Scope

In order to ensure the protection and safety of patients, every dental facility must be properly equipped, supplied and permitted for the administration of specific types of anesthesia and levels of sedation, and every dentist and/or dental hygienist must be properly educated, trained, and permitted for the specific type of anesthesia or sedation being administered. To guarantee a wide margin of safety for the patient, the qualifications and requirements for permits for anesthesia administration shall be based on a continuum of types of procedures, equipment, drugs, qualifications and training of personnel necessary and appropriate for each type of anesthesia or sedation to be administered at the site. The following standards are based on the ADA Guidelines for The Use of Sedation and General Anesthesia by Dentists 2007 and the Guidelines for Office Anesthesia On-site Evaluation of the Massachusetts Society of Oral and Maxillofacial Surgeons, 2006, and shall be applied in determining the adequacy of the facility and competence of the personnel administering anesthesia and/or sedation. (1) A dentist licensed to practice dentistry in the Commonwealth pursuant to M.G.L. c. 112, §§ 45 and 45A, may administer local anesthesia in a facility that complies with the requirements of 234 CMR 6.15. (2) Facility Permits. A dental facility where general anesthesia or deep sedation, moderate sedation, minimal sedation and/or nitrous oxide-oxygen are administered shall have a Facility Permit D issued by the Board for the type of anesthesia to be administered, unless the facility is exempt from permitting requirements pursuant to 234 CMR 6.03(1)(c). (3) A Facility Permit D is not required for the administration of local anesthesia only. (4) Individual Anesthesia Permits for a Qualified Dentist. A qualified licensee pursuant to M.G.L. c. 112, § 45 is required to obtain an Individual Anesthesia Permit issued by the Board for the type of anesthesia to be administered before he or she may administer general anesthesia, deep sedation, moderate sedation, minimal sedation, or nitrous oxide-oxygen in a dental facility having a Facility D Permit for the type of anesthesia the dentist will be administering. (5) Individual Anesthesia Permit for Qualified Dental Hygienist. A qualified dental hygienist is required to obtain a Permit L issued by the Board for the administration of local anesthesia under the direct supervision of a licensed dentist. (6) A dentist issued an individual anesthesia permit may administer anesthesia or sedation of the type authorized by his/her individual anesthesia permit only at those sites which have a Facility Permit issued by the Board for the type of anesthesia being administered by said dentist, unless the facility is exempt from these standards under 234 CMR 6.03(1)(c). (7) Anesthesia Administration Evaluations. The Board may conduct anesthesia administration evaluations as deemed necessary by the Board to ensure compliance with the requirements in 234 CMR 6.00. Such an evaluation may include observing the administration of anesthesia appropriate to the permit sought by the licensee. Every applicant shall be given notice by the Board of all deficiencies reported as a result of the evaluation. The Board may provide the applicant with a reasonable period of time in which any deficiencies must be corrected. If the results of the evaluation are deemed unsatisfactory, the Board may conduct a second evaluation, within a reasonable time, or upon written request of the applicant. (8) Inspections. The Board may require an on-site inspection of any facility, medications, equipment and qualifications of personnel utilized in the administration of general anesthesia, deep sedation, moderate sedation or nitrous oxide-oxygen sedation. (9) Refusal to permit an anesthesia evaluation or inspection shall constitute a valid ground for denial, suspension or revocation of an anesthesia permit.