On Friday, Aug. 23, the Florida Board of Dentistry (BOD) covered topics such as a petition for variance of waiver of rule that requires only a dentist employ another dentist, as well as updates to the sterilization and anesthesia rules.

The Florida Board of Dentistry (BOD) met in Jacksonville on Friday, Aug. 23 at 7:30 a.m. The Florida Dental Association (FDA) was represented by FDA BOD Liaison Dr. Don Ilkka and Director of Third Party Payer and Professional Affairs Casey Stoutamire. Other FDA members in attendance included Drs. Andy Brown, Michael Ragan, Clive Rayner, Roger Robinson and Rick Stevenson. Northeast District Dental Association Executive Director Ms. Debbie Deville also was in attendance.

Six the BOD members were present, which included Dr. Claudio Miro, chair; Drs. Nick Kavouklis, T.J. Tejera and Nick White; Ms. Angie Sissine, hygiene member; and, Mr. Fabio Andrade, consumer member. Drs. Naved Fatmi and Matt Freedman, and Ms. Cathy Cabanzon, hygienist, were absent. There is one dentist position and one consumer position open on the board that the governor has not yet filled.

The BOD discussed a petition for variance of waiver of rule submitted by Tallahassee Memorial Healthcare. The hospital would like to hire a dentist to be on staff but needs a variance of waiver of the rule that requires only a dentist employ another dentist. The hospital wants to employ a dentist to be on call for trauma and treat patients in the ER. The hospital said on the record, under oath that the dentist would not be treating patients on an out-patient basis (not setting up a dental office/oral surgery practice in the hospital) and that the dentist could still maintain his/her private practice. The BOD was deadlocked, and the issue was tabled to the November meeting. The hospital will need to come back with another petition for variance of waiver of rule and/or a declaratory statement to address if the oral surgeon practicing in the ER is the operation of a dental office. In the declaratory statement, the hospital can delineate the exact services that the oral surgeon will be able to provide in the ER. Then, the BOD can determine if that is or is not the operation of a dental office.

The BOD approved an update to Rule 64B5-25.003, Required Sterilization and Disinfection Procedures. Please go to bit.ly/2lBUmsg to read this rule.

Finally, the BOD approved numerous revisions to 64B5-14, which are the Anesthesia Rules. These revisions are not yet effective and will start moving through the administrative process. Please watch your inbox for notices from the FDA on this important topic. Some highlights of the proposed revisions include:

Requiring the team approach for all types of sedation, which includes the operating dentist, a person responsible for monitoring the patient and a person to assist the operating dentist.
Clarifying that a dentist using general anesthesia, deep sedation, moderate sedation or pediatric moderate sedation in the dental office may only have one patient at a time induced. A second patient shall not be induced until the first patient is awake, alert, conscious, spontaneously breathing, has stable vital signs, is under the care of a responsible adult and that portion of the procedure required in the participation of the dentist is complete. In an office setting where two or more permit holders are present simultaneously, each may sedate one patient provided that the office has the necessary staff and equipment for each sedated patient.
Effective March 1, 2022, if treating a patient under the age of 7, a dentist using any level of sedation must be currently trained in pediatric advanced life support.
During the initial inspection prior to the issuance of a general anesthesia permit, moderate sedation permit or pediatric moderate sedation permit, the applicant must demonstrate the placement of an intravenous catheter.
Routine inspections shall be conducted at a minimum of every three years. And any additional location shall be subject to a routine inspection no later than one year from the date the location was added.
All rooms where sedation is being performed must accommodate the patient on a table or in an operating chair and permit an operating team consisting of at least three individuals to freely move about the patient. An operating table or chair which permits the patient to be positioned so the operating team can maintain the airway quickly, alter patient position in an emergency and provide a firm platform for the management of CPR.
The anesthesia record must include the duration of the procedure, including the start and finish time of the procedure.

There were six disciplinary cases and two informal hearings requesting for reconsideration dealing with a death of a special needs patient (license was revoked), failing to keep adequate records and failing to meet the minimum standard of care. It is much better to be a spectator than a participant in BOD disciplinary cases.

The next BOD meeting is scheduled for Friday, Nov. 22, 2019, at 7:30 a.m. EST in Jacksonville.

Today's FDA - Sept/Oct 2019

Sep 30, 2024