Section 1220.510  Conscious Sedation in the Dental Office Setting

a)         Conscious sedation includes the prescription or administration of pharmocologic agents to be used for the purposes of conscious sedation.  Conscious sedation must be administered by an individual qualified under this Section. (See Appendix D for characteristics of levels of anesthesia.)

b)         A licensed dentist seeking a Permit A for conscious sedation administration privileges shall file an application with the Division, on forms provided by the Division, that includes:

1)         Certification of completion of an anesthesiology training program that meets the requirements set forth in Section 1220.540(a);

2)         A signed affidavit certifying that the dentist will practice in a facility properly equipped in accordance with subsection (h) of this Section for the administration of conscious sedation and staffed with a supervised team that consists of a minimum of 2 individuals per patient, in addition to the dentist, capable of assisting  with procedures, problems and emergencies incident to the administration of such sedation (e.g., Basic Life Support (BLS)); and

3)         The required fee set forth in Section 21 of the Act.

c)         Dentists who have a current valid permit for conscious sedation issued by the Division shall be permitted to administer without additional application.

d)         Dentists who need to obtain a permit will be required to complete the required training and apply for the permit by December 1, 2003.

e)         Upon review and recommendation of the Board in accordance with the standards set forth in this Section, the Division will:

1)         Issue a conscious sedation permit (Permit A).

2)         Re-issue a conscious sedation permit to Permit A holders who attest to completing continuing education.

f)          Licensees qualified to administer deep sedation (Permit B) pursuant to Section 1220.520 may administer conscious sedation without a Permit A.

g)         If the accuracy, relevance or sufficiency of any submitted documentation is questioned by the Division or the Board, because of discrepancies or conflicts in information, needing further clarification, and/or missing information, additional documentation may be required and/or an on-site evaluation of the facilities, equipment and personnel may be conducted by the Division.

h)         A properly equipped facility shall include at minimum:

1)         Sphygmomanometer and stethoscope;

2)         An oxygen delivery system with full face masks and connectors that is capable of delivering oxygen to the patient under positive pressure, with a backup system;

3)         Emergency drugs and equipment appropriate to the medications administered;

4)         Suction equipment;

5)         An emergency back-up lighting system that will permit the completion of any operation underway; and

6)         A pulse oximeter.

i)          The following records shall be kept during the administration of conscious sedation:

1)         Medical history of the patient and consent for administration of anesthesia prior to the performance of any procedure;

2)         Preoperative, intraoperative, and pre-discharge monitoring of blood pressure, pulse, respiration and oxygen saturation;

3)         Drugs and dosages of these drugs used during the operative procedure, including the identification of the person administering drugs and times of their administration over the course of the procedure.

j)          A licensed dentist shall hold Permit A in order to perform dentistry while a licensed certified nurse anesthetist administers conscious sedation.  A nurse anesthetist for purposes of this Section is a licensed certified nurse anesthetist who holds a license as an advanced practice nurse under the Illinois Nursing and Advanced Practice Nursing Act [225 ILCS 65].  The dentist shall enter into a written practice agreement with the nurse anesthetist in accordance with Section 15-25 of the Illinois Nursing and Advanced Practice Nursing Act and 68 Ill. Adm. Code 1305.

k)         Proof of 4 hours of continuing education in sedation techniques, including medications and recognition and management of complications and emergencies, is required for renewal of Permit A.

l)          A treating dentist does not need to hold Permit A to perform dentistry when another dentist, who holds Permit A or Permit B, or a physician assists the treating dentist by administering conscious sedation. Physician for purposes of this Section means a physician who is licensed to practice medicine in all of its branches under the Medical Practice Act [225 ILCS 60] and is authorized to provide anesthesia services in a licensed hospital or licensed ambulatory surgical treatment center or is an anesthesiologist.  The treating dentist shall be prepared to provide affidavits to the following if requested by the Division:

1)         Proof of Basic Life Support (BLS) training;

2)         That the facility used for sedation meets the criteria of subsection (g) of this Section;

3)         That the dentist shall staff the facility with a supervised team that includes a minimum of 2 individuals (in addition to the provider sedating) per patient capable of assisting with procedures, problems and emergencies incident to the administration of such sedation (e.g., BLS).  In addition, the dentist shall report adverse occurrences to the Division as set forth in Section 1220.405 and accept the responsibility to verify the certification and licensure of any licensed provider present during the conscious sedation of a patient who is receiving dental care.

(Source:  Amended at 30 Ill. Reg. 19656, effective December 18, 2006)