North Dakota Administrative Code › Title 20 - State Board of Dental Examiners › Article 20-01 - General Administration › Chapter 20-01-02 - Definitions › Section 20-01-02-01 - Definitions

Current through Supplement No. 393, July, 2024
Unless specifically stated otherwise, the following
			  definitions are applicable throughout this title:
1. "Advertising" means any public
			communication, made in any form or manner, about a licensee's professional
			service or qualifications, for the purpose of soliciting business.
2. "Aldrete score" means a measurement of
			recovery after anesthesia that includes gauging consciousness, activity,
			respiration, and blood pressure.
Aldrete Scoring Guidelines
Activity
Respiration
Circulation
Consciousness
Oxygenation
2 Able to move four extremities voluntarily on
						command and/or returned to preprocedure level
2 Patient can cough and deep breathe on command
						and/or respirations unlabored, oxygen saturation at preprocedure level
2 Blood pressure and heart rate +/-20 percent of
						presedation level and/or asymptomatic alteration
2 Fully awake (able to answer questions) or at
						preprocedure level
2 Able to maintain oxygen saturation greater than
						92 percent or at preprocedure level
Pink or normal skin color
1 Able to move two extremities voluntarily on
						command and/or moves weakly, unable to stand
1 Dyspnea or limited breathing or requires oxygen
						greater than baseline level to maintain adequate saturation
1 Blood pressure and heart rate +/-20 to 50 percent
						of pre-anesthetic level or mildly symptomatic alteration that requires fluid
						bolus intervention or dopamine at less than ten micrograms per kilogram per
						minute for heart failure patients
1 Arousable on calling (arousable only to
						calling)
1 Needs oxygen to maintain adequate
						oxygenation
Pale, dusky, blotchy, jaundiced, or other
0 Unable to move
0 Apneic or requires airway support
0 Blood pressure and heart rate greater than 50
						percent =/- presedation levels and/or requires pharmacological intervention, or
						dopamine at greater than ten micrograms per kilogram per minute for heart
						failure patients
0 Unresponsive
0 Oxygen saturation less than 90 percent adult,
						less than 92 percent peds even with oxygen support.
Cyanotic
Target 2
Target 2
Target 1-2
Target 1-2
Target 2
A score of less than 8, re-evaluate q 15 minutes,
						greater than 8 discharge to recovery, or greater than or equal to discharge
						home
3.
			"Analgesia" means the diminution or elimination of pain.
4. "Anesthesia" means the art and science of
			managing anxiety, pain, and awareness. It includes analgesia, local anesthesia,
			minimal sedation, moderate sedation, deep sedation, and general
			anesthesia.
5. "Basic full upper
			and lower denture" means replacement of all natural dentition with artificial
			teeth. This replacement includes satisfactory tissue adaptation, satisfactory
			function, and satisfactory aesthetics. Materials used in these replacements
			must be nonirritating in character and meet all the standards set by the
			national institute of health and the bureau of standards and testing agencies
			of the American dental association for materials to be used in or in contact
			with the human body.
6. "Board
			certified" means the dentist has been certified in a specialty area in which
			there is a certifying body approved by an agency recognized by the United
			States department of education and is a diplomate of a nationally recognized
			certifying board that meets the criteria as provided by section
			20-02-01-01.
7. "Board eligible" means the dentist has
			successfully completed a duly accredited training program or in the case of a
			dentist in practice at the time of the adoption of these rules has experience
			equivalent to such a training program in an area of dental practice in which
			there is a certifying body approved by an agency recognized by the United
			States department of education and is a diplomate of a nationally recognized
			certifying board that meets the criteria as provided by section
			20-02-01-01.
8. "Bona fide specialties" means those
			specialties meeting the qualification as set forth in section
			20-02-01-01.
9. "Capnography" means a process to determine
			the presence and percent of carbon dioxide in a patient's breath through the
			use of a carbon dioxide monitor, the noninvasive measurement of the partial
			pressure of carbon dioxide in exhaled breath expressed as carbon dioxide
			concentration over time and is graphically represented. Carbon dioxide measured
			at the airway can be displayed as a function of time (carbon dioxide
			concentration over time) or exhaled tidal volume (carbon dioxide concentration
			over volume).
10. "Cardiopulmonary
			resuscitation course" means the American heart association's health care
			provider course, the American red cross professional rescuer course, or an
			equivalent course.
11. "Certified
			dental assistant" means a dental assistant who meets the education or
			experience prerequisites, or both, established by the dental assisting national
			board and passes the dental assisting national board's certified dental
			assistant examination, is currently cardiopulmonary resuscitation-certified,
			and continues to maintain the credential by meeting the dental assisting
			national board requirements. A certified dental assistant must be registered by
			the board as a qualified dental assistant or registered dental assistant to
			provide any expanded duties.
12.
			"Code of ethics" means the November 2020 version of the American dental
			association's principles of ethics and code of professional conduct.
13. "Complete evaluation" means an
			examination, review of medical and dental history, the formulation of a
			diagnosis, and the establishment of a written treatment plan, documented in a
			written record to be maintained in the dentist's office or other treatment
			facility or institution.
14.
			"Contiguous supervision" means that the dentist whose patient is being treated
			and has personally authorized the procedures to be performed. The supervising
			dentist is continuously onsite and physically present in the treatment facility
			while the procedures are performed by the qualified dental staff member and
			capable of responding immediately in the event of an emergency. The term does
			not require a supervising dentist to be physically present in the
			operatory.
15. "Clinical continuing
			education" means information that relates to the assessment, diagnosis, or
			treatment of patients.
16. "Coronal
			polishing" is the mechanical polishing of clinical crowns using a rubber cup or
			brush only and not to include any instrumentation.
17. "Deep sedation" means a drug-induced
			depression of consciousness during which patients cannot be easily aroused but
			respond purposefully following repeated or painful stimulation. The ability to
			independently maintain ventilatory function may be impaired. Patients may
			require assistance in maintaining a patent airway, and spontaneous ventilation
			may be inadequate. Cardiovascular function is usually maintained.
18. "Dental anesthesia assistant" means an
			individual who possesses the expertise to provide supportive anesthesia care in
			a safe and effective manner. The anesthesia assistant is educated in the
			perioperative and emergent care management of patients undergoing dental office
			sedation and anesthesia.
19.
			"Direct supervision" means the dentist is physically present in the dental
			office or treatment facility, personally diagnoses the condition to be treated,
			personally authorizes the procedures and remains in the dental office or
			treatment facility while the procedures are being performed by the dental
			hygienist or dental assistant, and before dismissal of the patient, evaluates
			the performance of the dental hygienist or dental assistant.
20. "Direct visual supervision" means the
			dentist is physically present to issue a verbal command and under direct line
			of sight.
21. "Evaluation" means
			the act or process by a dentist of assessing and determining the patient's oral
			health status, the progress of dental therapy, or the performance of the dental
			hygienist or dental assistant.
22.
			"General anesthesia" means a drug-induced loss of consciousness during which
			patients are not arousable, even by painful stimulation. The ability to
			maintain ventilatory function is often impaired. Patients often require
			assistance in maintaining patent airway, and positive pressure ventilation may
			be required because of depressed spontaneous ventilation or drug-induced
			depression of neuromuscular function. Cardiovascular function may be
			impaired.
23. "General supervision"
			means the dentist has authorized the procedures and they are carried out in
			accordance with the dentist's diagnosis, if necessary, and treatment plan. The
			dentist is not required to be in the treatment facility. A new patient who has
			not been examined by the authorizing dentist may be seen by a dental hygienist
			authorized to provide duties under general supervision. Limitations are
			contained in North Dakota Century Code section 43-20-03.
24. "Host dentist" is a dentist authorized by
			permit who may provide a qualified dentist or independently practicing
			qualified anesthesia health care provider administration of moderate, or deep
			sedation, or general anesthesia. The host dentist is subject to site
			evaluations for the level of sedation provided as per subsection 5 or 6 of
			section
			20-02-01-05.
25. "Inactive status" means the licensee
			shall not engage in the practice of dentistry or dental hygiene in the state of
			North Dakota. The license that is placed on inactive status remains on that
			status until such time as the license is reinstated.
26. "Incremental dosing" means administration
			of multiple doses of a single drug until a desired effect is reached, but not
			to exceed the maximum recommended dose at the recommended interval.
27. "Indirect supervision" means that a
			dentist is in the dental office or treatment facility, has personally diagnosed
			the condition to be treated, authorizes the procedures, and remains in the
			dental office or treatment facility while the procedures are being performed by
			the dental hygienist or dental assistant.
28. "Local anesthesia" means the elimination
			of sensations in one part of the body by regional injection of drugs without
			causing the loss of consciousness.
29. "Maximum recommended dose" means the
			maximum recommended dose of a drug as printed in the United States food and
			drug administration's approved labeling for unmonitored home use.
30. "Minimal sedation" means a drug-induced
			state during which patients respond normally to verbal commands. Although
			cognitive function and physical coordination may be impaired, airway reflexes
			and ventilatory and cardiovascular are unaffected. Minimal sedation may be
			achieved by the administration of a single drug administered in a single or
			divided dose not to exceed the maximum recommended dose for unmonitored home
			use during a single appointment. A permit is not required for minimal
			sedation.
31. "Moderate sedation"
			means a drug-induced depression of consciousness during which a patient
			responds purposefully to verbal commands either alone or accompanied by light
			tactile stimulation. No interventions are required to maintain a patent airway,
			and spontaneous ventilation is adequate. Cardiovascular function is usually
			maintained. Administration of sedative drugs exceeding the maximum recommended
			dose for unmonitored home use during a single appointment or use of more than
			one enteral drug administered, with or without concomitant use of nitrous oxide
			is considered moderate sedation.
32. "Nitrous oxide inhalation analgesia"
			means a technique in which the inhalation of nitrous oxide enables treatment to
			be carried out and in which purposeful verbal contact with the patient can be
			maintained or the patient responds appropriately to light tactile stimulation
			throughout the administration of nitrous oxide inhalation analgesia, and the
			drugs and techniques used have a margin of safety wide enough to render
			unintended loss of consciousness extremely unlikely.
33. "Oral assessment" means the evaluation of
			data pertaining to the patient's condition to help identify dental problems
			leading to a professional treatment plan. The final diagnosis of disease or
			treatment plan is the sole responsibility of the supervising or collaborative
			dentist.
34. "Oral hygiene
			treatment planning" is a component of a comprehensive treatment plan developed
			by the hygienist or dentist to provide the hygienist a framework for addressing
			the preventative, educational, and clinical treatment needs of the
			patient.
35. "Parenteral moderate
			sedation" means the intravenous, intramuscular, intranasal, subcutaneous,
			sublingual, submucosal, transdermal, or rectal administration of
			pharmacological agents with the intent to obtain a depressed level of
			consciousness that meets the definition of moderate sedation.
36. "Patient of record" means a patient who
			has undergone a complete dental evaluation, has had a medical and dental
			history completed and evaluated by a dentist, or a patient who has been
			examined, and has had oral conditions diagnosed and a written plan developed by
			the dentist or dental hygiene treatment authorized by a dentist, and the
			patient has compensated the dentist or dental facility for a
			procedure.
37. "Pediatric patient"
			means a dental patient ten years of age or younger.
38. "Primary practice site" means the office
			location that is to be considered the main location of the dental practice.
			This office location would be listed first on the biennial
			registration.
39. "Qualified dental
			assistant" means a dental assistant who has been employed and trained as a
			dental assistant and has received at least three hundred hours of on-the-job
			training, has successfully completed the national entry level dental assistant
			certification administered by the dental assisting national board or a
			board-approved course, and has applied to the board and paid the certificate
			fee and met any other requirements of section
			20-03-01-05.
40. "Qualified dental staff member" means an
			individual trained and competent in the use of monitoring and emergency
			equipment, capable of assisting with procedures and emergency incidents that
			may occur as a result of the sedation or secondary to the unexpected medical
			complication, and who has received documented training acquired directly by an
			employer-dentist or by a planned sequence of instruction in an educational
			institution and holds a current basic life support registration.
41. "Registered dental assistant" means a
			dental assistant who is a graduate of a dental assistant program accredited by
			the commission on dental accreditation of the American dental association or a
			substantially equivalent curriculum approved by the board or has been certified
			by the dental assistant national board, and has applied to the board and paid
			the registration fee and met any other requirements of section
			20-03-01-05.
42. "Remedial education" means an educational
			intervention prescribed by the board that is designed to restore an identified
			practice deficiency of a licensee. Remediation may include successful
			demonstration by the licensee that the learned knowledge and skills have been
			incorporated into the licensee's practice.
43. "Satellite office" means an office,
			building, or location used at any time by a dentist for the practice of
			dentistry other than the office listed on the dentist's biennial registration
			certificate.
44. "Screening" means
			an inspection used for the early identification of individuals at potentially
			high risk for a specific condition or disorder and can indicate a need for
			further evaluation or preliminary intervention. A screening is neither
			diagnostic nor a definitive indication of a specific condition and does not
			involve making diagnoses that lead to treatment plans.
45. "Self-study", for the purposes of
			continuing education requirements, means the licensee engages in obtaining
			education without direct supervision, without attendance in a classroom
			setting, or without a proctor during online education. A certificate of
			completion must be obtained as proof of education.
46. "Time-oriented anesthesia record" means
			documentation at appropriate intervals of drugs, doses, and physiologic data
			obtained during patient monitoring.
47. "Titration" means administration of
			incremental doses of an intravenous or inhalation drug until a desired effect
			is reached.
48. "Topical
			anesthesia" means the elimination of sensation, especially pain, in one part of
			the body by skin or mucous membrane surface application of a drug.
49. "Webinar", for the purposes of continuing
			education requirements, means the licensee engages in a live web-based seminar
			or presentation using video conferencing software. A webinar is interactive and
			has the ability to give, receive, and discuss information in real-time. A
			certificate of completion indicating "webinar" or other evidence of attendance
			must be maintained as proof of continuing education.
General Authority:
NDCC 43-20-10,
				43-28-06
Law Implemented:
NDCC 43-20-01.1, 43-20-03,
				43-20-10, 43-20-12, 43-20-13, 43-28-06