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BOD – Proposed Revision to Anesthesia Rule and More!
Proposed Revision to Anesthesia Rule and More!
By Casey Stoutamire, FDA Director of Third Party Payer and Professional Affairs
The Florida Board of Dentistry (BOD) met in Tampa on Friday, Aug. 12, at 7:30 a.m. The Florida Dental Association (FDA) was represented by FDA BOD Liaison Dr. Andy Brown and Director of Third Party Payer and Professional Affairs Casey Stoutamire. Dr. Jim Haddix was also in attendance. Several hygiene students from St. Petersburg College and Hillsborough Community College also attended the meeting.
BOD members present included: Dr. T.J. Tejera, chair; Drs. Brad Cherry, Tom McCawley, Jose Mellado, Claudio Miro and Nick White; hygiene members, Ms. Karyn Hill and Ms. Angela Johnson. Dr. Christine Bojaxhi and consumer member Mr. Fabio Andrade were absent (excused). There is one consumer member position open on the board that the governor has yet to fill.
The board approved proposed revisions to Rule 64B5-16.001 suggested by the Council to Dental Hygiene to align the rule with Florida Statute 466.003(10). The rule will now read:
64B5-16.001 Defintions of Remediable Tasks and Supervision Levels.
Sections (1)-(5); (7)-(9) No change
(6) General supervision requires that a licensed dentist examine the patient, diagnose a condition to be treated, and authorizes the procedures to be performed but need not be present when the authorized procedures are being performed. The authorized procedures may also be performed at a place other than the dentist’s usual place of practice. The board also approved a proposed revision to the anesthesia rules specifically about inspections. The main addition to Rule 64B-14.007(2), Inspection of Facilities and Demonstration of Sedation Techniques, states: (d)Demonstration of General Anesthesia/Deep Sedation, Moderate Sedation, and Pediatric Moderate Sedation as set forth in above subsections (2)(a)-(c) of this rule shall be conducted in accordance with the minimum standards of diagnosis and treatment when measured against generally prevailing peer performance. A demonstration that is not performed in accordance with minimum standards shall be cause for a failing grade.
The BOD Anesthesia Committee met the afternoon before the full board meeting. It asked board counsel to work on language removing the prohibition on the use of Dexmedetomidine by moderate sedation permit holders. The committee wants the rule to require the dentist to have an electrocardiogram, know how to read it and have a continuing education course on the drug if he/she is going to use the drug for sedation. The committee will meet again to discuss proposed language with the intent to bring the proposal to the full board at the November meeting. As always, the FDA will keep you updated with any developments.
As a reminder, in November 2021, the board unanimously approved language allowing a hygienist with appropriate training to administer nitrous oxide to American Society of Anesthesiology (ASA) I-III patients under indirect supervision. Language was
The next BOD meeting is scheduled for Friday, Nov. 18, at 7:30 a.m. ET in Ft. Lauderdale.
also 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 now effective.
At its Nov. 18, 2022 meeting, the board will also be discussing the rules on licensure as they relate to the timing of the dental exam. Currently, the Florida rule requires an applicant to complete and pass all parts of the American Board of Dental Examiners (ADEX) exam within 18 months of taking the first part of the exam. However, the Commission on Dental Competency Assessments (CDCA) rule (which the Florida rule was modeled after) now states that all parts of the ADEX exam must be completed within 18 months of an applicant starting his/her D4 year. As such, representatives from the CDCA will attend the November meeting to advise the board on this and any other changes it has made. The board can then make any necessary revisions to the rule.
There were six disciplinary cases, two informal hearings, and one petition for medication of final order dealing with failing to meet the minimum standard of care for the treatment of minor children in braces; root canals by a general dentist; periodontal surgery (sedation issues) where the patient ended up in the intensive care unit intubated for three days and in the hospital for nine days; a wrong tooth extraction; and failing to keep adequate records. If you have not attended a BOD meeting, it is suggested that you take the opportunity to attend and see the work of the BOD. It is much better to be a spectator than a participant in BOD disciplinary cases.
