Part 5.
STATE BOARD OF DENTAL EXAMINERS
Chapter 108.
PROFESSIONAL CONDUCT
Subchapter A. PROFESSIONAL RESPONSIBILITY
22 TAC §108.6
The State Board of Dental Examiners adopts amendments to §108.6,
Report of Patient Death or Injury requiring Hospitalization, with changes
to the text published in the April 27, 2001 issue of the
Texas Register
(26 TexReg 3109). Changes to the text of the rule are
found in paragraphs (1) and (2).
Rule 108.6 provides for the reporting of adverse consequences resulting
from the receipt of dental services by the treating dentist. The amended rule
shortens the time period within which a patient death must be reported and
clarifies language of the rule. In response to publication for comment, the
Board received written comments from representatives of the Texas Dental Association.
The language of the rule is modified to require that a patient death occurring
as a consequence of receiving dental services must be reported 72 hours of
the time when the reporting dentist knew or should have known of the death.
This time is shortened from 30 days. Language is also changed to reflect that
a report of injury occurring as a consequence of receiving dental services
must be reported within 30 days. The words "...or injury..." are added in
the last paragraph, to make it clear that the paragraph addresses reports
of both deaths and injuries.
The amended rule will assure the public that proper emphasis is placed
upon the unfortunate circumstance of the death of a patient as a consequence
of receiving dental services. Such an event requires timely inquiry and investigation
and the Board is of the opinion that 30 days is too long a period of time
to wait before reporting a patient death.
The written comments express strong support for the intent of the amendment
but suggest additional language, which will address those situations where
an adverse event has occurred but it is not clear that the event was a consequence
of receiving dental services.
The language of the rule, as written leaves open the possibility that a
treating dentist could conclude, on his/her own, that a patient death was
not a consequence of the receipt of dental services and thus did not require
a report. The Board should make that conclusion, after a thorough investigation.
Addition of the words "...may have..." to paragraph (1) and the word "...possible..."
to paragraph (2) as proposed by the Texas Dental Association eliminates guesswork.
The Board approves the language suggested by the Texas Dental Association.
Rule 108.6 is amended at paragraphs (1) and (2)
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 promulgate
rules consistent with the Dental Practice Act.
§108.6.Report of Patient Death or Injury Requiring Hospitalization.
A dentist must submit a written report to the Board as provided below:
(1)
The death of a dental patient which may have occurred as
a consequence of the receipt of dental services from the reporting dentist
must be reported within 72 hours of the death, or such time as the dentist
becomes aware or reasonably should have become aware of the death;
(2)
An injury to a dental patient requiring admission to a
hospital, as a possible consequence of receiving dental services from the
reporting dentist must be reported within 30 days of the injury.
(3)
The receipt of the report shall not be considered in the
nature of a complaint unless the Enforcement Committee determines that the
circumstances surrounding the patient death or injury should be investigated
by the Board.
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 June 20, 2001.
TRD-200103496
Jeffry R. Hill
Executive Director
State Board of Dental Examiners
Effective date: July 10, 2001
Proposal publication date: April 27, 2001
For further information, please call: (512) 463-6400
22 TAC §108.32
The State Board of Dental Examiners adopts amendments to §108.32
Minimum Standard of Care, Anesthesia, with changes to the text published in
the April 27, 2001 issue of the
Texas Register
(26 TexReg 3109). The change at paragraph (3) from "Shall obtain an review..."
to "Shall obtain and review..." is a grammatical correction only. No other
changes were made to rule 108.32.
The lead paragraph has been modified to delete the word "...parenteral..."
as a modifier of "deep sedation and general anesthesia". Deletion of the word
"parenteral" when it is such a modifier in Rules 108.32, 108.33, and 108.34
has the effect of requiring that all licensees who administer deep sedation
and/or general anesthesia must have a permit to do so, whether the sedative
agents are administered parenterally or by any other route. Without this change,
dentists, by use of orally administered sedative agents, could deeply sedate
patients without having a permit.
The amended rule will require that dentists who intend to administer deep
sedation and/or general anesthesia must obtain a permit to do so, no matter
how the sedative agents are administered.
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 promulgate
rules consistent with the Dental Practice Act.
§108.32.Minimum Standard of Care, Anesthesia.
In the interest of patient safety, a dentist licensed by the State
Board of Dental Examiners and practicing in Texas, who desires to utilize
nitrous oxide/oxygen inhalation conscious sedation, parenteral conscious sedation,
and/or deep sedation and general anesthesia:
(1)
Shall maintain a patient record:
(A)
from which a diagnosis may be made;
(B)
which includes a description of treatment rendered;
(C)
includes the date on which treatment is performed; and
(D)
which includes any information a reasonable and prudent
dentist in the same or similar circumstances would include.
(2)
Shall maintain and review an initial medical history and
perform limited physical evaluation for all dental patients to wit:
(A)
The initial medical history shall include, but shall not
necessarily be limited to, known allergies to drugs, serious illness, current
medications, previous hospitalizations and significant surgery, and a review
of the physiologic systems obtained by patient history. A "check list", for
consistency, may be utilized in obtaining initial information. The dentist
shall review the medical history with the patient at any time a reasonable
and prudent dentist in the same or similar circumstance would so do.
(B)
The initial limited physical examination should include,
but shall not necessarily be limited to, blood pressure and pulse/heart rate
as may be indicated for each patient.
(3)
Shall obtain and review an updated medical history and
limited physical evaluation when a reasonable and prudent dentist under the
same or similar circumstances would determine it is indicated.
(4)
Shall, for office emergencies:
(A)
maintain a positive pressure breathing apparatus including
oxygen which shall be in working order.
(B)
maintain other emergency equipment and/or currently dated
drugs as a reasonable and prudent dentist with the same or similar training
and experience in the same or similar circumstances would maintain;
(C)
provide training to dental office personnel in emergency
procedures which shall include, but not necessarily be limited to, basic cardiac
life support, inspection and utilization of emergency equipment in the dental
office, and office procedures to be followed in the event of an emergency
as determined by a reasonable and prudent dentist in the same or similar circumstances;
and
(D)
shall adhere to generally accepted protocols and/or standards
of care for management of complications and emergencies.
(5)
Shall successfully complete a current course in basic cardiopulmonary
resuscitation given or approved by either the American Heart Association or
the American Red Cross.
(6)
Should maintain a written informed consent signed by the
patient, or a parent or legal guardian of the patient if the patient is a
minor, or a legal guardian of the patient if the patient has been adjudicated
incompetent to manage the patient's personal affairs. Such consent is required
for all procedures where a reasonable possibility of complications from the
procedure exists, and such consent should disclose risks or hazards that could
influence a reasonable person in making a decision to give or withhold consent.
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 June 20, 2001.
TRD-200103497
Jeffry R. Hill
Executive Director
State Board of Dental Examiners
Effective date: July 10, 2001
Proposal publication date: April 27, 2001
For further information, please call: (512) 463-6400
22 TAC §108.33
The State Board of Dental Examiners adopts amendments to §108.33
Sedation/Anesthesia Permit without changes to the text published in the April
27, 2001 issue of the
Texas Register
(26 TexReg
3110).
The modifier "...parenteral..." has been deleted before "deep sedation
and general anesthesia" in Subsections (b), (c), (f)(5), (f)(5)(A), (g)(3),
(g)(3)(A), (g)(3)(A)(ii), (g)(3)(B), and (g)(3)(B)(i), (ii), (iii). Deletion
of the word "parenteral" when it is such a modifier in Rules 108.32, 108.33,
and 108.34 has the effect of requiring that all licensees who administer deep
sedation and/or general anesthesia must have a permit to do so, whether the
sedative agents are administered parenterally or by any other route. Without
this change, dentists, by use of orally administered sedative agents, could
deeply sedate patients without having a permit.
The language of subsection (g)(2)(A)(i) has been modified to substitute
the words "for the" in place of "in" and to add the words "technique requested."
Parenteral conscious sedation can be achieved intramuscularly, subcutaneously,
intravenously or submucosally. These changes clarify that an applicant for
a parenteral conscious sedation permit must have received training in the
particular technique or techniques that he/she will utilize to achieve parenteral
conscious sedation. Clause ii has been modified to add the words "...the parenteral
conscious sedation technique requested."
The amended rule will require that dentists who intend to administer deep
sedation and/or general anesthesia must be permitted to do so, no matter how
the sedative agents are administered. Further, the public will be assured
that one who holds a permit for a particular technique of administering parenteral
conscious sedation will have received training in that particular technique.
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 promulgate
rules consistent with the Dental Practice Act.
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 June 20, 2001.
TRD-200103498
Jeffry R. Hill
Executive Director
State Board of Dental Examiners
Effective date: July 10, 2001
Proposal publication date: April 27, 2001
For further information, please call: (512) 463-6400
22 TAC §108.34
The State Board of Dental Examiners adopts amendments to §108.34,
Permit Requirements and Clinical Provisions without changes to the text published
in the April 27,2001 issue of the
Texas Register
(26TexReg3113).
The modifier "...parenteral..." has been deleted before "deep sedation
and general anesthesia" in Subsections (c) (1) (A) and (B), (c) (2) (B), (D)
and (F), (c) (3), (A), (B)(ii), (C) (i), (iii), and (v), (D), (iv) and (v),
(F) (i) and (ii), (G) (i). Deletion of the word "parenteral" when it is such
a modifier in Rules 108.32, 108.33, and 108.34 has the effect of requiring
that all licensees who administer deep sedation and/or general anesthesia
must have a permit to do so, whether the sedative agents are administered
parenterally or by any other route. Without this change, dentists, by use
of orally administered sedative agents, could deeply sedate patients without
having a permit
The amended rule will assure the public that practitioners who wish to
utilize any technique to achieve deep sedation or general anesthesia will
have a permit from the Board.
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 promulgate
rules consistent with the Dental Practice Act.
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 June 20, 2001.
TRD-200103499
Jeffry R. Hill
Executive Director
State Board of Dental Examiners
Effective date: July 10, 2001
Proposal publication date: April 27, 2001
For further information, please call: (512) 463-6400
22 TAC §108.43
The State Board of Dental Examiners adopts amendments to §108.43,
Operating Requirements for Permitted Mobile Dental Facilities or Portable
Dental Units without changes to the text published in the April 27, 2001 issue
of the
Texas Register
(26TexReg3117).
The language of Subsection (b) (3) is modified to provide that a practitioner
who provides dental services to less than three persons at a private residence
is not required to prepare an annual report of those services. All other requirements
of the chapter apply to such a practitioner, but the Board agrees that the
detailed reporting requirements for services provided in private homes is
unduly burdensome.
The amended rule insures that application of the rule will not have an
unduly harsh impact upon those who make house calls to patients.
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 promulgate
rules consistent with the Dental Practice Act.
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 June 20, 2001.
TRD-200103500
Jeffry R. Hill
Executive Director
State Board of Dental Examiners
Effective date: July 10, 2001
Proposal publication date: April 27, 2001
For further information, please call: (512) 463-6400
22 TAC §115.1
The State Board of Dental Examiners adopts amendments to §115.1,
Definitions without changes to the text published in the April 27, 2001, issue
of the
Texas Register
(26 TexReg 3118).
Paragraph 5 has been added to provide a definition of a supervising dentist,
in the context of the practice of dental hygiene. Paragraph 6 has been added
to define the term "General Supervision", and clarifies that a dental hygienist
can be generally supervised by a supervising dentist even when the dentist
is not on the premises. It should be noted that this definition has no effect
on the provisions of Section 262.151 of the Occupations Code that a dental
hygienist may see a patient when the dentist is not on the premises if the
patient has been examined within the 12 months previous to the appointment
with the hygienist.
The amended rule will clarify respective relationships between a dentist,
a dental hygienist and a dental patient.
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 promulgate
rules consistent with the Dental Practice Act.
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 June 20, 2001.
TRD-200103502
Jeffry R. Hill
Executive Director
State Board of Dental Examiners
Effective date: July 10, 2001
Proposal publication date: April 27, 2001
For further information, please call: (512) 463-6400
22 TAC §115.2
The State Board of Dental Examiners adopts amendments to §115.2,
Permitted Duties without changes to the text published in the April 27, 2001,
issue of the
Texas Register
(26 TexReg 3119).
Language of the lead paragraph has been changed to reflect the codification
of the former Dental Practice Act into the Texas Occupations Code. Language
in the paragraph has also been modified to reflect that a dental hygienist
must work in the office of and under the supervision of a licensed dentist
or in an alternate setting. This language complies with the statutory language
of Senate Bill 964, Section 20, enacted by the 76th Legislature, effective
September 1, 1999. Paragraph 1 has been divided into two subparagraphs, which
provide that a dental hygienist who graduated from an accredited and approved
dental or dental hygiene school after December 31, 1980, may place pit and
fissure sealants without first having obtained a certificate from the Board.
Dental hygienists who graduated from such a school before December 31, 1980,
must apply to the Board for certification to place pit and fissure sealants.
Every dental hygienist who graduated from a Texas dental or dental hygiene
school that is accredited and approved after December 31, 1980 has completed
the necessary course work to obtain a certificate to place pit and fissure
sealants from the Board. The Board agrees that is unnecessary to require such
graduates to apply for that certificate.
The amended rule will be in compliance with statutory language and will
recognize the realities of modern dental practice and education.
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 promulgate
rules consistent with the Dental Practice
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 June 20, 2001.
TRD-200103501
Jeffry R. Hill
Executive Director
State Board of Dental Examiners
Effective date: July 10, 2001
Proposal publication date: April 27, 2001
For further information, please call: (512) 463-6400
Chapter 463.
APPLICATIONS AND EXAMINATIONS
22 TAC §463.9
The Texas State Board of Examiners of Psychologists adopts
amendments to §463.9, concerning Licensed Specialist in School Psychology,
without changes to the proposed text as published in the April 20, 2001, issue
of the
Texas Register
(26 TexReg 2923).
The amendments are being adopted in order to clarify the training requirements
for licensed specialists in school psychology.
The adopted rule will make the rules easier for the applicants for licensure
to follow and understand.
No comments were received regarding the adoption of the amendments.
The amendments are adopted under Texas Occupations Code, Title
3, Subtitle I, Chapter 501, which provides the Texas State Board of Examiners
of Psychologists with the authority to make all rules, not inconsistent with
the Constitution and Laws of this State, which are reasonably necessary for
the proper performance of its duties and regulations of proceedings before
it.
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 June 18, 2001.
TRD-200103449
Sherry L. Lee
Executive Director
Texas State Board of Examiners of Psychologists
Effective date: July 8, 2001
Proposal publication date: April 20, 2001
For further information, please call: (512) 305-7700
22 TAC §463.11
The Texas State Board of Examiners of Psychologists adopts
amendments to §463.11, concerning Licensed Psychologist, without changes
to the proposed text as published in the April 20, 2001, issue of the
The amendments are being adopted to update requirements, consistent with
Attorney General Opinion JC-0321.
The adopted rule will make the rules easier for the general public and
licensees to follow and understand.
No comments were received regarding the adoption of the amendments.
The amendments are adopted under Texas Occupations Code, Title
3, Subtitle I, Chapter 501, which provides the Texas State Board of Examiners
of Psychologists with the authority to make all rules, not inconsistent with
the Constitution and Laws of this State, which are reasonably necessary for
the proper performance of its duties and regulations of proceedings before
it.
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 June 18, 2001.
TRD-200103450
Sherry L. Lee
Executive Director
Texas State Board of Examiners of Psychologists
Effective date: July 8, 2001
Proposal publication date: April 20, 2001
For further information, please call: (512) 305-7700
22 TAC §463.14
The Texas State Board of Examiners of Psychologists adopts
amendments to §463.14, concerning Written Examinations, without changes
to the proposed text as published in the April 20, 2001, issue of the
The amendments are being adopted in order to change the passing rate on
the Jurisprudence Examination from 70% to 90% to accommodate the conversion
of this exam to open-book format.
The adopted rule will protect the public by helping to ensure that only
qualified applicants are licensed.
No comments were received regarding the adoption of the amendments.
The amendments are adopted under Texas Occupations Code, Title
3, Subtitle I, Chapter 501, which provides the Texas State Board of Examiners
of Psychologists with the authority to make all rules, not inconsistent with
the Constitution and Laws of this State, which are reasonably necessary for
the proper performance of its duties and regulations of proceedings before
it.
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 June 18, 2001.
TRD-200103451
Sherry L. Lee
Executive Director
Texas State Board of Examiners of Psychologists
Effective date: July 8, 2001
Proposal publication date: April 20, 2001
For further information, please call: (512) 305-7700
22 TAC §465.6
The Texas State Board of Examiners of Psychologists adopts
amendments to §465.6, concerning Listings, Public Statements and Advertisements,
Solicitations, and Specialty Titles without changes to the proposed text as
published in the April 20, 2001, issue of the
Texas
Register
(26 TexReg 2925).
The amendments are being adopted in order to address changing practices
within the profession.
The adopted rule will make the rules easier for the general public and
licensees to follow and understand.
No comments were received regarding the adoption of the amendments.
The amendments are adopted under Texas Occupations Code, Title
3, Subtitle I, Chapter 501, which provides the Texas State Board of Examiners
of Psychologists with the authority to make all rules, not inconsistent with
the Constitution and Laws of this State, which are reasonably necessary for
the proper performance of its duties and regulations of proceedings before
it.
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 June 18, 2001.
TRD-200103452
Sherry L. Lee
Executive Director
Texas State Board of Examiners of Psychologists
Effective date: July 8, 2001
Proposal publication date: April 20, 2001
For further information, please call: (512) 305-7700
22 TAC §465.38
The Texas State Board of Examiners of Psychologists adopts
amendments to §465.38, concerning Psychological Services in the Schools
without changes to the proposed text as published in the April 20, 2001, issue
of the
Texas Register
(26 TexReg 2926).
The amendments are being adopted in order to clarify contracting allowed
by non-LSSPs in the public schools.
The adopted rule will make the rules easier for the general public and
licensees to follow and understand.
No comments were received regarding the adoption of the amendments.
The amendments are adopted under Texas Occupations Code, Title
3, Subtitle I, Chapter 501, which provides the Texas State Board of Examiners
of Psychologists with the authority to make all rules, not inconsistent with
the Constitution and Laws of this State, which are reasonably necessary for
the proper performance of its duties and regulations of proceedings before
it.
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 June 18, 2001.
TRD-200103453
Sherry L. Lee
Executive Director
Texas State Board of Examiners of Psychologists
Effective date: July 8, 2001
Proposal publication date: April 20, 2001
For further information, please call: (512) 305-7700
Subchapter C. ANESTHESIA AND ANESTHETIC AGENTS
Subchapter D. MOBILE DENTAL FACILITIES
Chapter 115.
EXTENSION OF DUTIES OF AUXILIARY PERSONNEL--DENTAL HYGIENE
Part 21.
TEXAS STATE BOARD OF EXAMINERS OF PSYCHOLOGISTS
Chapter 465.
RULES OF PRACTICE
Chapter 470.
ADMINISTRATIVE PROCEDURE