Section 12 AAC 28.015 - Permit requirements for use of moderate sedation, or for use of minimal sedation for a patient younger than 13 years of age(a) Unless exempt under 12 AAC 28.065, before administering moderate sedation to a patient, or minimal sedation to a patient younger than 13 years of age, a dentist licensed under AS 08.36 must have a moderate sedation permit issued by the board.(b) The requirement to obtain a permit to administer moderate or minimal sedation under this section does not apply to a dentist currently permitted under 12 AAC 28.010 to administer deep sedation and general anesthesia.(c) A dentist who holds a permit under this section may not administer or employ an agent or technique that has so narrow a margin for maintaining consciousness that the agent or technique is most likely to produce deep sedation or general anesthesia. These agents include ketamine, propofol, brevital, and sodium pentothal.(d) An applicant for an initial or renewed permit to administer moderate or minimal sedation under this section must (1) submit a completed application on a form provided by the board;(2) submit a dated and signed affidavit stating that the information provided is true, and that the dentist has read and complied with all applicable statutes and regulations;(3) submit, on a form provided by the board, a dated and signed affidavit attesting that the dentist's facility meets the requirements of this chapter for the administration of moderate or minimal sedation under this section;(4) hold a current registration to prescribe and administer controlled substances in this state issued by the United States Drug Enforcement Administration (DEA);(5) provide proof of current certification in advanced resuscitative techniques with hands-on simulated airway and megacode training for healthcare providers, including basic electrocardiographic interpretation; qualifying certification for an applicant who seeks to treat patients 13 years of age and older includes the American Heart Association's Advanced Cardiac Life Support (ACLS) for Health Professionals; qualifying certification for an applicant who seeks to treat patients younger than 13 year of age includes Pediatric Advanced Life Support (PALS) for Health Professionals; an applicant who seeks to treat patients of any age must also be certified in both ACLS for Health Professionals and PALS for Health Professionals or must be certified in equivalent qualifying certifications under this paragraph, one for advanced cardiac life support for health professionals and one for pediatric advanced life support for health professionals; and(6) submit the applicable fees specified in 12 AAC 02.190. (e) In addition to meeting the requirements of (d) and (g) of this section an applicant for an initial permit to administer moderate sedation to a patient who is at least 13 years of age under this section must (1) provide documentation that the applicant completed either (A) training in moderate sedation consistent with the Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students, as adopted by the American Dental Association (ADA) House of Delegates, October 2016, adopted by reference; the applicant must complete the training required under this subparagraph while enrolled in (i) a dental program accredited by the Commission on Dental Accreditation (CODA) of the American Dental Association; or(ii) a post-doctoral university or teaching hospital program; or(B) a board-approved continuing education course in sedation consistent with the Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students, adopted by reference in (A) of this paragraph, and required under 12 AAC 28.026; the course must consist of a minimum of 60 hours of instruction plus administration of sedation for at least 20 individually managed patients per participant to establish competency and clinical experience in moderate sedation and management of a compromised airway; and(2) Before administering moderate or minimal sedation to a patient younger than 13 years of age, an applicant for an initial permit must (A) provide proof that the applicant completed an additional 30 hours of board-approved coursework in pediatric moderate sedation required under 12 AAC 28.027(a); and(B) provide proof of administration of sedation for at least 20 individually managed patients younger than 13 years of age while under the supervision of a sedation provider holding a current moderate or deep sedation permit in good standing for patients under 13 years of age or an anesthesiologist or certified registered nurse anesthetist licenced in this state or another jurisdiction.(f) In addition to meeting the requirements of (d) and (g) of this section, an applicant for an initial permit to administer moderate or minimal sedation only to patients who are younger than 13 years of age under this section must provide proof of administration of sedation for at least 20 individually managed patients younger than 13 years of age to establish competency and clinical experience in management of a compromised airway, and provide documentation that the applicant has completed a Commission on Dental Accreditation (CODA) accredited residency in pediatric dentistry. (g) In addition to meeting the requirements of (d) and (e) of this section, or (f) of this section if administering moderate or minimal sedation to a patient who is younger than 13 years of age, an applicant for an initial permit to provide moderate sedation and minimal sedation under this section must provide documentation that (1) within three years immediately before application, the applicant completed training or education as required in this section in moderate sedation;(2) if more than three years but less than five years have elapsed since completing training or education as required in this section in moderate sedation, the applicant completed all continuing education that would have been required for a permit under this section;(3) if more than three years but less than five years have elapsed since completing training or education as required in this section in moderate sedation, the applicant completed a comprehensive review course approved by the board in moderate sedation;(4) if more than five years have elapsed since completing training or education as required in this section in moderate sedation, the applicant holds a permit for moderate sedation from another jurisdiction where the applicant is also licensed to practice dentistry and where the applicant completed at least 25 anesthesia cases at the moderate sedation level not earlier than the 24 months immediately preceding application; or(5) demonstrates current competency to the satisfaction of the board that the applicant has skill in moderate sedation to safely deliver moderate sedation services to the public.(h) In addition to meeting the requirements of (d) of this section, on or after March 1, 2019, a dentist who seeks to renew a permit to administer moderate or minimal sedation under this section must (1) during each biennial licensing period participate in four or more contact hours of continuing education that relates specifically to hands-on advanced airway management; contact hours earned from certification in health care provider basic life support (BLS), advanced cardiac life support (ACLS), and pediatric advanced life support (PALS) courses may be used to meet the continuing education requirements for obtaining or renewing a permit to administer moderate or minimal sedation under this section; if the permit holder provides (A) moderate or minimal sedation for patients younger than 13 years of age, the course must be a pediatric course;(B) moderate or minimal sedation for patients older and younger than 13 years of age, at least four contact hours of continuing education must relate specifically to hands-on advanced airway management of patients older than 13 years of age, and at least four additional contact hours of continuing education must relate specifically to hands-on advanced airway management of patients younger than 13 years of age;(2) during each biennial licensing period participate in four contact hours of continuing education that focuses on one or more of the following: (B) intravenous sedation;(F) nitrous oxide analgesia;(G) patient evaluation, patient monitoring, or medical emergencies;(3) complete at least 25 moderate sedation cases each biennial renewal period;(4) maintain continuing education records that can be audited, including course titles, instructors, dates attended, sponsors, and number of contact hours for each course; and(5) if seeking to renew a permit to administer moderate or minimal sedation to a patient younger than 13 years of age, (A) meet the requirements of this section;(B) provide documentation that at least 10 of the 25 moderate sedation cases were individually managed patients younger than 13 years of age.(i) A dentist who holds a permit for parenteral sedation that the board issued before April 14, 2018 will be issued a moderate sedation permit immediately.(j) After March 1, 2019, in order to provide moderate or minimal sedation to patients younger than 13 years of age, a dentist who holds a moderate sedation permit for a patient 13 years of age or older must (1) provide proof of an additional 30 hours of board-approved continuing education in pediatric moderate sedation required under 12 AAC 28.027; and(2) provide proof of administration of sedation for at least 20 individually managed patients younger than 13 years of age while under the supervision of a sedation provider holding a current moderate or deep sedation permit in good standing for patients under 13 years of age or an anesthesiologist or certified registered nurse ancsthetisty licensed in this state or another jurisdiction.(k) A dentist who has met the requirements of this section to administer moderate or minimal sedation to patients younger than 13 years of age will be issued a permit that so indicates.(l) A permit to administer moderate or minimal sedation under this section (1) Will be renewed when the dentist's license to practice is renewed if the dentist demonstrates continued compliance with AS 08.36 and this chapter; (2) lapses or expires on the date the dentist's license lapses or expires; and (3) may be reinstated if the permit has lapsed more than 60 days but less than two years if the applicant submits (A) a completed application for renewal on a form provided by the department; (B) the applicable renewal fee established in 12 AAC 02.190; and(C) evidence of continuing education and documentation of sedation cases required by (h)(1), (2), (3) and (5) of this section, as applicable; The sedation cases required under this subparagraph must be completed while holding a current moderate sedation permit, or while under the supervision of a current deep sedation and general anesthesia permit holder, or an anesthesiologist or certified registered nurse anesthetist. (m) For purposes of this section, (1) one contact hour equals 50 minutes of instruction;(2) one academic semester credit hour equals 15 contact hours;(3) one academic quarter credit equals 10 contact hours; and(4) one continuing education credit equals one contact hour.(n) Credit is given only for class hours and not hours devoted to class preparation.Eff. 4/14/2018, Register 226, July 2018; am 12/9/2018, Register 228, January 2019; am 5/1/2019, Register 230, April 2019; am 3/5/2020, Register 233, April 2020 Authority:AS 08.01.065
AS 08.36.070
AS 08.36.100
AS 08.36.110
AS 08.36.234
AS 08.36.250