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49 Pa. Code § 33.340b. Duties of dentists who are restricted permit II holders.

§ 33.340b. Duties of dentists who are restricted permit II holders.

 (a)  A dentist who possesses a restricted permit II issued under this subchapter shall ensure that:

   (1)  Prior to the administration of nitrous oxide/oxygen analgesia, the permitholder takes or updates a patient medical history and gives the patient a physical evaluation sufficient to determine the patient’s suitability to receive nitrous oxide/oxygen analgesia.

   (2)  The dental office in which the permitholder administers nitrous oxide/oxygen analgesia on an outpatient basis contains the following:

     (i)   An operating room.

     (ii)   An operating table or chair.

     (iii)   A lighting system.

     (iv)   Dental office suction equipment.

     (v)   Oxygen and supplemental gas delivery systems, including primary and back-up sources and a fail-safe control mechanism.

     (vi)   A sterilization area.

     (vii)   A gas storage area and scavenger system.

     (viii)   Communications equipment.

     (ix)   Monitoring equipment, procedures and documentation to conform to the age, size and condition of the patient and the AAOMS Manual and AAOMS Guidelines for adult and pediatric patients (OMS), the ADA Guidelines for adult patients (general dentists) and the AAPD Guidelines for pediatric patients (general dentists).

     (x)   Results of patient medical history, patient physical evaluation and identification of the nitrous oxide/oxygen analgesia procedure to be utilized, prior to the administration of nitrous oxide/oxygen analgesia.

     (xi)   Signed, written, informed patient consent, prior to the administration of nitrous oxide/oxygen analgesia, which includes a description of the procedure, its risks and possible alternative treatments. Consent for a minor patient shall be obtained from the minor’s parent or guardian.

     (xii)   Stethoscope.

   (3)  Nitrous oxide/oxygen analgesia is administered to adult and pediatric patients in accordance with the AAOMS Guidelines and AAOMS Manual (OMS) or to adult patients in accordance with the ADA Guidelines (general dentists) or to pediatric patients in accordance with the AAPD Guidelines (general dentists). Conflicts between the AAOMS Guidelines, the AAOMS Manual, the ADA Guidelines or the AAPD Guidelines and this subchapter shall be resolved in favor of this subchapter.

   (4)  Monitoring equipment and equipment used to administer nitrous oxide/oxygen analgesia is installed, maintained and calibrated according to the equipment manufacturer’s guidelines, contains a fail-safe system and is in proper working condition prior to the administration of nitrous oxide/oxygen analgesia.

   (5)  Patient records are prepared, maintained and retained in accordance with §  33.209 (relating to preparing, maintaining and retaining patient records).

 (b)  A dentist’s failure to comply with this section will be considered unprofessional conduct and will subject the dentist to disciplinary action under section 4.1 of the act (63 P. S. §  123.1).


   The provisions of this §  33.340b issued under sections 3(o) and 11.2(a) of The Dental Law (63 P. S. § §  122(o) and 130c(a)).


   The provisions of this §  33.340b adopted May 13, 2005, effective May 14, 2005, 35 Pa.B. 2880.

Cross References

   This section cited in 49 Pa. Code §  33.331 (relating to definitions); 49 Pa. Code §  33.341 (relating to duties of dentists who are not permitholders); and 49 Pa. Code §  33.342 (relating to inspection of dental offices).

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