Rule 24.138.3221 - MINIMUM QUALIFYING STANDARDS(1) A Montana licensed dentist must possess a permit to administer moderate sedation or deep sedation/general anesthesia.(2) All requirements for the use of moderate sedation or deep sedation/general anesthesia apply, regardless of the agent used or the route of administration, when the intended or probable effect is a level of depression greater than minimal sedation.(3) A deep sedation/general anesthesia permit is required to administer or employ any agent(s) which has a narrow margin for maintaining consciousness, including, but not limited to, ultrashort-acting barbiturates, including, but not limited to, sodium methohexital, thiopental, propofol, ketamine, etomidate, and similarly acting drugs, or quantity of agent(s), or technique(s), or any combination, thereof, that would possibly render a patient deeply sedated or generally anesthetized.(4) All applicants for deep sedation/general anesthesia permits must have: (a) completed a residency accredited by the Commission on Dental Accreditation in one of the following areas: (i) a minimum of four years in an oral and maxillofacial surgery residency; or(ii) a minimum of two years in an advanced general dentistry education program in dental anesthesiology; and(b) completed an advanced course in cardiac life support within two years of the date of permit application. Web-based courses must include a hands-on lab or megacode portion of training.(5) All applicants for moderate sedation permits must have: (a) received formal training in moderate sedation techniques from an institution, organization, or training course. If training for moderate sedation is through continuing education, proof of course content must accompany the initial application in the form of a course outline or syllabus; and(b) a minimum of 60 hours of instruction plus management of at least 20 dental patients, by the intravenous route.(6) Applicants seeking to use inhalation sedation must: (a) complete a course of instruction of a minimum of 14 hours, including a clinical component. This course of instruction may be completed as part of the predoctoral dental education program or in a postdoctoral continuing education competency course; or(b) demonstrate competence and skill in administering nitrous oxide/oxygen sedation by virtue of experience and/or comparable alternative training.(7) Applicants seeking to administer enteral minimal and/or combination inhalation sedation must complete a minimum of 16 hours of training, including a clinical component. Training must include the treatment of a compromised airway and other life-threatening emergencies. The course may be completed in a predoctoral dental education curriculum or in a postdoctoral continuing education competency course. (a) Supplemental dosing can be used for enteral minimal sedation or enteral minimal sedation and/or combination inhalation sedation.(b) Nitrous oxide/oxygen may only be used with a single drug for minimal sedation.(8) Applicants who meet all requirements for a moderate sedation or deep sedation/general permit with the exception of having passed an initial inspection may be issued a temporary permit to administer moderate sedation or deep sedation/general prior to the initial inspection.Mont. Admin. r. 24.138.3221
NEW, 1985 MAR p. 1994, Eff. 12/27/85; AMD, 1987 MAR p. 155, Eff. 2/14/87; AMD, 1989 MAR p. 2179, Eff. 12/22/89; AMD, 1993 MAR p. 393, Eff. 3/26/93; AMD, 1994 MAR p. 1130, Eff. 4/29/94; TRANS, from Commerce, & AMD, 2003 MAR p. 2435, Eff. 10/31/03; AMD and TRANS, from 24.138.3203, 2011 MAR p. 2629, Eff. 12/9/11; AMD, 2017 MAR p. 2281, Eff. 12/9/2017; AMD, 2024 MAR p. 2205, Eff. 9/21/2024AUTH: 37-1-131, 37-4-205, MCA; IMP: 37-1-131, 37-4-101, 37-4-511, MCA