New sweeping regulations went into effect on July 1, 2017 for dental anesthesia services in New York. The regulations, among other things, would require dentists to meet specific practice requirements, maintain more exacting records than previously required and complete additional and specific continued education courses. The regulations will also impose more stringent requirements on dentists providing dental sedation to patients 12 years old and younger. Below is a brief summary of the new requirements.
New practice requirements include, among other things, specifying that the licensed dentist is directly responsible for the anesthetic/sedative management, adequacy of the facility and staff, diagnosis and treatment of emergencies related to the administration of the sedation and provision of the equipment, drugs as well as protocols for patient rescue. Similarly, only a licensed dentist, licensed physician, a registered professional nurse or a licensed practical nurse can personally monitor recovery from conscious or deep sedation or general anesthesia. To minimize potential liability and professional misconduct charges dentists administering dental anesthesia should become familiar with the pre-operative preparation, monitoring, recover and discharge requirements now delineated in the regulations.
New and extensive record keeping requirements have also been implemented. This includes, among others, an obligation to obtain for certain patients a written or verbal medical consult for anesthesia administration as well as maintaining specific documentation of time oriented anesthesia records for the specific level of anesthesia administered. Time oriented anesthesia record, depending on the level of anesthesia, must include, among other requirements, the date of treatment, specific demographic information, specific pre-treatment evaluation, specific clinical care notations, as well as others.
New and more stringent requirements for certificate holders or those newly applying (after January 1, 2018) also went into effect. While certificate holders do not need to renew their registration until it expires they must still comply with the new practice requirements as of July 1, 2017. Additionally, certificate holders must demonstrate compliance with new registration requirements. For example, the licensed dentist must demonstrate the completion of an Advanced Cardiac Life Support (ACLS) or the Pediatric Advanced Life Support (PALS) for those administering dental anesthesia to patients 12 years or younger. Additionally, renewing dentists must have completed coursework that includes 12 clock hours (exclusive of the ACLS requirements) in anesthesia and anesthesia management, as further specified in the regulation (including specific coursework for dentists administering anesthesia to patients 12 years or younger).
Additionally, dentists should be ready for a Department review of dental anesthesia records upon renewal of their certificates. Similarly, dentists providing anesthesia services to patients 12 years or younger will have to submit to the Department for review 9 time-oriented anesthesia records of patients who were either treated by the dentist during their last triennial registration period or who were patients where dentist was the supervising attending dentists or a faculty member supervising student administration.
Certificates will be issued based on the type of anesthesia administered and the age of the patient population.
Dentists should also understand the different terms used by the regulations as many have specific meanings. For example, dentists should become familiar with the difference between conscious (moderate) sedation, deep sedation, general anesthesia, various pathways to induce, as well as other terms, such as continual, continually, continuous, and continuously as defined by the regulations.
If you have any questions about the new dental anesthesia regulations in New York, dental practice, or have other health law related questions please contact our office.