Part 5.
STATE BOARD OF DENTAL EXAMINERS
Chapter 101.
DENTAL LICENSURE
22 TAC §101.7
The State Board of Dental Examiners adopts amendments to §101.7,
Licensure by Credentials in conjunction with its review of Chapter 101, Dental
Licensure and in accordance with the General Appropriations Act of 1997, Article
IX, Acts of the 75th Legislature 1997, §167, without changes to the proposed
text as published in the February 16, 2001 issue of the
Texas Register
(26 TexReg 1458).
Paragraph (3)(A) and (3)(B) will be amended by deleting the phrase "prior
to applying" and adding the phrase "preceding application to the State Board
of Dental Examiners." The adopted amendments clarify language in the rule
requiring that a dentist licensed in another jurisdiction who applies for
a Texas dental license by virtue of credentials, must have continuously practiced
dentistry during the five years immediately preceding application. In the
past some applicants interpreted current language to mean "five calendar years"
rather than the five year period immediately prior to application.
The amended rule provides assurance to the public that the intent of the
rule will be easier to understand. The language of the amendment makes it
clear that the five-year period must have occurred immediately before the
application.
No comments were received regarding adoption of the proposal.
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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101852
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §101.8
The State Board of Dental Examiners adopts amendments to §101.8,
Persons with Criminal Backgrounds, in conjunction with its review of Chapter
101, Dental Licensure and in accordance with the General Appropriations Act
of 1997, Article IX, Acts of the 75th Legislature 1997, §167, without
changes to the proposed text as published in the February 16, 2001 issue of
the
Texas Register
(26 TexReg 1459).
The adopted amendments track the language of the statutes. The former subsection
(a) is amended to include the wording now found in current subsection (b).
Former subsection (d), now subsection (e) is amended at (8) to specify felony
theft. Changes in statutory references have been made to reflect the codification
of the Dental Practice Act into the Occupations Code.
The adopted rule provides that the public will have a clearer understanding
of the types of criminal offenses that could lead to revocation or suspension
of a license or denial of an application for licensure. The enabling statutes
require that the board issue guidelines stating how particular crimes relate
to fitness for licensing and other criteria that affect licensing decisions.
New subsection (a) states the purpose of the rule, that is, to comply with
the requirements of the enabling statute. New subsection (b) clarifies that
revocation, suspension or denial may be based on conviction under state or
federal law of a felony or misdemeanor that directly relates to the duties
of the profession. Paragraph (8) of new subsection (e) clarifies that a felony
theft directly relates. Paragraph (10) clarifies that felony driving while
intoxicated is another offense that is considered to directly relate. Former
language concerning habitual use or addiction to controlled substance abuse
has been deleted because a finding of such conduct might or might not result
in a criminal conviction.
No comments were received regarding adoption of the proposal.
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; §53.022 and §53.023
which establishes whether a conviction relates to practice dentistry.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101853
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §103.2
The State Board of Dental Examiners adopts amendments to §103.2,
Licensure by Credentials, Dental Hygienists, in conjunction with its review
of Chapter 103, Dental Hygiene Licensure and in accordance with the General
Appropriations Act of 1997, Article IX, Acts of the 75th Legislature 1997, §167,
without changes to the proposed text as published in the February 16, 2001
issue of the
Texas Register
(26 TexReg 1460).
Paragraph (3)(A) and (3)(B) will be amended by deleting the phrase "prior
to applying" and adding the phrase "preceding application to the State Board
of Dental Examiners." The adopted amendments clarify language in the rule
requiring that a dental hygienist licensed in another jurisdiction who applies
for a Texas dental hygiene license by virtue of credentials, must have continuously
practiced dental hygiene during the five years immediately preceding application.
In the past some applicants interpreted current language to mean "five calendar
years" rather than the five year period immediately prior to application.
The amended rule provides assurance to the public that the intent of the
rule will be more easier to understand. The language of the amendment makes
it clear that the five year period must have occurred immediately before the
application.
No comments were received regarding adoption of the proposal.
The amended rule is adopted under Texas Government Code §2001.021
et.seq; Texas Civil Statutes, the Occupations Code §262.102 which authorizes
the Board to make rules affecting the practice of dental hygiene; §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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101851
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §104.2
The State Board of Dental Examiners adopts amendments to §104.2,
Providers in conjunction with its review of Chapter 104, Continuing Education
and in accordance with the General Appropriations Act of 1997, Article IX,
Acts of the 75th Legislature 1997, §167, without changes to the proposed
text as published in the February 16, 2001 issue of the
Texas Register
(26 TexReg 1461).
The rule is amended to add the Western Regional Examining Board, the American
Academy of Dental Hygiene, the American Dental Education Association, and
the American Heart Association to the list of providers.
The amended rule provides an expanded list of educational providers available
for dental professionals to obtain the continuing education required for annual
license renewal.
No comments were received regarding adoption of the proposal.
The amended rule is adopted under Texas Government Code §2001.021
et.seq; Texas Civil Statutes, the Occupations Code §257.005 which provides
that the Board shall develop a mandatory Continuing Education program and §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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101850
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §§110.1-110.4
The State Board of Dental Examiners adopts new Chapter 110,
Enteral Conscious Sedation and new §§110.1 Definitions, 110.2 Permit,
110.3 Permit Requirements and Clinical Provisions and 110.4 Effective Date
with changes to the text published in the December 8, 2000 issue of the
When the Board conducted public hearings in the summer of 1998 and again
in 1999 on the parenteral conscious sedation rules, many speakers, especially
those from the Texas dental schools, urged the Board to include enteral conscious
sedation in those rules. The Board President appointed an ad hoc committee
to study the issues and to prepare enteral conscious sedation rules. The rules
adopted are the result of the Board's review of that committee's recommendations
with changes based on input from the public.
Written comments were received and a public hearing was conducted by the
entire Board on January 26, 2001. Most, if not all, commenters generally approved
of the rules and proposed improvements to the rules rather than objecting
to the concept of the rules. The Board has made minor changes to the rules
in response to comments made. A discussion of all comments follows.
Written comments were made by four individuals. One commenter made written
comments and suggested two changes. The first was a recommendation that §110.2(e)(2)(B)
be changed by deleting the requirement that the permitted dentist and his/her
staff must maintain current certification in basic cardiopulmonary resuscitation
(CPR) and replacing it with a one time requirement that a PALS course be taken.
Even though that section of the rule addresses both the dentist and staff,
its effect is primarily directed toward staff. In order for dentists to renew
their licenses they must submit proof of current completion of a cardiopulmonary
resuscitation course. Staff should not be required to have training at the
intense level provided by PALS. A basic CPR course is adequate to prepare
them to assist the dentist in the event of an emergency. Further, CPR training
for dentist and staff should periodically be reinforced and a one time program
cannot accomplish this.
The commenter also proposed that §110.3 be amended to allow a dentist
to make use of the service of a certified registered nurse anesthetist (CRNA)
to administer anesthesia in a hospital or surgery center setting. The rule
at subsection (d)(4) provides that a dentist may not allow a CRNA to administer
anesthesia in the dentist's office unless the dentist has a permit for the
procedure being performed. In a hospital setting where the hospital is responsible
for the administration of anesthesia, non-dentists who administer anesthesia
are not affected by the board's rules.
Another commenter also indicated that he heartily endorsed the rules. He
suggested that various definitions of "supervision" be included and that the
term "continuous direct supervision" be printed in bold type face. His issue
is that by defining all types of supervision in the rules and by highlighting
the one that applies in the context of these rules the reader will have no
question about which definition applies. The board is of the opinion that
only definitions that apply should be included within the rule and that highlighting
is unnecessary since there is only the one definition of supervision.
Another commenter also wrote and commented that §110.3(c) and (d)
should be amended to make it clear that a permit is required when nitrous
oxide/oxygen inhalation sedation is used with any enteral agent by changing
(c) as follows: "Administration of nitrous oxide inhalation conscious sedation
in combination with enteral administration of any agent, including minor tranquilizers
used for anxiolysis, used for any sedation procedure requiring a permit under
board rules requires both an enteral conscious sedation permit and a nitrous
oxide/oxygen inhalation conscious sedation permit.".
His point is well taken as the proposed language requires a permit only
when an enteral agent is being used for sedation purposes. The better view
is that when any enteral agent is being used in combination with nitrous oxide/oxygen
inhalation conscious sedation an enteral conscious sedation permit is required.
Accordingly the language proposed by the commenter is adopted.
The same commenter also noted that subsection (d) of §110.3 could
be interpreted by some readers to allow administration of potent benzodiazepines
in combination with nitrous oxide/oxygen inhalation conscious sedation without
a permit. The Board is of the opinion that the language change to subsection
(c) discussed above makes it clear that such an interpretation is unreasonable.
Another commenter made written comments and made three suggestions. First,
that "anesthesia services" be amended to read "anesthesia/sedation services".
The board agrees and the term is changed in each place it shows up in all
the rules. The commenter also suggested that §110.1(7) be amended to
make it clear that the Board could require a facility inspection of a location
where a permitted dentist is employed. The Board agrees with the commenters'
point but the Board is of the opinion that the language should be changed
beyond the insertion of the word "in" to avoid reference to "primary or satellite
facilities". The language is changed as follows: "Facility inspection - an
on-site inspection to determine if a facility where the applicant proposes
to provide anesthesia/sedation is supplied, equipped, staffed and maintained
in a condition to support provision of anesthesia/sedation services that meet
the minimum standard of care; may be required by the State Board of Dental
Examiners prior to the issuance of a sedation/anesthesia permit or any time
during the term of the permit."
The commenter also proposed inclusion of a definition of the term "anesthesia/sedation
services". The Board is of the opinion that the term is defined by the context
of the entire set of rules, and that an attempt to define the term would not
serve to clarify the issue.
Two other commenters appeared at the public hearing and in general offered
support for the rules as published. Both, however, offered suggested changes.
The first speaker appeared on behalf of the Texas Dental Association. He
proposed that the board include a definition of the term "enteral". The board
agrees that a definition is appropriate, and proposes to amend §110.1
by adding new definition (18) as follows: "(18) Enteral sedation - sedation
that is achieved by a route of administration through the alimentary tract
either orally or rectally."
The Texas Dental Association representative also suggested adding a list
of minor tranquilizers be included in §110.3(d) to avoid questions concerning
who must be permitted. The ad hoc committee appointed by the Board devoted
a great deal of time to the issue and determined that listing those agents
requiring a permit before use would be difficult to administer for a number
of reasons including the fact that such a list would frequently change as
new drugs are developed and as existing drugs are approved or accepted for
oral use. More troubling than frequent changes to a list is the fact that
many agents used for sedation are also used for analgesic and anxiolytic effect.
To require that a dentist who, for example, wishes to orally administer Demerol
for relief of pain to have an enteral conscious sedation permit simply because
Demerol is also used for sedation is not reasonable. The Board recognizes
that leaving it to the practitioner to define the purpose for which a medication
is administered may result in a few individuals claiming that a permit is
not needed when in fact medications are being administered for sedative effect.
Nevertheless, the positive effect of these rules, the assurance that dentists
who use enteral agents for sedation are trained to do so, far out weigh the
possible negative mentioned. Should the Board attempt stricter rules, the
legitimate outcry from the profession would likely be so great that the rules
would not be adopted.
The Board will monitor the effectiveness of the rules and should they prove
to be ineffective because of this "loophole" the Board can consider closing
it.
Another individual appeared at hearing and proposed several changes addressed
below. The commenter proposed adding a definition of "protective reflexes".
The Board agrees and has added new definition (19) to §110.1 as follows:
"(19) Protective reflexes - includes the ability to swallow water sprays and
breath independently without coughing (i.e., laryngospasm) as well as maintain
an unobstructed airway (i.e., lack of snoring and other signs of an obstructed
airway). Severe and/or persistent coughing is probably indicative of a deep
sedation level and partial loss of protective reflexes."
The commenter also suggested that §110.1(15) should be amended by
changing the word "conscious" to "consciousness". The Board agrees and has
made the change.
The commenter proposed amending Rule §110.1(3) to reflect that patient
s who are sleeping and whose only response to painful stimuli is a reflex
withdrawal are not in a state of conscious sedation. The Board agrees and
the last sentence of paragraph (3) is amended as follows: "...Further, patients
who are sleeping and whose only response is reflex withdrawal from repeated
painful stimuli would not be considered to be in a state of conscious sedation."
The commenter also proposed amending the definitions of deep sedation, §110.1(4)
to show "sleep" as an example of depressed consciousness and to provide that
a patient may lose the ability to independently maintain an airway on room
air. The definition in the rule is the definition used by the American Dental
Association in its anesthesia guidelines. The Board is of the opinion that
it is an appropriate description for use in these rules.
The commenter also proposed that §110.2 be amended to provide for
different permits for dentists who orally sedate children, and for those who
orally sedate adults. The ad hoc committee also discussed this type of approach
at great length and determined that requiring a permit only for administration
of enteral conscious sedation for children or having multiple levels of permits
was not the most effective way to fully address the concerns with enteral
sedation. Further, two levels of permits would impose an additional administrative
burden on the agency with very little, if any, benefit. The commenter proposed
language changes to §110.2(e)(C) to address dentists who would be permitted
to sedate children only. Since the rules do not provide for levels of permits
there is no need for this change.
The commenter recommended amending §110.3(b) to provide that enteral
sedation may only be used to achieve conscious sedation unless the practitioner
has a deep sedation permit. These rules address only conscious sedation levels
and are not intended to in any way affect administration of deep sedation
by those dentists having a deep sedation permit. Further, an individual who
is permitted under these rules only is not permitted to administer deep sedation,
whatever the route.
The commenter also proposed amending §110.3(h)(4) to eliminate an
exception for brief procedures on the basis that the period of sedation will
outlast the time of the procedure. Once a procedure is completed and the patient
is in recovery the section of the rule addressing recovery will control. That
section (i) requires continual monitoring of vital signs until oxygenation
and circulation are stable.
The commenter also proposed that §110.3(h)(2) be amended to emphasize
a need to monitor patients on room air unless oxygen saturation of the blood
falls below 93%. This change falls under the heading of the knowledge needed
to safely administer enteral conscious sedation. A permit will not be issued
to licensees until they have completed appropriate training. This addition
is not needed.
The last two proposals made by the commenter are similar to the comment
addressed above in that they would add verbage to the rules that is part of
the information that is included in the training necessary to obtain an enteral
conscious sedation permit. The first is a proposal to add a statement that
use of nitrous oxide/oxygen inhalation conscious sedation may obscure respiratory
depression because nitrous oxide/oxygen inhalation conscious sedation is administered
with oxygen. The second is an admonition to the permittee to be mindful of
the pharmacological half life of the drugs utilized.
Finally, the Board on its own has amended §110.2(e)(1)(A)
to include a requirement that completion of training must include documentation
that the applicant has administered enteral conscious sedation in a minimum
of five cases.
The new rules are adopted under Texas Government Code §2001.021 et.seq;
Texas Civil Statutes, the Occupations Code §254.001(a) 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 to protect the public health and
safety.
§110.1.Definitions.
The following words and terms, when used in this section, shall have
the following meanings, unless the context clearly indicates otherwise.
(1)
Analgesia -- the diminution or elimination of pain.
(2)
Competent -- displaying special skill or knowledge derived
from training and experience.
(3)
Conscious Sedation -- a minimally depressed level of consciousness
that retains the patient's ability to independently and continuously maintain
an airway and respond appropriately to physical stimulation and verbal command,
and that is produced by a pharmacologic or non-pharmacologic method, or a
combination thereof. In accord with this particular definition, the drugs
and/or techniques used should carry a margin of safety wide enough to render
unintended loss of consciousness unlikely. Further, patients who are sleeping
and whose only response is reflex withdrawal from repeated painful stimuli
would not be considered to be in a state of conscious sedation.
(4)
Deep Sedation -- an induced state of depressed consciousness
accompanied by partial loss of protective reflexes, including the inability
to continually maintain an airway independently and/or respond purposefully
to verbal command, and is produced by a pharmacological or non-pharmacological
method, or a combination thereof.
(5)
Direct supervision -- the dentist responsible for the sedation/anesthesia
procedure shall be physically present in the office and shall be continuously
aware of the patient's physical status and well being.
(6)
Facility -- the office where a permit holder practices
dentistry and provides anesthesia/sedation services.
(7)
Facility inspection -- an on-site inspection to determine
if a facility where the applicant proposes to provide anesthesia/sedation
is supplied, equipped, staffed and maintained in a condition to support provision
of anesthesia/sedation services that meet the minimum standard of care; may
be required by the State Board of Dental Examiners prior to the issuance of
a sedation/anesthesia permit or any time during the term of the permit.
(8)
General anesthesia -- an induced state of unconsciousness
accompanied by partial or complete loss of protective reflexes, including
inability to independently maintain an airway and respond purposefully to
physical stimulation or verbal command, and is produced by a pharmacological
or non-pharmacological method or a combination thereof.
(9)
Immediately available -- on-site in the facility and available
for immediate use.
(10)
Local anesthesia -- the elimination of sensations, especially
pain, in one part of the body by the regional injection of a drug.
(11)
May -- indicates freedom or liberty to follow a reasonable
alternative.
(12)
Must or shall -- indicates an imperative need and/or duty;
an essential or indispensable item; mandatory.
(13)
Behavioral management -- to modify pharmacologically and/or
psychologically behavior to a level that dental treatment can be performed
effectively and efficiently.
(14)
Enteral conscious sedation-- light to mild conscious sedation
administered not for analgesic effect, but primarily for behavioral management.
(15)
Anti-anxiety sedative -- a sedative agent administered
in a dosage intended to reduce anxiety without diminishing consciousness or
protective reflexes.
(16)
Minor tranquilizer -- a pharmacological agent which allows
for uninterrupted interactive ability in a totally awake patient with no compromise
in the ability to maintain a patent airway continuously and without assistance.
(17)
Anxiolysis -- pharmacological reduction of anxiety through
the administration of a minor tranquilizer, which allows for uninterrupted
interactive ability in a totally awake patient with no compromise in the ability
to maintain a patent airway continuously and without assistance.
(18)
Enteral sedation -- sedation that is achieved by a route
of administration through the alimentary tract either orally or rectally.
(19)
Protective reflexes -- includes the ability to swallow
water sprays and breath independently without coughing (i.e., laryngospasm)
as well as maintain an unobstructed airway (i.e., lack of snoring and other
signs of an obstructed airway). Severe and/or persistent coughing is probably
indicative of a deep sedation level and partial loss of protective reflexes.
§110.2.Permit.
(a)
A dentist licensed to practice in Texas who desires to
use enteral conscious sedation either, must have a parenteral conscious sedation
anesthesia permit or a deep/general sedation anesthesia permit issued pursuant
to board rule or must obtain an enteral conscious sedation permit from the
State Board of Dental Examiners. A permit is not required for administration
of Schedule II drugs prescribed for pain control.
(1)
A permit may be obtained by completing an application form
approved by the State Board of Dental Examiners, a copy of which may be obtained
from the SBDE.
(2)
The application form must be filled out completely and
appropriate fees paid.
(3)
Prior to issuance of a sedation/anesthesia permit the Board
may require that the applicant undergo a facility inspection or further review
of credentials. The SBDE may direct an Anesthesia Consultant, appointed pursuant
to board rule to assist in this inspection or review. The applicant will be
notified in writing if an inspection is required and provided with the name
of an Anesthesia Consultant who will coordinate the inspection. The applicant
must make arrangements for completion of the inspection within 180 days of
the date the notice is mailed. An extension of no more than 90 days may be
granted if the designated Anesthesia Consultant requests one.
(4)
An applicant for a sedation/anesthesia permit must be licensed
and in good standing with the State Board of Dental Examiners. For purposes
of these rules "good standing" means that a licensee is not suspended, whether
or not the suspension is probated. Applications from licensees who are not
in good standing will not be approved.
(b)
Once a permit is issued, the State Board of Dental Examiners
upon payment of required fees shall automatically renew the permit annually
unless after notice and opportunity for hearing the Board finds the permit
holder has, or is likely to provide anesthesia/sedation services in a manner
that does not meet the minimum standard of care. At such hearing the Board
shall consider factors including patient complaints, morbidity, mortality,
and anesthesia consultant recommendations.
(c)
Annual dental license renewal certificates shall include
the annual permit renewal, except as provided for in subsection (b) of this
section and shall be assessed an annual renewal fee of $5.00 payable with
the license renewal. New permit fees are $28.75 payable with the application
for permit.
(d)
Permit Restrictions: the Board may elect to issue a temporary
enteral conscious sedation permit which will expire on a date certain. A full
sedation/anesthesia permit may be issued after the dentist has complied with
requests of the Board which may include, but shall not be limited to, review
of the dentist's anesthetic technique, facility inspection and/or review of
patient records to ascertain that the minimum standard of care is being met.
If a full permit is not issued, the temporary permit will expire on the stated
date, and no further action by the State Board of Dental Examiners will be
required, and no hearing will be conducted.
(e)
Educational/Professional Requirements:
(1)
To become permitted to administer enteral conscious sedation,
the dentist must satisfy one of the following criteria:
(A)
must have completed training consistent with that described
in Part I or Part III of the American Dental Association (ADA) Guidelines
for Teaching the Comprehensive Control of Pain and Anxiety in Dentistry, and
have documented administration of enteral conscious anesthesia/sedation in
a minimum of five cases;
(B)
must have completed an ADA accredited post-doctoral training
program which affords comprehensive and appropriate training necessary to
administer and manage enteral conscious sedation;
(C)
must have completed the two-day conscious sedation course
in Pediatric Dentistry approved and developed by the American Academy of Pediatric
Dentistry; or
(D)
must have completed a two day enteral conscious sedation
course approved by the SBDE.
(2)
The following shall apply to the administration of enteral
conscious sedation in the dental office:
(A)
the operating dentist must complete at least every three
years appropriate Continuing Education in enteral conscious sedation.
(B)
the operating dentist and his/her clinical staff must maintain
current certification in basic cardiopulmonary resuscitation given by the
American Heart Association or the American Red Cross.
§110.3.Permit Requirements and Clinical Provisions.
(a)
Enteral conscious sedation may be induced and maintained
by a permitted dentist licensed by the State of Texas and practicing in Texas,
a physician anesthesiologist licensed by the Texas State Board of Medical
Examiners, or a Certified Registered Nurse Anesthetist (CRNA) licensed in
Texas. When a Certified Registered Nurse Anesthetist (CRNA) is permitted to
function under the supervision of a dentist, in the dental office, provision
of enteral conscious sedation by a CRNA shall require the operating dentist
to be permitted for its utilization.
(b)
Enteral conscious sedation is indicated for use only for
conscious sedation as defined in Rule 110.1 of this title (relating to Definitions).
Enteral conscious sedation is not indicated for use to achieve deep sedation.
(c)
Administration of nitrous oxide/oxygen inhalation conscious
sedation in combination with enteral administration of any agent, including
minor tranquilizers used for anxiolysis, requires both an enteral conscious
sedation permit and a nitrous oxide/oxygen inhalation conscious sedation permit.
(d)
Minor tranquilizers used for anxiolysis may be prescribed
for administration outside of the dental office when pre-procedure instructions
are likely to be followed. Medications such as chloral hydrate and all drugs
included in the Drug Enforcement Administration (DEA) Controlled Substances
Schedule II must not be administered outside of the dental office for sedation
purposes. Medications other than minor tranquilizers used for anxiolysis administered
outside of the office require a permit.
(e)
Standard of care requirements. Each dentist must maintain
the minimum standard of care as detailed in board rules, and shall in addition:
(1)
adhere to the clinical requirements as detailed in subsection
(f) of this section;
(2)
maintain under continuous direct supervision auxiliary
personnel who shall be capable of reasonably assisting in procedures, problems,
and emergencies incident to the use of enteral conscious sedation.
(3)
maintain current certification in basic cardiopulmonary
resuscitation for the assistant staff by having them pass a course given by
the American Heart Association or the American Red Cross; and
(4)
not allow an enteral conscious sedation procedure to be
performed in his/her office by a Certified Registered Nurse Anesthetist (CRNA)
unless the dentist holds a permit issued by the State Board of Dental Examiners
for the procedure being performed. This provision addresses dentists and is
not intended to address the scope of practice of persons licensed by any other
agency.
(f)
Clinical Requirements. Each dentist must meet the following
clinical requirements for utilization of enteral conscious sedation:
(1)
Patient Evaluation. Patients who are administered enteral
conscious sedation must be suitably evaluated prior to the start of any sedative
procedure. In healthy or medically stable individuals (ASA I, II), this may
be simply a review of their current medical history and medication use. However,
with individuals who may not be medically stable or who have a significant
health disability (ASA III, IV) consultation with their primary care physician
or consulting medical specialist regarding potential procedure risk is recommended.
(2)
Pre-Procedure preparation, informed consent:
(A)
the patient and/or guardian must be advised of the procedure
associated with the delivery of the enteral conscious sedation.
(B)
equipment must be evaluated and maintained for proper operation.
(C)
baseline vital signs should be obtained at the discretion
of the operator depending on the medical status of the patient and the nature
of the procedure to be performed.
(D)
dentists administering enteral conscious sedation shall
use sedative agents that he/she is competent to administer and shall administer
such agents is a manner that is within the standard of care.
(g)
Personnel and Equipment: In addition to the dentist, at
least one member of the assistant staff should be present during the administration
of enteral conscious sedation.
(h)
Monitoring and Documentation:
(1)
Patients who have been administered enteral conscious sedation
must be monitored during waiting periods prior to operative procedures. A
responsible adult given appropriate written pre-procedural instruction may
provide such monitoring. The patient should be monitored for alertness, responsiveness,
breathing and skin coloration.
(2)
Dentists administering enteral conscious sedation must
maintain direct supervision of the patient during the operative procedure
and for such a period of time necessary to establish pharmacologic and physiologic
vital sign stability.
(A)
Oxygenation. Color of mucosa, skin or blood shall be continually
evaluated. Oxygen saturation must be evaluated continuously by pulse oximetry,
except as provided in paragraph (4) of this section.
(B)
Ventilation. Must perform observation of chest excursions
and/or auscultation of breath sounds.
(C)
Circulation. Must take and record an initial blood pressure
and pulse and thereafter as appropriate except as provided in paragraph (4)
of this section.
(3)
An appropriate time oriented anesthetic record must be
maintained including documentation of individual administering the drug(s)
and showing the name(s) of drug(s) and dosage(s) used.
(4)
In selected circumstances, enteral conscious sedation may
be utilized without pulse oximetry or taking blood pressure and pulse. These
circumstances include: sedation administered for brief procedures; extremely
young children, patients who cooperate poorly due to unwillingness or inability
to follow instructions, or patients whose level of anxiety will tend to be
heightened by monitoring. When these situations occur, the dentist responsible
for administering enteral conscious sedation must document the reasons preventing
the recommended monitoring.
(i)
Recovery and Discharge:
(1)
recovery from enteral conscious sedation must include:
(A)
positive pressure oxygen and suction equipment must be
immediately available in the recovery area and/or operatory;
(B)
continual monitoring of vital signs when the sedation/anesthesia
is no longer being administered; i.e., the patient must have direct continuous
supervision until oxygenation, and circulation are stable and the patient
is appropriately responsive for discharge from the facility;
(C)
the dentist must determine and provide for documentation
that oxygenation, circulation, activity, skin color and level of consciousness
are appropriate and stable prior to discharge;
(D)
must provide explanation and documentation of written postoperative
instructions to patient and/or a responsible adult at time of discharge;
(E)
the dentist must determine that the patient has met the
following discharge criteria prior to leaving the office:
(i)
cardiovascular function satisfactory and stable;
(ii)
airway patency uncompromised and satisfactory;
(iii)
patient easily arousable and protective reflexes intact;
(iv)
state of hydration adequate;
(v)
patient can talk, if applicable;
(vi)
patient can sit unaided, if applicable;
(vii)
patient can ambulate, if applicable, with minimal assistance;
(viii)
For the child who is very young or disabled, and incapable
of the usually expected responses, the pre-sedation level of responsiveness
or the level as close as possible for that child should be achieved.
(ix)
Responsible individual is available.
(2)
patients who have unusual reactions to enteral conscious
sedation must be assisted and monitored either in an operatory chair or recovery
room until stable for discharge;
(3)
the dentist must determine that the patient is appropriately
responsive prior to discharge.
(j)
Emergency Management. The dentist, personnel and facility
must be prepared to treat emergencies that may arise from the administration
of enteral conscious sedation, and must have the ability to provide positive
pressure ventilation with 100% oxygen with an age appropriate device.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 26, 2001.
TRD-200101778
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 15, 2001
Proposal publication date: December 8, 2000
For further information, please call: (512) 463-6400
22 TAC §111.6
The State Board of Dental Examiners adopts the repeal of
Chapter 111, Professional Corporations and §111.6, Requirements, as part
of the rules review process and in accordance with the General Appropriations
Act of 1997, Article IX, Acts of the 75th Legislature 1997, §167, without
changes to the proposed text as published in the February 16, 2001 issue of
the
Texas Register
(26 TexReg 1462).
The rule, last reviewed in 1984, impermissibly restricts the application
of the Professional Corporations Act, Article 1528e, Texas Revised Civil Statutes.
The rule as written limits the incorporators of a dental practice to licensed
dentists. There is no basis for such a limitation in the statutes. Only a
licensed dentist can be a director, officer or shareholder of a professional
corporation formed by dentists, but any individual is allowed to be an incorporator.
The role of the incorporator is largely limited to the act of execution of
the articles of incorporation and restrictions on who may serve as incorporators
have largely been eliminated.
No comments were received regarding the adoption of the proposal.
The rule is adopted for repeal 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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101849
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §113.2
The State Board of Dental Examiners adopts amendments to §113.2,
X-Ray Laboratories, in conjunction with its review of Chapter 113, Requirements
for Dental Offices, and in accordance with the General Appropriations Act
of 1997, Article IX, Acts of the 75th Legislature 1997, §167, without
changes to the proposed text as published in the February 16, 2001, issue
of the
Texas Register
(26TexReg1462).
The new language of subsection (a) clarifies that in-house dental laboratories
are regulated by the Dental Practice Act and must be on the premises of a
dental office. The new language substitutes the words "Texas licensed dentist"
for "legally practicing dentist." The new language is more precise. The new
language about supervision acknowledges that ultimate responsibility for those
activities that occur in a dental office, such as the taking of x-rays, rests
with a licensed dentist and eliminates confusion.
New subsection (b) adds the requirement that the lead apron have a thyroid
collar and is also corrected for grammar. New subsection (c) is also restructured
for grammatical consistency.
The amendments provide for a rule that is easier to read and understand
and that reflects the realities of modern dental practices.
No comments were received regarding adoption of the proposal.
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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101848
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §113.3
The State Board of Dental Examiners adopts the repeal of §113.3,
Office Leases, in conjunction with its review of Chapter 113, Requirements
for Dental Offices and in accordance with the General Appropriations Act of
1997, Article IX, Acts of the 75th Legislature 1997, §167, without changes
to the proposed text as published in the February 16, 2001, issue of the
The repeal of the rule provides for the elimination of a rule that was
obsolete, irrelevant and unnecessary duplicative.
Rule 113.3 addresses a narrow segment of the spectrum of improper influence
on the independent professional judgment of a dentist by persons other than
dentists and is provided for in greater detail and clarity in subsection (c)
paragraph (1) of Rule 109.500, Improper Influence on Professional Judgment,
effective February 7, 2000. The intent of Rule 113.3 was to prevent the improper
sharing of dental fees with a non-dentist. The intent is still valid and is
well served by the language of Rule 109.500. Rule 109.500 has been repealed
contemporaneously with adoption of new Rule 108.70, which will supplant the
current Rule 109.500. Because the language of rule 113.3 is unnecessarily
duplicative, it is repealed.
No comments were received regarding adoption of the proposal.
The repeal 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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101847
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §113.4
The State Board of Dental Examiners adopts the repeal of §113.4,
Retail Leases, in conjunction with its review of Chapter 113, Requirements
for Dental Offices and in accordance with the General Appropriations Act of
1997, Article IX, Acts of the 75th Legislature 1997, §167, without changes
to the proposed text as published in the February 16, 2001, issue of the
The intent of the language of Rule 113.4 as written is exhaustively addressed
in new rule 108.1, Professional Responsibility, which supplanted former rule
109.103. The former rule 113.4 was intended to prevent the unauthorized practice
of dentistry by commercial establishments. A dental license is issued to a
person who may structure the operation of his/her practice in any one of several
business entities, including partnerships, associations and corporations so
long as such structures are lawful. Rule 113.4 is inappropriate, obsolete,
irrelevant and unnecessarily duplicative and is proposed for repeal.
No comments were received regarding adoption of the proposal.
The repeal 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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101846
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §116.2
The State Board of Dental Examiners adopts amendments to §116.2,
Dental Technicians in conjunction with its review of Chapter 116 Dental Laboratories
and in accordance with the General Appropriations Act of 1997, Article IX,
Acts of the 75th Legislature 1997, §167, without changes to the proposed
text as published in the February 16, 2001 issue of the
Texas Register
(26TexReg1464).
The reference to Article 4551, Section 1 has been changed to refer to Section
266.001, Occupations Code, reflecting the codification of the Dental Practice
Act into the Occupations Code, effective September 1, 1999. Language is also
amended to comply with statutory language, which states that a dental technician
may be certified by a nationally recognized board and does not specify a particular
board.
The amended rule provides assurance to the public that the statutory references
are current and that the rule accurately tracks statutory language
No comments were received regarding adoption of the proposal.
The amended rule is adopted under Texas Government Code §2001.021
et.seq; Texas Civil Statutes, the Occupations Code §266.102(b) which
authorizes the Board to adopt rules affecting dental laboratories and §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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101845
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §116.3
The State Board of Dental Examiners adopts amendments to §116.3,
Requirements, in conjunction with its review of Chapter 116, Dental Laboratories,
and in accordance with the General Appropriations Act of 1997, Article IX,
Acts of the 75th Legislature 1997, §167, without changes to the proposed
text as published in the February 16, 2001 issue of the
Texas Register
(26TexReg1464).
The references to articles in the former Dental Practice Act are changed
to the Occupations Code, effective September 1, 1999. The 76th Legislature
also enacted Senate Bill 964, referred to properly in the amendment, which
impacted on the former Dental Practice Act provisions dealing with registration
of laboratories.
Amendments to subsection (c) are intended to clarify that, in order to
satisfy the requirement for a certified dental technician, that person must
be present at the dental laboratory and working as an employee of the laboratory.
The former language was vague and difficult to interpret. The last sentence
in subsection (c) is deleted. The requirement is that a certified dental technician
work as an employee for a dental laboratory a minimum of 30 hours per week.
It is conceivable, albeit doubtful, that a technician could serve more than
one laboratory a minimum of 30 hours per week. It is not unheard of for employees
to work 60 hour weeks and this restriction that a CDT may be the designated
CDT for only one laboratory per year will not withstand constitutional scrutiny.
The amended rule provides assurance to the public that the requirements
for registration and operation of a dental laboratory in Texas will be in
compliance with the most recent legislation and reasonable and fair in their
application.
No comments were received regarding adoption of the proposal.
The amended rule is adopted under Texas Government Code §2001.021
et.seq; Texas Civil Statutes, the Occupations Code§266.102 (b) which
authorizes the Board to adopt rules affecting dental laboratories; §266.152
(d) which requires dental laboratories to have a CDT working on premise 30
hours per week and §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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101844
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §116.4
The State Board of Dental Examiners adopts amendments to §116.4
Continuing Education in conjunction with its review of Chapter 116 Dental
Laboratories and in accordance with the General Appropriations Act of 1997,
Article IX, Acts of the 75th Legislature 1997, §167, without changes
to the proposed text as published in the February 16, 2001 issue of the Texas
Register (26TexReg1466).
Amendments to §116.4 at subsection (b) are to correct grammar only.
The phrase "...shall be comprised of..." is changed to read "...shall comprise...".
Language in subsection (a) paragraph (1) and subsection (c) is amended to
comply with statutory language, which states that a dental technician may
be certified by a nationally recognized board and does not specify a particular
board.
The amended rule provides assurance to the public that the language of
the rule will be easier to read and accurately tracks statutory language.
No comments were received regarding adoption of the proposal.
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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101843
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §116.5
The State Board of Dental Examiners adopts amendments to §116.5
Exemption in conjunction with its review of Chapter 116 Dental Laboratories
and in accordance with the General Appropriations Act of 1997, Article IX,
Acts of the 75th Legislature 1997, §167, without changes to the proposed
text as published in the February 16, 2001 issue of the
Texas Register
(26TexReg1466).
Subsection (a) is amended to comply with Senate Bill 964, Section 25, effective
September 1, 1999. Paragraphs (1) and (2) are changed to modify the language
to comply with statutory language. Subsection (b) is amended to make it clear
that a dental technician must be present and working as an employee in the
dental laboratory.
The amended rule provides assurance to the public that the rule complies
with statutory language and is easier to understand.
No comments were received regarding adoption of the proposal.
The amended rule is adopted under Texas Government Code §2001.021
et.seq; Texas Civil Statutes, the Occupations Code §266.102 which authorizes
the Board to adopt rules affecting dental laboratories and §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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101842
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §116.20
The State Board of Dental Examiners adopts amendments to §116.20
Definitions and in conjunction with its review of Chapter 116 Dental Laboratories
in accordance with the General Appropriations Act of 1997, Article IX, Acts
of the 75th Legislature 1997, §167, without changes to the proposed text
as published in the February 16, 2001 issue of the
Texas Register
(26TexReg1467).
Changes in statutory references have been made to reflect the codification
of the Dental Practice Act into the Occupations Code, effective September
1, 1999.
The amended rule provides assurances to the public that statutory references
are current.
No comments were received regarding adoption of the proposal.
The amended rule is adopted under Texas Government Code §2001.021
et.seq; Texas Civil Statutes, the Occupations Code §266.102 which authorizes
the Board to adopt rules affecting dental laboratories and §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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101841
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §116.21
The State Board of Dental Examiners adopts amendments to §116.21,
Dental Laboratory and in conjunction with its review of Chapter 116 Dental
Laboratories in accordance with the General Appropriations Act of 1997, Article
IX, Acts of the 75th Legislature 1997, §167, without changes to the proposed
text as published in the February 16, 2001 issue of the
Texas Register
(26TexReg1468).
Changes in statutory references have been made to reflect the codification
of the Dental Practice Act into the Occupations Code.
The amended rule provides assurances to the public that statutory references
are current.
No comments were received regarding adoption of the proposal.
The amended rule is adopted under Texas Government Code §2001.021
et.seq; Texas Civil Statutes, the Occupations Code §266.102 which authorizes
the Board to adopt rules affecting dental laboratories and §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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101840
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §116.22
The State Board of Dental Examiners adopts amendments to §116.22,
In House Dental Laboratory in conjunction with its review of Chapter 116 Dental
Laboratories and in accordance with the General Appropriations Act of 1997,
Article IX, Acts of the 75th Legislature 1997, §167, without changes
to the proposed text as published in the February 16, 2001, issue of the
The language of the rule is changed to correct grammar and to reflect
the changes in statutory references by the codification of the Dental Practice
Act into the Occupations Code, effective September 1, 1999. The clause "...and
the laboratory does not employ more than two dental technicians..." is changed
to read "An in house laboratory may not employ more than two dental technicians."
The amended rule provides assurance to the public that statutory references
are current and that the language of the rule will be easier to understand.
No comments were received regarding adoption of the proposal.
The amended rule is adopted under Texas Government Code §2001.021
et.seq; Texas Civil Statutes, the Occupations Code §266.102 which authorizes
the Board to adopt rules affecting dental laboratories and §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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101839
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §116.24
The State Board of Dental Examiners adopts amendments to §116.24,
Registration Application and in conjunction with its review of Chapter 116
Dental Laboratories in accordance with the General Appropriations Act of 1997,
Article IX, Acts of the 75th Legislature 1997, §167, without changes
to the proposed text as published in the February 16, 2001, issue of the
The language of the rule is amended to reflect changes in statutory references
of the Dental Practice Act into the Occupations Code, effective September
1, 1999.
The amended rule provides assurances to the public that statutory references
are current.
No comments were received regarding adoption of the proposal.
The amended rule is adopted under Texas Government Code §2001.021
et.seq; Texas Civil Statutes, the Occupations Code §266.102 which authorizes
the Board to adopt rules affecting dental laboratories and §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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101838
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §116.25
The State Board of Dental Examiners adopts amendments to §116.25,
Responsibility and in conjunction with its review of Chapter 116, Dental Laboratories
in accordance with the General Appropriations Act of 1997, Article IX, Acts
of the 75th Legislature 1997, §167, without changes to the proposed text
as published in the February 16, 2001, issue of the
Texas Register
(26 TexReg 1458).
The language of the rule is amended to reflect changes in statutory references
of the Dental Practice Act into the Occupations Code, effective September
1, 1999.
The amended rule provides assurance to the public that statutory references
are current.
No comments were received regarding adoption of the proposal.
The amended rule is adopted under Texas Government Code §2001.021
et.seq; Texas Civil Statutes, the Occupations Code §266.102 which authorizes
the Board to adopt rules affecting dental laboratories and §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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101837
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §119.6
The State Board of Dental Examiners adopts amendments to §119.6,
Pediatric Dentistry and in conjunction with its review of Chapter 119, Special
Areas of Dental Practice, in accordance with the General Appropriations Act
of 1997, Article IX, Acts of the 75th Legislature 1997, §167, without
changes to the proposed text as published in the February 16, 2001, issue
of the
Texas Register
(26 TexReg 1470).
The language of the rule is amended to comply with the definition of the
specialty recommended and adopted in 1995 by the American Dental Association.
The Board has determined that the new definition is a refinement of the original
definition and contains more precise language.
The amended rule provides assurance to the public that the language of
the definition of pediatric dentistry comports with an updated and acceptable
interpretation of this special area of dental practice.
No comments were received regarding adoption of the proposal.
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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101836
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §119.7
The State Board of Dental Examiners adopts amendments to §119.7
Periodontology and in conjunction with its review of Chapter 119 Special Areas
of Dental Practice in accordance with the General Appropriations Act of 1997,
Article IX, Acts of the 75th Legislature 1997, §167, without changes
to the proposed text as published in the February 16, 2001 issue of the
The language of the rule is amended to comply with the definition of the
specialty recommended and adopted in 1995 by the American Dental Association.
The Board has determined that the new definition is a refinement of the original
definition and contains more precise language.
The amended rule provides assurance to the public that the language of
the definition of periodontics comports with an updated and acceptable interpretation
of this special area of dental practice.
No comments were received regarding adoption of the proposal.
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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101835
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
22 TAC §125.1
The State Board of Dental Examiners adopts amendments to §125.1
Board to Rule on Requests for Exceptions to Rules, and in conjunction with
its review of Chapter 125 Applications for Special Consideration or Exception
to Board Rules in accordance with the General Appropriations Act of 1997,
Article IX, Acts of the 75th Legislature 1997, §167, without changes
to the proposed text as published in the February 16, 2001 issue of the
Rule 125.1 was adopted in 1976 at a time when the Board conducted adjudicative
hearings under the Administrative Procedure and Texas Register Act. Hearings
are now conducted by the State Office of Administrative Hearings (SOAH). The
rule, as written, requires notice and hearing before an exception to the rules
can be considered. Many of the former rules concerning practices and procedures
before the agency have been supplanted by provisions of the Administrative
Procedure Act and SOAH rules. The Board has determined that it is appropriate
to have a vehicle for applicants to request an exception to the rules, so
long as such appearance does not involve a discussion of the merits of a pending
investigation or contested case that is scheduled for hearing at SOAH.
The amended rule provides an avenue to request exceptions to Board rules
that is easily understood and followed.
No comments were received regarding adoption of the proposal.
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.
This agency hereby certifies that the adoption has been reviewed
by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of
the Secretary of State on March 28, 2001.
TRD-200101834
Jeffry Hill
Executive Director
State Board of Dental Examiners
Effective date: April 17, 2001
Proposal publication date: February 16, 2001
For further information, please call: (512) 463-6400
Chapter 395.
CODE OF OPERATING PROCEDURE OF POLYGRAPH EXAMINERS
Chapter 103.
DENTAL HYGIENE LICENSURE
Chapter 104.
CONTINUING EDUCATION
Chapter 110.
ENTERAL CONSCIOUS SEDATION
Chapter 111.
PROFESSIONAL CORPORATIONS
Chapter 113.
REQUIREMENTS FOR DENTAL OFFICES
Chapter 116.
DENTAL LABORATORIES
Chapter 119.
SPECIAL AREAS OF DENTAL PRACTICE
Chapter 125.
APPLICATIONS FOR SPECIAL CONSIDERATION OR EXCEPTION TO BOARD RULES
Part 19.
POLYGRAPH EXAMINERS BOARD