthesia continuum as defined in paragraph (B)(6) of rule 4715-3-01 of the Administrative Code. The moderate sedation provider must be prepared to manage a level of anesthesia deeper than intended as it is not always possible to predict how a given patient will respond to anesthesia. The moderate sedation provider's ultimate responsibility is to protect the patient including, but not limited to, identification and management of any complication(s) occurring during the anesthesia time. (4) With the exception of nitrous oxide-oxygen, no dentist shall administer to a patient under thirteen years of age, any drug, or techniques, or any combination thereof that would likely render the patient minimally or moderately sedated unless the dentist is qualified as described in paragraph (B)(2) of this rule and holds a moderate sedation permit with a pediatric endorsement, provisional moderate sedation privileges with a pediatric endorsement, a general anesthesia permit or provisional general anesthesia privileges. (5) No dentist shall administer or employ any agent(s) with a narrow margin for maintaining consciousness including, but not limited to, potent volatile inhalation anesthetic agents, ultra-short acting barbiturates, propofol, ketamine, and similarly acting drugs, or quantity of agent(s), or techniques, or any combination thereof that would likely render a patient deeply sedated, generally anesthetized or otherwise not meeting the conditions of the definition of minimal sedation or moderate sedation in paragraph (B)(18) or (B)(19) of rule 4715-3-01 of the Administrative Code, unless the dentist holds a valid general anesthesia permit or provisional general anesthesia privileges as issued by the board. (B) Moderate sedation permit - In order to receive a moderate sedation permit, the dentist must apply on a prescribed application form to the board, indicate whether applying for a permit to sedate patients age thirteen and over, patients under thirteen or both, submit the fee as established by division (A) of section 4715.13 of the Revised Code, and produce evidence showing that the dentist: (1) Has satisfactorily completed one of the following within two years of submitting the application for moderate sedation permit to treat patients age thirteen or older: (a) A comprehensive predoctoral or advanced dental education program accredited by the commission on dental accreditation which includes training in moderate sedation commensurate with the "Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students" as adopted by the October 2016 American dental association house of delegates; or (b) A continuing education course in moderate sedation commensurate with the "Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students" as adopted by the October 2016 American dental association house of delegates. The course must be approved by either the American dental association commission for continuing education provider recognition or the academy of general dentistry program approval for continuing education council. The course must be designed to assess and document competency in all aspects of moderate sedation. At a minimum, such courses must include all the following: (i) No fewer than sixty hours of didactic instruction, excluding advanced cardiac life support (ACLS) and basic life support for the healthcare provider (BLS-HCP) instruction time, plus administration of moderate sedation as defined in this document for at least twenty individually managed dental patients, ensuring that only a single course participant earns credit for each patient encounter. An individual patient may be sedated no more than once per day for these sedation encounters; (ii) Written certification by the course director of competence in moderate sedation techniques; (iii) Written certification of competence by the course director in rescuing patients from a level of sedation deeper than intended including managing the airway, intravascular or intraosseous access, and reversal medication use; and (iv) Provision of additional clinical experience if the participant competency has not been demonstrated in the alloted time. (2) Has satisfactorily completed one of the following within two years of submitting the application for a moderate sedation permit to treat patients under age thirteen: (a) An advanced dental education program in pediatric dentistry accredited by the commission on dental accreditation; or (b) A program in pediatric moderate sedation for children under age thirteen which includes: (i) Sixty hours of didactic instruction in pediatric sedation; (ii) Written documentation of competency in pediatric moderate sedation after having completed a minimum of: (a) Twenty-five moderate pediatric sedation cases with other sedative agent(s) (with or without being combined with nitrous oxide-oxygen) administered by any route, ensuring that only a single course participant earns credit for each patient sedation encounter. An individual patient may be sedated no more than once per day for these sedation encounters; (b) Twenty-five additional sedation experiences by individual or group participation or with human sedation/anesthesia simulation experiences or a combination thereof; and (c) Four weeks of a hospital anesthesiology rotation experience that includes preoperative evaluation/assessment, risk management, pharmacology, venipuncture, advanced airway placement, patient monitoring, recognition and management of anesthetic emergencies in pediatric patients. (iii) Written certification by the program director of competency in: (a) Rescuing pediatric patients from a level of anesthesia deeper than intended; an (b) Reversal of sedation medications. (iv) A course provision of additional clinical experience if participant competency has not been demonstrated in the allotted time. (3) Has maintained records of instruction and clinical experiences, including complete records of moderate sedation as defined in this document for all patients treated, and certification(s) of competence; (4) Documents successful completion of basic life support for healthcare providers (BLS-HCP) and; (a) For sedating patients age thirteen and over, successful completion of advanced cardiac life support (ACLS) courses; or (b) For sedating patients under age thirteen, successful completion of pediatric advanced life support (PALS) training. (5) Has a properly equipped facility for the administration of moderate sedation in which the permit holder has available and agrees to utilize adequate monitoring, personnel, emergency equipment and drugs as recommended in the "Guidelines for the Use of Sedation and General Anesthesia by Dentists" as adopted by the October 2016 American dental association house of delegates and/or the American association of oral and maxillofacial surgeon's "Office Anesthesia Evaluation Manual," 9th edition. (C) Provisional privileges - Prior to the issuance of a moderate sedation permit, if the applicant dentist meets the requirements set forth in paragraph (B) of this rule: (1) The board shall issue to the applicant dentist provisional moderate sedation privileges valid for up to one year pending successful completion of the clinical onsite evaluation. (2) Unless otherwise authorized by the board, a dentist with provisional moderate sedation privileges shall request an extension no later than ninety days before the expiration of their provisional moderate sedation privileges if necessary to complete the onsite evaluation. (D) Clinical onsite evaluation (1) The board shall require an onsite evaluation of the facility(s), equipment, personnel, moderate sedation techniques and related document(s) to determine if the requirements set forth in paragraph (B) of this rule have been met. This evaluation shall be conducted by a qualified consultant appointed by the board and for sedating patients age thirteen and older must follow the "Guidelines for the Use of Sedation and General Anesthesia by Dentists" as adopted by the October 2016 American dental association house of delegates, or, for sedating children under thirteen, the "Guidelines for the Monitoring and Management of the Pediatric Patient, Before, During, and After Sedation for Diagnostic and Therapeutic Procedures" June 2019 revised policy of the American academy of pediatrics; (2) In the case of a mobile or portable facility, one inspection of that facility shall be conducted in the office of an Ohio-licensed dentist where moderate sedation is administered. A written list of all monitors, emergency equipment and other materials which the mobile moderate sedation provider agrees to have available at all times while administering moderate sedation in multiple locations shall be provided to the board; and (3) The applicant shall be responsible for the cost of this evaluation, which will be an amount not to exceed four hundred dollars. (E) Unsatisfactory permit application - In the event the board deems the application or evaluation unsatisfactory, a written explanation documenting deficiencies and suggested remedies shall be forwarded to the applicant. The board may issue a permit based on documentation that the deficiencies have been corrected; or the board may require a formal re-evaluation; or the board may issue a notice of opportunity for hearing pursuant to Chapter 119. of the Revised Code to deny the application for a moderate sedation permit. (F) Permit renewal - The board shall, without charge, renew the moderate sedation permit biennially at the time of dental licensure renewal, provided the permit holder attests to the board that the permit holder: (1) Maintains successful completion of: (a) A basic life support course for healthcare providers (BLS-HCP); (b) A course in advanced cardiac life support (ACLS) for sedation of patients age thirteen and over, or for sedation of children under age thirteen, pediatric advanced life support (PALS); and (c) A minimum of six hours of board approved continuing education devoted specifically to the management and/or prevention of emergencies which may result from the use of moderate sedation. (2) Has performed emergency drills at least quarterly during the biennium, documenting in a log the date, nature of simulated emergencies, and names and roles of all participants. Required simulated emergencies include, on an annual basis, the following scenarios: (a) Hypotensive, hypertensive, bradycardic and tachycardic emergencies; (b) Recognition and management of loss of capnography tracing requiring appropriate management of the airway and of the underlying cause, e.g. anesthetic overdose, secretions, etc. due to: (i) Hypoventilation that progresses to respiratory arrest; (ii) Soft tissue or foreign body obstruction of the airway; (iii) Laryngospasm; and (iv) Bronchospasm. (c) An unexpected decline in level of consciousness, including consideration of multiple possible etiologies, e.g. over-sedation, stroke, seizure, street drug use, hypoxia, anaphylaxis, etc.; (d) With the exception of those who solely possess a pediatric endorsement, recognition and management of chest pain progressing to cardiac arrest; (e) In offices where moderate sedation is performed less frequently than quarterly, or for the first time, the requirement for emergency drills may be satisfied by performing emergency drills for, at a minimum, all of the above scenarios immediately preceding the administration of moderate sedation for an actual patient. (3) Has reviewed the laws and rules governing the administration of moderate sedation; and (4) Has verified that all licensed/registered personnel involved in the administration of moderate sedation maintain current, active licensure or registration. (G) Licensed dentists who did not complete a comprehensive predoctoral or advanced dental education program accredited by the U.S. department of education as defined in paragraph (B)(1)(a) or paragraph (B)(2)(a) of this rule who hold a current permit and have been using or employing sedation prior to adoption of this rule and who desire to continue to use or employ sedation, shall within one year of the effective date of this rule submit an attestation to the board along with evidence demonstrating competency of successful administration of sedation to a minimum of twenty patients in the three years preceding attestation. Evidence of competency shall be commensurate with each intended patient age range whether: (1) Patiens age thirteen and over; (2) Patients twelve years or younger; or (3) Both (forty case total). (H) Reciprocity - The board may grant a moderate sedation permit to a dentist who has administered moderate sedation in another state when training as outlined in paragraphs (B)(1) and/or (B)(2) of this rule was completed more than two years before the submission of the application and the applicant provides a log of all moderate sedation cases performed during the previous three years. A minimum of twenty age-appropriate cases logged in the preceding three years is required to demonstrate current competency. The board may request complete moderate sedation records of cases selected from this log. (I) General anesthesia permit holders - A dentist holding a general anesthesia permit under rule 4715-5-05 of the Administrative Code may administer moderate sedation without a moderate sedation permit. (J) Certified registered nurse anesthetist (CRNA) - A dentist holding a moderate sedation permit may supervise a licensed, certified registered nurse anesthetist only for moderate sedation procedures for which the dentist is qualified by permit. The permitted dentist must provide direct, personal, on-site supervision of the CRNA within the scope of the permit of the CRNA throughout the entire anesthesia time. (K) New facility - All moderate sedation permit holders shall provide written notification within ten business days to the board if conscious sedation services are to be provided an any new facility(s) other than those already listed with the board. (L) Anesthetic team - During moderate sedation, the following persons must be physically present in the room and caring exclusively for the patient: (1) A moderate sedation provider; and (2) A person currently certified in BLS-HCP who may assist the moderate sedation provider, shares the patient monitoring and documentation duties and who is able to assist the moderate sedation provider in an emergency if needed. (M) Recovery monitoring - The moderate sedation provider must remain on the premises of the dental facility until any patient given moderate sedation has been discharged. Assuming that the patient continues to respond appropriately to verbal command after the procedure has ended, further recovery until ready for discharge must be monitored by one person described in paragraph (K)(2) of this rule. (N) Employing a moderate sedation provider - A dentist who employs or works with a moderate sedation provider must: (1) Ensure that the anesthesia provider meets the requirements defined in paragraph (B)(4) or (B)(5) of rule 4715-3-01 of the Administrative Code; (2) Ensure that the facility meets the requirements set forth in paragraph (B)(5) of this rule; and (3) Be currently certified in BLS-HCP and able to assist the moderate sedation provider in an emergency if needed. (O) Reevaluation - The board may conduct additional evaluations, as described in paragraph (D) of this rule, upon informing the permit holder in writing that a reevaluation is required of the permit holder's facility(s) and/or methods. In determining whether such reevaluation is necessary, the board shall consider such factors as it deems pertinent including, but not limited to, patient complaints, report of adverse occurrences, and random quality assurance audits. Such quality assurance audit(s), may include, but are not limited to, a review of documentation of pre-sedation evaluation(s), sedation and recovery records, and documentation of appropriateness for discharge. The permit holder shall be responsible for any costs incurred in a reevaluation, not to exceed four hundred dollars. (P) Reference materials for paragraphs (B)(1)(b), (B)(5), and (D) of this rule may be found at the following addresses: (1) American dental association: 211 E. Chicago avenue, Chicago, Illinois, 60611-2678; telephone - 312-440-2500; facsimile - 312-440-2800; internet website address - www.ada.org. (2) American academy of pediatrics: 345 Park avenue, Itasca, Illinois 60143; internet website address - www.aappublications.org/news. Last updated April 2, 2024 at 9:01 AM Supplemental Information |
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Rule 4715-5-08 | Removable prosthesis identification.
Each licensed dentist shall ensure that every removable prosthesis is identified. (A) After the effective date of this rule, every removable prosthesis fabricated by a dentist, or fabricated pursuant to his or her work authorization form, shall be marked with the name and/or social security number of the patient for whom the denture is intended. The markings shall be made prior to final seating and shall be permanent, legible and cosmetically acceptable. The exact location of the markings and the methods used to apply or implant them shall be determined by the dentist, entity or person fabricating the prosthesis. (B) Any removable prosthesis which has not been marked in accordance with paragraph (A) of this rule at the time of fabrication, shall be so marked at the time of any subsequent rebasing or duplication. (C) For the purposes of this rule removable prosthesis means a manufactured device that replaces one or more teeth and may be removed by the patient. Last updated September 8, 2023 at 1:55 PM Supplemental Information |