By Dimitri Davis

On December 21, 2021, the Dental Board of California (DBC) published notice of its intent to adopt sections 1017, 1043.8.1, 1043.9, 1043.9.1, 1043.9.2, and Article 5.1, and amend sections 1021, 1043, 1043.1, 1043.2, 1043.3, 1043.4, 1043.5, 1043.6, 1043.7, 1043.8, 1044, 1044.1, 1044.2, 1044.3, 1044.4, 1044.5, and 1070.8 of Title 16 of the California Code of Regulations (CCR) to implement  significant regulatory updates to the current anesthesia and sedation permit program regulations  pursuant to SB 501 (Glazer) (Chapter 929, Statutes of 2018) as set forth in the proposed language.

According to the initial statement of reasons, SB 501 (Glazer) established a series of new provisions in the Dental Practice Act governing the use of deep sedation and general anesthesia such as, among other things, requiring dentists to possess either a current license in good standing and a general anesthesia permit, or other specified credentials in order to administer or order the administration of deep sedation or general anesthesia on an outpatient basis. The bill also required dentists to possess a pediatric endorsement of their general anesthesia permit to administer or order the administration of deep sedation or general anesthesia to patients under seven years of age and will require dentists to be present in the dental office during the ordering and administration of general anesthesia or deep sedation. It requires the presence of the operating dentist and at least two additional personnel for patients under 13 years of age for procedures involving deep sedation or general anesthesia, and requires that certain personnel be present throughout the procedure. It further requires a dentist who orders the administration of moderate sedation to be physically present in the treatment facility while the patient is sedated and would require the presence of additional specified personnel for sedation of patients 13 years of age or younger. It requires that specified permit holders establish continuing competency to administer general anesthesia, deep sedation or moderate sedation by completing 20 cases of anesthesia or sedation for specified pediatric populations within the 24-month period immediately preceding each permit renewal period.

The proposed rulemaking is intended to implement all the new provisions, ensure that minimum standards for the professions are met and ensure that there are no clarity issues in compliance with SB 501. On several previous occasions, DBC discussed proposed rulemaking at its meetings that would amend section 1017, Title 16 of the CCR. At its May 13, 2021 meeting, the Board consolidated proposed amendments to sections 1016, 1016.2, and 1017 into a single rulemaking proposal. The Board decided to add the first rulemaking package into the SB 501 package to remove the clarity issue by having all new proposed sections that refer to one another in the same regulatory package. This rulemaking would also provide grammatical and other non-substantive changes to affected sections. This rulemaking would also establish permit application requirements for general anesthesia permits and moderate sedation permits and establish requirements to pay a fee to process those applications

DBC anticipates the most fiscal impact will occur during the first two years of this proposed rulemaking implementation. The Board estimates that the expected permit application workload costs will roughly equal the expected permit application revenue. The public comment period will end on February 15, 2022. DBC has not scheduled a public hearing on this proposed action. However, DBC will hold a hearing if it receives a written request for a public hearing from any interested person no later than 15 days before the close of the written comment period.