R156-69-301a. Dentist Anesthesia and Analgesia - Permit Classifications and Scopes of Practice -- Dermal Filler -- Botulinum Toxin

(1) Under Section 58-1-510 and Subsection 58-69-301(4)(a), the classification of dentist anesthesia and analgesia permits are as follows: (a) local anesthesia permit; (b) minimal sedation permit; (c) moderate sedation permit; and (d) deep sedation and general anesthesia permit. (2) Under Section 58-1-510 and Subsection 58-69-301(4)(b), the scope of practice for each dentist anesthesia and analgesia permit is established as follows: (a) a dentist with a local anesthesia permit may administer local anesthesia and nitrous oxide analgesia and supervise the administration of local anesthesia and nitrous oxide analgesia in compliance with the standards in Subsection (3); (b) a dentist with a minimal sedation permit may: (i) exercise the privileges of a local anesthesia permit; and (ii) administer and supervise the administration of minimal sedation via nitrous oxide analgesia and oxygen, with or without the administration of enteral medications, in compliance with the standards in Subsection (3); (c) a dentist with a moderate sedation permit may: (i) exercise the privileges of a minimal sedation permit; (ii) administer and supervise the administration of moderate sedation in compliance with the standards in Subsection (3); and (iii) when engaging in the administration of moderate sedation shall: (A) use pulse oximetry; and (B) have at least one ACLS or PALS trained individual present in-operatory during sedation; and (d) a dentist with a deep sedation and general anesthesia permit may: (i) exercise the privileges of a moderate sedation permit; (ii) administer or supervise the administration of deep sedation or general anesthesia in compliance with the standards in Subsection (3); and (iii) when engaging in the administration of deep sedation or general anesthesia, shall: (A) use pulse oximetry and end-tidal carbon dioxide (CO2) monitoring with capnography; and (B) have at least one ACLS or PALS trained individual present in-operatory during sedation. (3) Under Section 58-1-510 and Subsections 58-69-102(6) and 58-69-807(2) and (5), a dentist shall possess the knowledge, skills, education, and training required by and shall comply with the following standards, as applicable to the dentist's permitted scope of practice: (a) the ADA Use of SGA Guidelines; (b) the Pediatric Sedation Guidelines; (c) the ADA SGA Policy Statement; (d) the AAOMS standards; (e) the ASA standards; and (f) Section 58-1-510. (4)(a) A dentist who meets the requirements of Subsections (4)(b) and R156-69-304a(4) may administer a dermal filler: (i) within the oral and maxillofacial areas of a patient for cosmetic purposes; and (ii) in the dentist's regularly announced office location during standard business hours. (b) A dentist who provides treatment to a patient under Subsection (4)(a) shall demonstrate competency by successfully completing an approved ten-hour CPE course on dermal fillers that: (i) is taught by an instructor who: (A) has an active and current license; (B) is qualified by education, training, and experience to provide instruction on dermal fillers; (C) has at least 4,000 hours of clinical experience; (D) has successfully administered dermal fillers on at least 50 patients; (E) is teaching within the scope of practice for the instructor's license; and (F) meets the CPE requirements of Section R156-69-304a; and (ii) includes: (A) a hands-on component on a live patient; (B) infection control; and (C) risk factors for administering dermal fillers. (5)(a) A dentist who meets the requirements of Subsections (5)(b) and R156-69-304a(5) may administer a botulinum toxin injection: (i) within the oral and maxillofacial areas of a patient: (A) for cosmetic purposes; or (B) as a therapeutic treatment to reduce the pain or discomfort of diagnosed TMD as defined in Subsection R156-69-102(44) and other medical conditions of the oral and maxillofacial areas including bruxism and migraines; and (ii) in the dentist's regularly announced office location during standard business hours. (b) A dentist who provides treatment to a patient under Subsection (5)(a) shall demonstrate competency by successfully completing an approved 20-hour CPE course on administering botulinum toxin injections that meets the following education requirements: (i) includes: (A) didactic instruction; (B) hands-on training on a live patient; (C) at least ten hours of training on administering botulinum toxin for treating TMD and other medical conditions of the oral and maxillofacial areas including bruxism and migraines; and (D) at least ten hours of training on administering botulinum toxin for cosmetic purposes; (ii) covers the following topics: (A) anatomy; (B) neurophysiology; (C) pharmacology; (D) risk factors for administration of botulinum; (E) infection control; (F) injection techniques; (G) dental facial asymmetry and aesthetics; (H) lip hypermobility; (I) treatment for TMD as defined in Subsection R156-69-102(44) and other medical conditions of the oral and maxillofacial areas including bruxism and migraines; (J) management of complications; (K) indications and contraindications; (L) long-term use of botulinum toxin; and (M) risk factors for administering the neurotoxin botulinum toxin; and (iii) except as provided in Subsection (5)(c), is taught by an instructor who: (A) has an active and current license; (B) is qualified by education, training, and experience to provide instruction on administering botulinum toxin injections; (C) has at least 4,000 hours of clinical experience; (D) has successfully administered botulinum toxin injections on at least 50 patients; (E) is teaching within the scope of practice for the instructor's license; and (F) meets the CPE requirements of Section R156-69-304a. (c) A dental hygienist may not be an instructor under Subsection (5)(b)(iii).