reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › DELEGATIONS OF DUTIES TO PERSONS NOT LICENSED AS DENTISTS › Section 246-817-540 - Acts that may not be performed by registered dental assistants

Current through Register Vol. 24-14, July 15, 2024
This list is not all inclusive. Delegation of procedures
					 not in subsections (1) through (22) of this section should not be assumed to be
					 allowed. Supportive services approved for delegation to registered dental
					 assistants are under WAC
					 246-817-520. A dentist may not
					 allow registered dental assistants who are in his or her employ or are acting
					 under his or her supervision or direction to perform any of the following
					 procedures:
(1) Any removal of or
				  addition to the hard or soft natural tissue of the oral cavity.
(2) Any placing of permanent restorations in
				  natural teeth.
(3) Any diagnosis of
				  or prescription for treatment of disease, pain, deformity, deficiency, injury,
				  or physical condition of the human teeth or jaws, or adjacent
				  structure.
(4) Any administration
				  of general or local anesthetic, including intravenous sedation.
(5) Any oral prophylaxis, except coronal
				  polishing as a part of oral prophylaxis as defined under WAC
				  246-817-510 and
				  246-817-520(4)(e).
(6) Any scaling procedure.
(7) The taking of any impressions of the
				  teeth or jaws, or the relationships of the teeth or jaws, for the purpose of
				  fabricating any intra-oral restoration, appliances, or prosthesis, other than
				  impressions allowed as a delegated task under WAC
				  246-817-520.
(8) Intra-orally adjust and finish permanent
				  restorations.
(9) Cement or
				  recement any permanent restoration or stainless steel crown.
(10) Incise gingiva or other soft
				  tissue.
(11) Elevate soft tissue
				  flap.
(12) Luxate teeth.
(13) Curette to sever epithelial
				  attachment.
(14) Suture.
(15) Establish occlusal vertical dimension
				  for dentures.
(16) Try-in of
				  dentures set in wax.
(17) Insertion
				  and post-insertion adjustments of dentures.
(18) Endodontic treatment - Open, extirpate
				  pulp, ream and file canals, establish length of tooth, and fill root
				  canal.
(19) Use of any light or
				  electronic device for invasive procedures.
(20) Intra-oral air abrasion or mechanical
				  etching devices.
(21) Place direct
				  pulp caps.
(22) Fit and adjust
				  occlusal guards.
Statutory Authority:
						RCW
						18.260.120 and
						18.32.0365. 08-14-010, §
						246-817-540, filed 6/19/08, effective 7/1/08. Statutory Authority: RCW
						18.32.035. 95-21-041, § 246-817-540, filed 10/10/95, effective
						11/10/95.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › DELEGATIONS OF DUTIES TO PERSONS NOT LICENSED AS DENTISTS › Section 246-817-545 - Acts that may not be performed by licensed expanded function dental auxiliaries (EFDAs)

Current through Register Vol. 24-14, July 15, 2024
This list is not all inclusive. Delegation of procedures
					 not in subsections (1) through (20) of this section should not be assumed to be
					 allowed. Supportive services approved for delegation to licensed expanded
					 function dental auxiliaries are under WAC
					 246-817-525. A dentist may not
					 allow EFDAs who are in his or her employ or are acting under his or her
					 supervision or direction to perform any of the following procedures:
(1) Any removal of or addition to the hard or
				  soft natural tissue of the oral cavity except for placing and carving direct
				  restorations .
(2) Any diagnosis of
				  or prescription for treatment of disease, pain, deformity, deficiency, injury,
				  or physical condition of the human teeth or jaws, or adjacent
				  structure.
(3) Any administration
				  of general or local anesthetic, including intravenous sedation.
(4) Any oral prophylaxis, except coronal
				  polishing as a part of oral prophylaxis as defined under WAC
				  246-817-510 and
				  246-817-520(4)(e).
(5) Any scaling procedure.
(6) Intra-orally adjust and finish permanent
				  inlays, crowns, and bridges.
(7)
				  Cement or recement any permanent restoration or stainless steel
				  crown.
(8) Incise gingiva or other
				  soft tissue.
(9) Elevate soft
				  tissue flap.
(10) Luxate
				  teeth.
(11) Curette to sever
				  epithelial attachment.
(12)
				  Suture.
(13) Establish occlusal
				  vertical dimension for dentures.
(14) Try-in of dentures set in wax.
(15) Insertion and postinsertion adjustments
				  of dentures.
(16) Endodontic
				  treatment - Open, extirpate pulp, ream and file canals, establish length of
				  tooth, and fill root canal.
(17)
				  Use of any light or electronic device for invasive procedures.
(18) Intra-oral air abrasion or mechanical
				  etching devices.
(19) Place direct
				  pulp caps.
(20) Fit and adjust
				  occlusal guards.
Statutory Authority:
						RCW
						18.260.120 and
						18.32.0365. 08-14-010, §
						246-817-545, filed 6/19/08, effective
						7/1/08.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › DELEGATIONS OF DUTIES TO PERSONS NOT LICENSED AS DENTISTS › Section 246-817-550 - Acts that may be performed by licensed dental hygienists under general supervision

Current through Register Vol. 24-14, July 15, 2024
A dentist may allow a dental hygienist licensed under
					 chapter 18.29 RCW to perform the following acts under the dentist's general
					 supervision:
(1) Head and neck
				  examination.
(2) Oral inspection
				  and measuring of periodontal pockets, with no diagnosis.
(3) Record health histories.
(4) Take and record blood pressure and vital
				  signs.
(5) Take intraoral and
				  extraoral radiographs.
(6) Take
				  intraoral and extraoral photographs.
(7) Patient education in oral
				  hygiene.
(8) Give preoperative and
				  postoperative instructions.
(9)
				  Oral prophylaxis and removal of deposits and stains from the surfaces of the
				  teeth.
(10) Give fluoride
				  treatments.
(11) Apply topical
				  anesthetic agents.
(12) Deliver
				  oral antibiotic prophylaxis as prescribed by a dentist.
(13) Place and remove the rubber
				  dam.
(14) Apply topical preventive
				  or prophylactic agents.
(15)
				  Administer local anesthetic agents and adjunctive procedures if all conditions
				  in (a) through (d) of this subsection are met. Adjunctive procedures include
				  local anesthetic reversal agents and buffered anesthetic.
(a) The patient is at least eighteen years of
				  age;
(b) The patient has been
				  examined by the delegating dentist within the previous twelve months;
(c) There has been no change in the patient's
				  medical history since the last examination. If there has been a change in the
				  patient's medical history within that time, the dental hygienist must consult
				  with the dentist before administering local anesthetics;
(d) The delegating dentist who performed the
				  examination has approved the patient for the administration of local
				  anesthetics by a dental hygienist under general supervision and documented this
				  approval in the patient's record;
(e) If any of the conditions in (a) through
				  (d) of this subsection are not met, then close supervision is
				  required.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › DELEGATIONS OF DUTIES TO PERSONS NOT LICENSED AS DENTISTS › Section 246-817-560 - Acts that may be performed by licensed dental hygienists under close supervision

Current through Register Vol. 24-14, July 15, 2024
In addition to the acts allowed in WAC
					 246-817-520 and
					 246-817-550, a dentist may allow
					 a dental hygienist licensed under chapter 18.29 RCW to perform the following
					 acts under the dentist's close supervision:
(1) Perform soft-tissue curettage.
(2) Administer local anesthetic agents and
				  adjunctive procedures.
(a) General
				  supervision is allowed if all conditions in WAC
				  246-817-550(6)(a) through
				  (d) are met.
(b) Adjunctive procedures include local
				  anesthetic reversal agents and buffered anesthetic.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › DELEGATIONS OF DUTIES TO PERSONS NOT LICENSED AS DENTISTS › Section 246-817-570 - Acts that may not be performed by dental hygienists

Current through Register Vol. 24-14, July 15, 2024
No dentist shall allow a dental hygienist duly licensed
					 under the provisions of
					 chapter
					 18.29 RCW who is in
					 his/her employ or is acting under his/her supervision or direction to perform
					 any of the following procedures:
(1)
				  Any surgical removal of tissue of the oral cavity, except for soft-tissue
				  curettage, as defined in WAC
				  246-817-510.
(2) Any prescription of drugs or medications
				  requiring the written order or prescription of a licensed dentist or
				  physician.
(3) Any diagnosis for
				  treatment or treatment planning.
(4) The taking of any impression of the teeth
				  or jaw, or the relationship of the teeth or jaw, for the purpose of fabricating
				  any intra-oral restoration, appliances, or prosthesis. Not prohibited are the
				  taking of impressions solely for diagnostic and opposing models or taking wax
				  bites solely for study casts.
(5)
				  Intra-orally adjust occlusal of inlays, crowns, and bridges.
(6) Intra-orally finish margins of inlays,
				  crowns, and bridges.
(7) Cement or
				  recement, permanently, any cast restorations or stainless steel
				  crowns.
(8) Incise gingiva or other
				  soft tissue.
(9) Elevate soft
				  tissue flap.
(10) Luxate
				  teeth.
(11) Curette to sever
				  epithelial attachment.
(12)
				  Suture.
(13) Establish occlusal
				  vertical dimension for dentures.
(14) Try-in of dentures set in wax.
(15) Insertion and post-insertion adjustments
				  of dentures.
(16) Endodontic
				  treatment -- Open, extirpate pulp, ream and file canals, establish length of
				  tooth, and fill root canal.
Statutory Authority: RCW 18.32.035. 95-21-041, §
						246-817-570, filed 10/10/95, effective
						11/10/95.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › DELEGATIONS OF DUTIES TO PERSONS NOT LICENSED AS DENTISTS › Section 246-817-580 - Novel coronavirus disease 2019 screening

Current through Register Vol. 24-14, July 15, 2024
(1) A supervising dentist may delegate the
				  administration of a test for screening of novel coronavirus disease 2019 to a
				  registered dental assistant and licensed expanded function dental auxiliary
				  under the dentist's close supervision, provided the registered dental assistant
				  and licensed expanded function dental auxiliary have demonstrated skills
				  necessary to perform the task competently.
(2) A supervising dentist may delegate the
				  administration of a test for screening of novel coronavirus disease 2019 to a
				  licensed dental hygienist under the dentist's general supervision, provided the
				  licensed dental hygienist has demonstrated skills necessary to perform the task
				  competently.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › DELEGATIONS OF DUTIES TO PERSONS NOT LICENSED AS DENTISTS › Section 246-817-581 - Novel coronavirus disease 2019 vaccination

Current through Register Vol. 24-14, July 15, 2024
(1) A supervising dentist may delegate the
				  administration of a vaccination of novel coronavirus disease 2019 to a licensed
				  dental hygienist under the dentist's close supervision, provided the licensed
				  dental hygienist has demonstrated skills necessary to perform the task
				  competently.
(2) For the purpose of
				  administering vaccination for the novel coronavirus disease 2019, a dentist's
				  approval of the vaccination protocol and screening meets the dentist's
				  requirement to diagnose the condition to be treated and personal authorization
				  of the procedure as required by close supervision under WAC
				  246-817-510(1).
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › INFECTION CONTROL › Section 246-817-601 - Purpose

Current through Register Vol. 24-14, July 15, 2024
The purpose of WAC 246-817-601 through 246-817-660 is to
					 establish requirements for infection control where dentistry is provided in the
					 state of Washington to protect the health and well-being of the people. The
					 Centers for Disease Control and Prevention
Guidelines for Infection
					 Control in Dental Health-Care Settings
2003, MMWR Vol. 52, No. RR-17,
					 and the
Summary of Infection Prevention Practices in Dental Settings:
					 Basic Expectations for Safe Care
, March 2016, are the basis for these
					 rules. Case reports and public health events regarding the transmission of
					 diseases from patient to patient, practitioner to patient, and patient to
					 practitioner have been published that demonstrate risks that were either
					 unrecognized in the past or new. This includes people accompanying patients and
					 visitors. A strong educational component for practitioners is necessary to
					 prevent disease transmission from patient to practitioner, practitioner to
					 patient, and patient to patient.
Statutory Authority: RCW 18.32.035. 95-21-041, §
						246-817-601, filed 10/10/95, effective
						11/10/95.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › INFECTION CONTROL › Section 246-817-615 - Administrative, education, and training

Current through Register Vol. 24-14, July 15, 2024
(1)
				  A licensed dentist shall develop and maintain written infection prevention
				  policies and procedures appropriate for the dental services provided by the
				  facility.
(2) A licensed dentist
				  shall review with all practitioners the current office infection prevention
				  policies and procedures annually. A licensed dentist shall maintain
				  documentation of the annual review with all practitioners for five
				  years.
(3) A practitioner shall
				  complete one hour of current infection prevention standards education annually
				  provided by a qualified individual or organization.
(4) Infection prevention standards education
				  must include:
(a) Standard precautions and
				  prevention of disease transmission;
(b) Prevention of
				  cross-contamination;
(c)
				  Practitioner safety and personal protection equipment;
(d) Hand hygiene;
(e) Respiratory hygiene and cough
				  etiquette;
(f) Sharps safety and
				  safe injection practices;
(g)
				  Sterilization and disinfection of patient care items and devices;
(h) Environmental infection prevention and
				  control;
(i) Dental unit water
				  quality; and
(j) The requirements
				  in WAC 246-817-601 through
				  246-817-660.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › INFECTION CONTROL › Section 246-817-610 - Definitions

Current through Register Vol. 24-14, July 15, 2024
The following definitions apply throughout WAC
					 246-817-601 through 246-817-660
					 unless the context clearly requires otherwise.
(1) "Hand hygiene" means the use of soap and
				  water when hands are visibly soiled; or use of an alcohol-based hand
				  rub.
(2) "Practitioner" means a
				  licensed dentist under chapter 18.32 RCW, licensed dental hygienist under
				  chapter 18.29 RCW, a licensed expanded function dental auxiliary under chapter
				  18.260 RCW, a certified dental anesthesia assistant, or a registered dental
				  assistant under chapter 18.260 RCW.
(3) "The Centers for Disease Control and
				  Prevention" or "CDC" means a federal agency that conducts and supports health
				  promotion, prevention and preparedness activities in the United
				  States.
Statutory Authority: RCW 18.32.035. 95-21-041, §
						246-817-610, filed 10/10/95, effective
						11/10/95.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › INFECTION CONTROL › Section 246-817-620

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority: RCW 18.32.035. 95-21-041, §
						246-817-620, filed 10/10/95, effective
						11/10/95.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › INFECTION CONTROL › Section 246-817-625 - Personnel safety

Current through Register Vol. 24-14, July 15, 2024
A practitioner shall comply with the applicable
					 requirements of the Washington Industrial Safety and Health Act under chapter
					 49.17 RCW.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › INFECTION CONTROL › Section 246-817-630

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority: RCW 18.32.035. 95-21-041, §
						246-817-630, filed 10/10/95, effective
						11/10/95.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › INFECTION CONTROL › Section 246-817-635 - Hand hygiene

Current through Register Vol. 24-14, July 15, 2024
A practitioner shall perform hand hygiene as defined in WAC
					 246-817-610 in any of these
					 situations:
(1) When hands are visibly
				  soiled;
(2) In the event of
				  barehanded touching of instruments, equipment, materials, and other objects
				  likely to be contaminated by blood, saliva, or respiratory secretions;
				  or
(3) Before and after treating
				  each patient.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › INFECTION CONTROL › Section 246-817-640 - Personal protective equipment

Current through Register Vol. 24-14, July 15, 2024
(1)
				  A practitioner shall wear gloves whenever there is a potential for contact with
				  blood, body fluids, mucous membranes, nonintact skin, or contaminated
				  equipment.
(a) New gloves are required for
				  each patient.
(b) Gloves must not
				  be washed or reused.
(c) Gloves
				  selection must be based on the performance characteristics of the glove in
				  relation to the task to be performed as applicable in WAC
				  296-800-16065 and
				  296-823-15010.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › INFECTION CONTROL › Section 246-817-645 - Respiratory hygiene and cough etiquette

Current through Register Vol. 24-14, July 15, 2024
(1) A licensed dentist shall post signs in a
				  place visible to individuals receiving services in the premises with
				  instructions to patients with symptoms of respiratory infection to:
(a) Cover their mouth/nose when coughing or
				  sneezing;
(b) Use and dispose of
				  tissues;
(c) Perform hand hygiene
				  after hands have been in contact with respiratory secretions.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › INFECTION CONTROL › Section 246-817-650 - Safe injection and sharps safety

Current through Register Vol. 24-14, July 15, 2024
(1) A practitioner shall follow the CDC
Summary of Infection Prevention Practices in Dental Settings: Basic
				  Expectations for Safe Care
, March 2016, guidelines for safe injection
				  practices in dental settings.
(2) A
				  practitioner shall use either a one-handed scoop technique or mechanical device
				  designed for holding the needle cap when recapping needles. A practitioner
				  shall not recap used needles by using both hands or any other technique that
				  involves directing the point of a needle toward any part of the body.
(3) A practitioner shall place used
				  disposable syringes and needles, scalpel blades, and other sharp items in
				  appropriate puncture-resistant containers in each operatory.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › INFECTION CONTROL › Section 246-817-655 - Sterilization and disinfection, environmental infection prevention and control

Current through Register Vol. 24-14, July 15, 2024
A practitioner shall:
(1) Follow the CDC
Guidelines for
				  Infection Control in Dental Health-Care Settings
2003, MMWR Vol. 52,
				  No. RR-17, Appendix C for Methods for Sterilizing and Disinfecting Patient-Care
				  Items and Environmental Surfaces, including:
(a) Clean and reprocess through disinfection
				  or sterilization reusable critical, semicritical, and noncritical dental
				  equipment and devices according to manufacturer instructions before use on
				  another patient.
(i) Effective August 31,
				  2022, sterilization of low-speed hand piece motors after use on a patient is
				  required.
(ii) Sterilization is not
				  required for those sections of a battery operated hand piece system that cannot
				  be sterilized according to manufacturer's instructions. However, battery
				  operated hand piece systems that have specific engineering controls to isolate
				  the sections that cannot be sterilized, render those sections "noncritical,"
				  must be used if commercially available; those sections that cannot be
				  sterilized must be processed according to manufacturer's instructions between
				  patient uses.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › INFECTION CONTROL › Section 246-817-660 - Dental unit water quality

Current through Register Vol. 24-14, July 15, 2024
(1) A
				  licensed dentist shall use water for nonsurgical procedures that meets United
				  States Environmental Protection Agency regulatory standards for drinking water
				  of five hundred or less colony-forming units or CFUs/mL.
(2) A licensed dentist shall follow dental
				  equipment manufacturer's instructions when testing the water delivery system
				  for acceptable water quality. If manufacturer's instructions are unavailable, a
				  licensed dentist shall test the water delivery system for acceptable water
				  quality quarterly. A licensed dentist shall test the water delivery system five
				  to ten days after repair or changes in the plumbing system and again at
				  twenty-one to twenty-eight days later.
(a)
				  Effective December 1, 2021, all water lines must be tested.
(i) All water lines for each operatory or
				  dental unit can be pooled as one single sample.
(A) A pooled sample must use an equal amount
				  of water from each water line.
(B)
				  A pooled sample can have up to ten water lines included.
(C) The number of water lines pooled into one
				  sample must be documented.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-701 - Administration of anesthetic agents for dental procedures

Current through Register Vol. 24-14, July 15, 2024
The purpose of WAC
					 246-817-701 through
					 246-817-790 is to govern the
					 administration of anesthetic, sedation, and general anesthesia by dentists
					 licensed in the state of Washington in settings other than hospitals as defined
					 in WAC 246-320-010 and ambulatory
					 surgical facilities as defined in WAC
					 246-310-010, pursuant to the DQAC
					 authority in
					 RCW
					 18.32.640.
(1) The DQAC has determined that sedation and
				  anesthesia permitting should be based on the level of sedation or anesthesia
				  because sedation or anesthesia is a continuum, and the route of administration
				  and drug combinations are both capable of producing a deeper level of sedation
				  or anesthesia than is initially intended. Practitioners intending to produce a
				  given level of sedation should be able to rescue patients who enter a state
				  deeper than initially intended.
(2)
				  All anesthesia providers must provide 24 hour, on-call availability following
				  an anesthesia procedure.
(a) A licensed
				  dentist that only administers local anesthesia shall provide timely telephonic
				  or electronic communication with the patient or their representative by the
				  provider or a designated provider.
(b) In the event a licensed dentist will be
				  unavailable for timely assistance, the licensed dentist shall have a
				  prearranged agreement with another provider that is available to provide timely
				  care to a patient.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-720 - Basic life support requirements

Current through Register Vol. 24-14, July 15, 2024
(1)
				  Dental staff providing direct patient care in an in-office or out-patient
				  setting must hold a current and valid health care provider BLS certification.
				  Initial and renewal certification must include both didactic and hands-on
				  components.
(2) Health care
				  provider BLS certification must be obtained from an individual, organization,
				  or training center who holds a current and valid BLS instructor certification
				  and teaches the current International Liaison Committee on Resuscitation or
				  ILCOR standard including, but not limited to, American Heart Association or
				  American Red Cross.
(3) Health care
				  provider BLS instruction must include online or in-person didactic instruction
				  with a written assessment, in-person skills assessment on high quality chest
				  compressions, rescue breathing using the bag valve mask, correct use of AED or
				  defibrillator for adults, children, and infants, feedback to students, and a
				  valid health care provider BLS certification card upon completion.
(4) Dental staff providing direct patient
				  care include: Licensed dentists, licensed dental hygienists, licensed expanded
				  function dental auxiliaries, certified dental anesthesia assistants, and
				  registered dental assistants.
(5)
				  Newly hired office staff providing direct patient care are required to obtain
				  the required certification within 45 days from the date hired.
Statutory Authority:
						RCW
						18.32.640 and
						18.32.0365. WSR 09-04-042, §
						246-817-720, filed 1/30/09, effective 3/2/09. Statutory Authority: RCW
						18.32.035. WSR 95-21-041, § 246-817-720, filed 10/10/95, effective
						11/10/95.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-722 - Defibrillator

Current through Register Vol. 24-14, July 15, 2024
When anesthetic agents of any kind are administered, the
					 dentist and staff must have access to an AED or defibrillator. The AED or
					 defibrillator must be available and in reach within 60 seconds.
Statutory Authority:
						RCW
						18.32.640 and
						18.32.0365. 10-23-001, §
						246-817-722, filed 11/3/10, effective 12/4/10; 09-04-042, § 246-817-722,
						filed 1/30/09, effective 3/2/09.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-724 - Recordkeeping, equipment, and emergency medications or drugs

Current through Register Vol. 24-14, July 15, 2024
When anesthetic agents of any kind are administered, the
					 dentist must comply with the requirements in this section.
(1) The anesthesia provider or anesthesia
				  monitor shall record the patient's condition. The record must include
				  documentation of all medications administered with dosages, regular and
				  consistent time intervals, and route of administration. The provider
				  administering the sedation may determine time intervals.
(2) All patients receiving any anesthetic
				  agent including local anesthesia or minimal sedation with nitrous oxide, vital
				  signs including, but not limited to, blood pressure and heart rate must be
				  recorded, unless the cooperation of the patient or circumstances of the case
				  will not allow it. If pretreatment vitals cannot be obtained, the reason or
				  reasons why must be recorded. Obtaining vital signs on ASA 1 age 13 and under
				  will be at the dentist's discretion.
(3) The following equipment must be available
				  and include:
(a) Suction equipment capable of
				  aspirating gastric contents from the mouth and pharynx;
(b) Portable oxygen delivery system including
				  full face masks and a bag-valve-mask combination with appropriate connectors
				  capable of delivering positive pressure, oxygen enriched ventilation to the
				  patient;
(c) Blood pressure cuff or
				  sphygmomanometer of appropriate size;
(d) Stethoscope or equivalent monitoring
				  device.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-730 - Local anesthesia

Current through Register Vol. 24-14, July 15, 2024
Local anesthesia must only be administered by a provider
					 qualified under this chapter and dental hygienists as provided in chapter 18.29
					 RCW.
(1) "Local anesthesia" means the
				  elimination of sensations, especially pain, in one part of the body by the
				  topical application or regional injection of a drug.
(2) A licensed dentist administering local
				  anesthetic agents shall comply with recordkeeping, equipment, and emergency
				  medication requirements in WAC
				  246-817-724.
(3) A permit of authorization is not
				  required.
Statutory Authority:
						RCW
						18.32.640 and
						18.32.0365. 09-04-042, §
						246-817-730, filed 1/30/09, effective 3/2/09. Statutory Authority: RCW
						18.32.035. 95-21-041, § 246-817-730, filed 10/10/95, effective
						11/10/95.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-740 - Minimal sedation with nitrous oxide

Current through Register Vol. 24-14, July 15, 2024
(1) To administer minimal sedation with
				  nitrous oxide, a licensed dentist shall successfully complete a minimum of 14
				  hours of education and training in one of the following:
(a) Minimal sedation with nitrous
				  oxide;
(b) Moderate sedation with
				  nitrous oxide;
(c) Advanced
				  education program accredited by the CODA that meets comprehensive and
				  appropriate training necessary to administer and manage minimal sedation with
				  nitrous oxide; or
(d) Education and
				  training must be consistent with ADA
Guidelines for Teaching Pain
				  Control and Sedation to Dentists and Dental Students
, adopted by ADA
				  House of Delegates October 2016 or prior adopted version in effect at the time
				  training was completed.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-745 - Minimal sedation

Current through Register Vol. 24-14, July 15, 2024
(1) To administer
				  minimal sedation which is limited to a single dose of a single oral agent with
				  or without nitrous oxide, a licensed dentist shall successfully complete a
				  minimum of 16 hours of education and training in one of the following:
(a) Minimal sedation; or
(b) Moderate sedation; or
(c) Advanced education program accredited by
				  the CODA that meets comprehensive and appropriate training necessary to
				  administer and manage minimal sedation; or
(d) Education and training must be consistent
				  with ADA
Guidelines for Teaching Pain Control and Sedation to Dentists
				  and Dental Students
, adopted by ADA House of Delegates October 2016 or
				  prior adopted version in effect at the time training was completed.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-755 - Moderate sedation with enteral agents

Current through Register Vol. 24-14, July 15, 2024
(1) A licensed dentist is required to hold a
				  permit of authorization to administer moderate sedation with enteral
				  agents.
(2) To obtain a moderate
				  sedation with enteral agents permit, a licensed dentist shall:
(a) Comply with the permitting and renewal
				  requirements in WAC
				  246-817-774; and
(b) Successfully complete:
(i) A minimum of 16 hours of education and
				  training in minimal sedation as required in WAC
				  246-817-745(1);
				  and
(ii) A minimum of 21 hours of
				  education and training in moderate sedation.
(iii) Moderate sedation education and
				  training must:
(A) Meet ADA
Guidelines
				  for Teaching Pain Control and Sedation to Dentists and Dental
				  Students
, adopted by ADA House of Delegates October 2016 or prior
				  adopted version in effect at the time training was completed; and
(B) Include medical emergency management, not
				  limited to airway management, conducted in-person with hands-on
				  skills.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-760 - Moderate sedation with parenteral agents

Current through Register Vol. 24-14, July 15, 2024
(1) A licensed dentist is required to hold a
				  permit of authorization to administer moderate sedation with parenteral agents.
				  A moderate sedation with parenteral agents permit allows the holder to deliver
				  moderate sedation with enteral agents without obtaining a separate
				  permit.
(2) To obtain a moderate
				  sedation with parenteral agents permit, a licensed dentist shall:
(a) Comply with the permitting and renewal
				  requirements in WAC
				  246-817-774;
(b) Successfully complete a postdoctoral
				  course or courses of 60 clock hours or more which includes:
(i) Basic moderate sedation;
(ii) Physical evaluation;
(iii) Venipuncture and intravenous drug
				  administration, training is a hands-on skill and must be completed
				  in-person;
(iv) Technical
				  administration;
(v) Recognition and
				  management of complications and emergencies, training is a hands-on skill and
				  must be completed in-person;
(vi)
				  Monitoring; and
(vii) Supervised
				  experience in providing moderate sedation with parenteral agents to 20 or more
				  patients.
(c) Training in
				  adult sedation, if treating an adult; and
(d) Training in pediatric sedation, if
				  treating a pediatric patient.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-765 - Pediatric sedation endorsement

Current through Register Vol. 24-14, July 15, 2024
A pediatric patient is physiologically and anatomically
					 unlike an adult, and different sedation drugs and practices may be used for
					 this population, it is necessary to ensure that adequately trained and skilled
					 individuals are treating pediatric patients.
(1) Effective January 1, 2025, a pediatric
				  sedation endorsement is required to administer moderate sedation with enteral
				  agents or moderate sedation with parenteral agents, to pediatric
				  patients.
(2) A licensed dentist
				  who holds a valid moderate sedation with enteral agents permit and a pediatric
				  sedation endorsement may administer intranasal midazolam to a pediatric
				  patient. This modality may be administered without a moderate sedation with
				  parenteral agents permit. Administration of intranasal drugs on patients over
				  the age of 12 requires the licensed dentist to hold a moderate sedation with
				  parenteral agents or general anesthesia permit.
(3) To obtain a pediatric sedation
				  endorsement a licensed dentist shall:
(a) Hold
				  a valid moderate sedation with enteral agents or moderate sedation with
				  parenteral agents permit;
(b)
				  Comply with the permitting and renewal requirements in WAC
				  246-817-774;
(c) Provide evidence of education and
				  training in:
(i) A CODA postgraduate
				  instruction in pediatric dentistry, oral and maxillofacial surgery, or dental
				  anesthesiology; or
(ii) Predoctoral
				  dental school, postgraduate instruction, or continuing education of at least 37
				  hours in minimal and moderate sedation and an additional 14 hours in pediatric
				  sedation.
(A) The 14 hours in pediatric
				  sedation must include:
(I) Pediatric specific
				  anatomical and physiological considerations;
(II) Pediatric behavioral management during
				  administration of sedating medication and intraoperatively;
(III) Pediatric drugs, dosages, and routes of
				  administration;
(IV) Appropriate
				  use of immobilization devices;
(V)
				  Recordkeeping;
(VI) Nitrous oxide
				  in combination with other sedating medications;
(VII) Prevention, recognition and management
				  of complications; and
(VIII) Four
				  or more hours must include hands-on instruction, simulations, live supervised
				  pediatric sedation case management, or a combination of those modalities.
				  Observation alone is not acceptable.
(B) The 37 hours in minimal and moderate
				  sedation must include:
(I) Physical
				  evaluation;
(II) Technical
				  administration;
(III) Drugs and
				  routes of administration;
(IV)
				  Recognition and management of complications and emergencies; and
(V) Monitoring and monitoring equipment
				  including training in expired CO2; and
(d) Provide
				  current health care provider BLS and PALS certifications.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-770 - General anesthesia and deep sedation

Current through Register Vol. 24-14, July 15, 2024
(1) A licensed dentist is required to hold a
				  permit of authorization to administer deep sedation or general anesthesia. A
				  general anesthesia permit allows the holder to deliver moderate sedation with
				  enteral or moderate sedation with parenteral agents without obtaining a
				  separate permit.
(2) To obtain a
				  general anesthesia permit, a licensed dentist shall:
(a) Comply with permitting and renewal
				  requirements in WAC
				  246-817-774;
(b) Successfully complete two years of
				  continuous full-time anesthesia training in at least one of the following:
(i) A dental anesthesiology program
				  accredited by CODA at the time the training was completed; or
(ii) A dental anesthesiology program approved
				  by the DQAC; or
(iii) An anesthesia
				  residency training, with a minimum of two years full-time, at a medical program
				  accredited by the Accreditation Council for Graduate Medical Education;
				  or
(iv) An oral and maxillofacial
				  surgery residency and obtain at least one of the following:
(A) Diplomate status of the American Board of
				  Oral and Maxillofacial Surgery;
(B)
				  Fellow status of the American Association of Oral and Maxillofacial Surgeons;
				  or
(C) Diploma in an Oral and
				  Maxillofacial Residency Program accredited by CODA at the time the training was
				  completed.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-771 - Dental anesthesia assistant

Current through Register Vol. 24-14, July 15, 2024
(1)
				  A dental anesthesia assistant shall be certified under chapter 18.350 RCW and
				  WAC 246-817-205.
(2) A dental anesthesia assistant may only
				  accept delegation from an oral and maxillofacial surgeon or dental
				  anesthesiologist who holds a valid Washington state general anesthesia
				  permit.
(3) Under close
				  supervision, the dental anesthesia assistant may:
(a) Initiate and discontinue an intravenous
				  line for a patient being prepared to receive intravenous medications, sedation,
				  or general anesthesia; and
(b)
				  Adjust the rate of intravenous fluids infusion only to maintain or keep the
				  line patent or open.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-772 - Anesthesia monitor requirements

Current through Register Vol. 24-14, July 15, 2024
(1)
				  When a licensed dentist is also administering moderate sedation with parenteral
				  agents, deep sedation or general anesthesia, one additional appropriately
				  trained team member must be designated for patient monitoring. The team member
				  designated for patient monitoring when general anesthesia is being administered
				  may not also perform dental assistant tasks.
(2) When moderate sedation with parenteral
				  agents, deep sedation or general anesthesia is administered by a dedicated
				  anesthesia provider who is not the operative dentist, the anesthesia provider
				  may serve as the monitoring personnel.
(3) A licensed dentist cannot employ an
				  individual to monitor patients receiving moderate sedation with parenteral
				  agents, deep sedation or general anesthesia unless that individual has received
				  a minimum of 14 hours of documented training, such as national certification
				  American Association of Oral and Maxillofacial Surgeons, on-site or in-office
				  training by a licensed dentist with a moderate sedation with parenteral agents
				  or general anesthesia permit, or other education course specifically designed
				  to include instruction and practical experience in use of equipment to include,
				  but not be limited to, the following equipment:
(a) Sphygmomanometer or a device able to
				  measure blood pressure;
(b) Pulse
				  oximeter or other respiratory monitoring equipment;
(c) Electrocardiogram;
(d) Bag-valve-mask resuscitation
				  equipment;
(e) Oral and
				  nasopharyngeal airways;
(f)
				  Defibrillator or automatic external defibrillator.
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-773 - Continuing education for dentists administering sedation

Current through Register Vol. 24-14, July 15, 2024
Continuing education must contribute to the professional
					 knowledge and development of the licensed dentist to enhance sedation services
					 provided to patients.
(1) The
				  continuing education reporting period for a licensed dentist that administers
				  sedation in Washington before December 31, 2023, begins January 1,
				  2024.
(2) The five-year continuing
				  education reporting period for a licensed dentist that administers minimal
				  sedation with nitrous oxide or minimal sedation in Washington on January 1,
				  2024, or later begins the date of first administration of sedation.
(3) The three-year continuing education
				  reporting period for a licensed dentist initially issued a moderate sedation
				  with enteral agents, moderate sedation with parenteral agents, pediatric
				  sedation endorsement, or general anesthesia permit in Washington on January 1,
				  2024, or later begins the date of permit issuance.
(4) A licensed dentist who holds a valid
				  permit or endorsement shall complete required hours of continuing education in
				  one or more of the subject categories as required in below table.
WAC
								  246-817-740 Minimal sedation with
								  nitrous oxide-7 hours
WAC
								  246-817-745 Minimal sedation-7
								  hours
WAC
								  246-817-755 Moderate sedation
								  with enteral agents-7 hours
WAC
								  246-817-760 Moderate sedation
								  with parenteral agents-14 hours
WAC
								  246-817-765 Pediatric sedation
								  endorsement-14 hours
WAC
								  246-817-770 General anesthesia
								  and deep sedation-18 hours
Appropriate use of immobilization
								  devices
X
ACLS
X
X
X
Behavioral
								  management
X
General
								  anesthesia
X
Inhalation
								  analgesia
X
Medical emergencies
X
X
X
X
X
X
Nitrous oxide analgesia
X
X
X
X
X
Oral or intravenous
								  sedation
X
Oral sedation
X
X
X
PALS
X
X
X
X
X
Patient evaluation
X
X
X
X
X
X
Patient monitoring
X
X
X
X
X
X
Pediatric behavioral
								  management
X
Pediatric
								  pharmacology
X
Pediatric
								  physiological
X
Pediatric
								  sedation
X
Pharmacology
X
X
Physiology
X
X
X
X
X
(5)
				  Verification of completion of continuing education hours will be due on the
				  dentist's sedation permit renewal date beginning in 2027.
(6) Continuing education in subject
				  categories identified in subsection (4) of this section may be completed using
				  any of the activities or methods authorized in WAC
				  246-817-440(4).
(7) Proof of continuing education
				  requirements are listed in WAC
				  246-817-440(5).
Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-817 - Dental quality assurance commission › ADMINISTRATION OF ANESTHETIC AGENTS FOR DENTAL PROCEDURES › Section 246-817-774 - Permitting and renewal requirements

Current through Register Vol. 24-14, July 15, 2024
(1)
				  To administer moderate sedation with enteral agents, moderate sedation with
				  parenteral agents, or general anesthesia, including deep sedation, a licensed
				  dentist shall:
(a) Meet the requirements of
				  this chapter;
(b) Possess and
				  maintain a valid dentist license pursuant to chapter 18.32 RCW; and
(c) Obtain a permit of authorization from the
				  DQAC.