N.Y. Comp. Codes R. & Regs. tit. 8 § 52.9

Current through Register Vol. 46, No. 45, November 2, 2024

Section 52.9 - Dental hygiene

(a) For licensure qualifying programs, admission requirements shall include successful completion of an approved four-year course of study in an approved secondary school.

(b) Requirements for programs leading to the dental hygiene restricted local infiltration anesthesia/nitrous oxide analgesia certificate.

(1) Definitions. As used in this subdivision:

(i) Analgesia means the diminution of pain.

(ii) Anxiolysis means the diminution or elimination of anxiety.

(iii) Conscious sedation means a minimally depressed level of consciousness that retains the patient's ability to independently and continuously maintain an airway and respond appropriate to physical stimulation and verbal command and that is produced by a pharmacologic or nonpharmacologic method or a combination thereof. Patients whose only response is reflex withdrawal from repeated painful stimuli shall not be considered to be in a state of conscious sedation.

(iv) Deep sedation means an induced state of depressed consciousness accompanied by partial loss of protective reflexes, including the inability to continually maintain and airway independently and/or to response purposefully to physical stimulation or verbal command, and is produced by a pharmacologic or nonpharmacologic method or a combination thereof.

(v) General anesthesia means an induced state of unconsciousness, accompanied by partial or complete loss of protective reflexes, including the inability to maintain an airway independently and response purposefully to physical stimulation or verbal command, and is produced by a pharmacologic or nonpharmacologic method or a combination thereof.

(vi) Infiltration anesthesia means local anesthetic solution deposited near the terminal nerve endings in the area of prospective dental hygiene treatment.

(vii) Local anesthesia means the elimination of sensation, especially pain, in one part of the body by topical application or regional injection of a drug.

(viii) Local infiltration anesthesia means the administration of a local anesthetic solution, meant for the elimination of sensation, especially pain, in one part of the body by the regional injection of a drug, near the terminal nerve endings in the area of prospective dental hygiene treatment.

(ix) Nitrous oxide analgesia means the administration of a combination of nitrous oxide and oxygen producing a diminution of pain and anxiety (anxiolysis).

(x) Scavenging system means the basic engineering control for waste nitrous oxide gas. Such systems collect waste gas and ventilate it from the operating room.

(xi) Under person supervision of a licensed dentist means that the supervising licensed dentist remains in the dental office or other location where the local infiltration anesthesia or nitrous oxide analgesia services are being performed by the licensed dental hygienist or other student in clinical practice in a program registered pursuant to this subdivision, personally authorizes and prescribes the use of local infiltration anesthesia or nitrous oxide analgesia for the patient and, before dismissal of the patient, personally examines the condition of the patient after the use of local infiltration anesthesia or nitrous oxide analgesia that is administered by the licensed dental hygienist or other student in clinical practice in a program registered pursuant to this subdivision is completed.

(2) In addition to meeting all applicable provisions of this Part, to be registered as a program leading to the dental hygiene restricted local infiltration anesthesia/nitrous oxide analgesia certificate, the program shall be offered by an institution which has programs that are registered by the department pursuant to this Part as leading to licensure in dentistry and/or dental hygiene and include the didactic component and clinical and laboratory experience component, as prescribed in this paragraph. A student admitted to the program must be a dental hygienist licensed in New York State or a student in a program registered as leading to licensure in dental hygiene pursuant to subdivision (a) of this section.

(i) Didactic component. The program shall include at least 30 clock hours of didactic instruction relating to the administration and monitoring of local infiltration anesthesia and nitrous oxide analgesia in the practice of dental hygiene. Such coursework shall include, but not be limited to, the following content areas:

(a) relevant New York State Education Law and commissioner's regulations;

(b) medical history and evaluation procedures;

(c) review of pediatric and adult respiratory and circulatory physiology and related anatomy;

(d) stages of drug-induced central nervous system depression through levels of anxiolysis, conscious sedation, deep sedation and general anesthesia;

(e) definitions and descriptions of physiological and psychological aspects of anxiety and pain;

(f) pharmacology of agents used in inhalation sedation, local anesthesia and vasoconstrictors, including drug interactions and incompatibilities;

(g) indications and contraindications for use of inhalation sedation and local anesthesia;

(h) recommended dosages of local anesthesia and nitrous oxide analgesia;

(i) patient monitoring using observation, with particular attention to vital signs and reflexes related to consciousness;

(j) selection and preparation of the armamentaria and recordkeeping for administering various local anesthetic agents and nitrous oxide analgesia;

(k) recognition and management of complications and management of reactions to local anesthetic agents and nitrous oxide analgesia;

(l) proper infection control techniques with regard to local anesthetic and nitrous oxide analgesia and proper disposal of sharps;

(m) description and use of inhalation sedation equipment;

(n) introduction to potential health hazards of trace anesthetics and proposed techniques for limiting occupational exposure such as appropriate scavenging systems;

(o) abuse potential and hallucinatory effects of nitrous oxide analgesia;

(p) post-operative care of the patient and instruction to the patient; and

(q) a course in basic life support (BLS), or its equivalent as determined by the department.

(ii) Clinical and laboratory experience component. The program shall include at least 15 clock hours of clinical and laboratory experience relating to the administration and monitoring of local infiltration anesthesia and nitrous oxide analgesia in the practice of dental hygiene. When a licensed dental hygienist or other student administers or monitors nitrous oxide analgesia or local infiltration anesthesia in such clinical or laboratory practice, the licensed dental hygienist or other student shall be under the personal supervision of a licensed dentist, as defined in paragraph (1) of this subdivision. Such experience shall include, but not be limited to, the following:

(a) selection and preparation of the armamentaria for administering various local anesthetic agents and nitrous oxide analgesia including demonstrations regarding scavenging systems;

(b) demonstration of proper infection control techniques with regard to local anesthetics agents and nitrous oxide analgesia and proper disposal of sharps;

(c) demonstration of proper evaluation of the patient's health status, taking the patient's vital signs and monitoring the patient's physical status while under the effects of local anesthesia and/or nitrous oxide analgesia;

(d) administration of local anesthetic in conjunction with inhalation sedation techniques;

(e) a clinical experience demonstrating the successful use of local infiltration anesthesia in no fewer than 15 instances involving the treatment of a patient, provided that no individual patient may be treated more than three times; and a clinical experience, demonstrating the successful use of nitrous oxide analgesia in no fewer than 15 instances involving the treatment of a patient, of which at least five instances would be induced by the candidate and the remaining instances would be observed by the candidate, provided that in no such instance may an individual patient be treated more than two times. The clinical experience prescribed in this clause shall be under the personal supervision of a licensed dentist, as defined in paragraph (1) of this subdivision.

N.Y. Comp. Codes R. & Regs. Tit. 8 § 52.9