BOD Meets in Orlando

By Casey Stoutamire, FDA Director of Third Party Payer and Professional Affairs

The Florida Board of Dentistry (BOD) met in Orlando on Friday, Nov. 19, at 7:30 a.m. The Florida Dental Association (FDA) was represented by FDA BOD Liaison Dr. Joe Calderone and Director of Third Party Payer and Professional Affairs Casey Stoutamire. Drs. Andy Brown, Dave Boden, Walter Colon and Steve Hochfelder also were in attendance.

The BOD members present included: Dr. Nick White, chair; Mr. Fabio Andrade (consumer member), vice chair; Drs. Christine Bojaxhi, Tom McCawley, Claudio Miro, Jose Mellado, Brad Cherry and T.J. Tejera; and hygiene members, Ms. Angela Johnson and Ms. Karyn Hill. There is one consumer position open on the board that the governor has not yet filled.

Ms. Hill gave the Council on Dental Hygiene report and presented the proposed rule language allowing hygienists to administer nitrous oxide under indirect supervision. Dr. Tejera informed the BOD that the Anesthesia Committee discussed the language and proposed adding special needs patients and previously sedated patients (including oral sedatives) to the American Society of Anesthesiologists (ASA) IV patients as those that must still be administered under direct supervision. The BOD unanimously approved language allowing a hygienist, with appropriate training, to administer nitrous oxide to ASA I-III patients under indirect supervision. Language also was approved that stated a hygienist, with appropriate training, can only administer nitrous oxide to ASA IV, special needs and previously sedated patients under direct supervision. This rule is not yet effective as it must still go through the administrative rulemaking process. The FDA will keep its members updated about this issue.

Dr. Tejera reported the Anesthesia Committee had a productive meeting with inspectors to discuss the amount of various drugs sedation permit holders must have in the dental office. Right now, the rule is an “adequate amount.” This objective standard is causing some confusion and leading to different inspectors requiring dentists to have different amounts upon inspection. Dr. Tejera said the proposed language will be presented to the BOD in February about how to better define the quantities of drugs required so it is not left up to interpretation. The language will most likely define “sufficient amounts to address medical emergencies” for 15 minutes in the definition section of the anesthesia rules and the definition will be based on advanced cardiovascular life support protocols. The FDA will continue to monitor and update its members accordingly.

Mr. Lawrence Harris, BOD attorney, discussed antitrust issues again; however, this time he mentioned the Alabama BOD case and its settlement with the Federal Trade Commission. As a reminder, President Biden created the White House Competition Council, whose goal is to promote competition in the American economy. Specifically, the council will coordinate, promote and advance federal government efforts to address overconcentration, monopolization and unfair competition in or

di- rectly affected the American economy. As a result, dental licensure and practice act issues will be scrutinized and all regulatory boards will increase anti-trust enforcement.

Finally, Dr. Tejera was elected chair and Mr. Andrade was elected vice chair for 2022. The FDA thanks Dr. White for his leadership as chair during the past year, and congratulates Dr. Tejera and Mr. Andrade on their elections. The FDA looks forward to working with them throughout the upcoming year.

There were five disciplinary cases, one informal hearing, one determination of waiver, two petitions for modification of final orders and two voluntary relinquishments dealing with failing to meet the minimum standard of care, ownership of a practice not entirely made up of licensed dentists and failing to keep adequate records. Peer Review could keep you from BOD disciplinary action. Only FDA members have the benefit of Peer Review. It is much better to be a spectator than a participant in BOD disciplinary cases.

The next BOD meeting is scheduled for Friday, Feb. 18 at 7:30 a.m. EDT in Gainesville.