Fall 2011 - North Dakota Board of Dental Examiners

sedation and anesthesia PerMit holdersState boards have the responsibility to establish rulesand regulations not only for professional licensure, butalso for adjunct services that the profession offers, such asanesthesia and sedation. Wide variation between state dentalboard requirements and private sector sedation educationprotocols can lead to practitioner confusion and frustration.The different standards that each body establishes mayrepresent different priorities and create difficulty for thepractitioner to understand what is expected of him/her topractice sedation and anesthesia.The NDSBDE administrative protocol for review ofanesthesia and sedation permits is structured in accordancewith the ADA’s Guidelines for Teaching Pain Control andSedation to dentists and dental students. Additionally, theBoard has adopted rules which support continuing educationrequirements specific to qualified dentists permitted toadminister sedation or anesthesia.Once a completed application for the anesthesia/sedation permit is received it, along with the continuingeducation and clinical training of the practitioner, is reviewedby the Board’s Anesthesia Application Committee. Thepractitioner must be current with ACLS. The practitionermust also be current with PALS if providing anesthesia topatients 12 and under. The Committee may grant temporaryand provisional privileges to the permit applicant if allrequirements of the application have been met.The applicant is then required to schedule and completean office inspection with the Anesthesia Committee withinninety days of application. Practitioners who fail to scheduleand complete the office evaluation within the ninetyday period may not provide anesthesia or sedation. Ananesthesia or sedation provider who establishes a satelliteoffice or new location must also request a site evaluation foreach site. Office inspections conducted as part of the AAOMScertification process may be considered in lieu of the officeevaluation required by the Board.Once the permit applicant has been granted temporaryand provisional sedation or anesthesia privileges,NDSBDE’s Anesthesia Committee conducts the scheduledsite evaluation within the required 90 day period. Carefulconsideration and review is given to patient selection andrecord keeping. Preoperative evaluation may be reviewedwith the practitioner consisting of a thorough review ofmedical records and current medications. The AnesthesiaCommittee may observe the dentist administeringanesthesia, equipment, and appropriately trained medicaland dental personnel conducting physiologic and visualmonitoring of the patient. Appropriate and readily availableemergency drugs are accounted for; emergency protocolsand adverse reaction protocols may be discussed with thepractitioner. A site evaluation also focuses on records anddocumentation including drugs used, dosages, vital signsmonitored and recovery from the anesthetic.Full sedation and/or anesthesia privileges are grantedonly after a successful site evaluation is completed. The siteevaluation must be completed every five years and is theresponsibility of the practitioner to schedule.Once a permit has been granted, the renewal processrequires a renewal application for anesthesia/sedation inconjunction with a renewal fee. All initial requirementssuch as PALS or ACLS must be current at the time of therenewal. Late fees are applicable after December 31st of therenewal year. The permit is renewed at the same time thedental license is renewed as required by statute. In review ofthe renewal application, required continuing education foranesthesia permit holders is also assessed by the AnesthesiaCommittee as well as a review of all auxiliary requirementssuch as BLS.Qualified dentists have a responsibility to minimizerisk to patients who consent to sedation or elevated levelsof anesthesia. Understanding these steps in obtainingsedation/anesthesia permits in North Dakota can make theprocess more efficient and less stressful for the applicant.Troy Petersen, DMD, MDProfessional CorPoration annual rePortsIs your dental practice organized as;A professional corporation?A professional limited liability company?A professional limited liability partnership?A foreign corporation authorized to transact business in this state?You may have noticed the question related to corporate annual reports on the latest dental renewal application. The questionserves as a reminder that a copy of the report must be submitted to the Board; a requirement of ND law. As mandated by NDCC § 10-31-13, when filing the organization’s annual report a copy must be filed with the regulatory board that licenses the shareholders describedin the report. No filing fee may be charged by the regulatory board. The information deemed relevant to the NDSBDE is for purposesof determining ownership of the dental practice as outlined by NDCC § 43-28-25 Subsection 9.If you have questions regarding Chapter 10-13 you may want to contact an attorney, or the North Dakota Secretary of State.Information can also be found at http://www.nd.gov/sos/businessserv/registrations/types/corporations/professional/annualreports.htmlPage 3