(c) Educational and training requirements.
(1) Initial certification.
(i) Certificate in dental general anesthesia.
A licensed dentist shall meet the educational and training requirements in this
subparagraph for the initial certificate in dental general anesthesia. The
licensed dentist shall successfully complete:
(a) a course in advanced cardiac life support
(ACLS), or its equivalent as determined by the department, and have current
documentation of course completion attesting to this fact; and
(b) if the licensed dentist is administering
general anesthesia to patients 12 years old and younger, a course in pediatric
advanced life support (PALS), or its equivalent as determined by the
department, and have current documentation of course completion attesting to
this fact; and
(c) either:
(1) for post-doctoral education completed
prior to January 1, 2002, at least one year of such education in anesthesia
acceptable to the department, which shall include but not be limited to,
coursework in anesthesia, anxiety and pain control, establishing and
maintaining emergency airway, and use and interpretation of appropriate
monitoring; or at least two years of such education in an approved specialty
program or residency, which includes acceptable training and experience,
including but not limited to, instruction in general anesthesia and parenteral
sedation; provided that the candidate has applied to the department for the
initial certificate to employ conscious (moderate) sedation (enteral or
parenteral route with or without inhalation agents), deep sedation, and general
anesthesia prior to January 1, 2004; or
(2) at least two years of post-doctoral
education acceptable to the department and accredited by an acceptable
accrediting body, which shall include but not be limited to coursework in
anesthesia and anxiety and pain control; and one year devoted exclusively to
clinical training in general anesthesia and related subjects such as
establishing and maintaining an emergency airway and use and interpretation of
appropriate monitoring prior to January 1, 2019; or
(3) at least three years of post-doctoral
education acceptable to the department and accredited by an acceptable
accrediting body, which shall include but not be limited to coursework in
anesthesia and anxiety and pain control; and one year devoted exclusively to
clinical training in general anesthesia and related subjects such as
establishing and maintaining an emergency airway and use and interpretation of
appropriate monitoring as of January 1, 2019; or
(4) a graduate level program in oral and
maxillofacial surgery acceptable to the department and accredited by an
acceptable accrediting body, which shall include but not be limited to
instruction in general anesthesia, parenteral sedation, and anxiety and pain
control.
(ii)
Certificate in dental parenteral conscious (moderate) sedation for patients 13
years old and older. A licensed dentist shall meet the educational and training
requirements of this subparagraph for the initial certificate in dental
parenteral conscious (moderate) sedation for patients 13 years older and older.
The licensed dentist shall successfully complete:
(a) a course in advanced cardiac life support
(ACLS), or its equivalent as determined by the department, and have current
documentation of course completion attesting to this fact; and
(b) pre-doctoral or post-doctoral education
acceptable to the department and accredited by an acceptable accrediting body,
which shall include a formal course consisting of at least 60 clock hours of
coursework that is provided through didactic instruction and/or an anesthesia
rotation, which has been previously approved by the department. Simulation
experiences may be part of the required coursework, which shall include but not
be limited to, coursework in patient evaluation and monitoring, management of
emergencies, rescue of patients from deep sedation, management of the pediatric
and adult airways, pediatric and adult cardiac and pulmonary anatomy and
physiology, pediatric and adult pharmacology, and the control of pain and
anxiety; and in addition to the 60 clock hours of coursework, a clinical
experience demonstrating the successful use of dental parenteral conscious
(moderate) sedation on no fewer than 20 live dental patients via the
intravenous route who shall be 13 years old or older in a 1 doctor/student to 1
patient ratio. Provided, however, that the Department, in its discretion, may
accept a clinical experience demonstrating the successful use of dental
parental conscious (moderate) sedation on no fewer than 15 live dental patients
via the intravenous route who shall be 13 years old or older in a 1
doctor/student to 1 patient ratio and up to 5 Objective Structured Clinical
Examinations (OSCE's) in a 1 doctor/student to 1 OSCE ratio for a total of 20
patients to meet the live dental patient requirement of this clause if such
requirement cannot be met due to the State of Emergency declared by the
Governor pursuant to an Executive Order for the COVID-19 crisis. The
student/licensed dentist enrolled in the course shall have his or her name
listed on the anesthesia record and shall be the individual administering the
medications and documenting said administration, as well as the physiologic
findings required on the anesthesia record. The patients shall be monitored, at
a minimum, pursuant to the practice requirements as set forth in subdivision
(d) of this section. If the clinical portion of the course is given outside a
teaching institution, a formal memorandum of understanding (MOU) between the
teaching institution and the clinical teaching center (facility) shall be in
place attesting that the clinical facility is held to the same practice
standards as the teaching institution.
(iii) Certificate in dental parenteral
conscious (moderate) sedation for patients 12 years old and younger. A licensed
dentist shall meet the educational and training requirements of this
subparagraph for the initial certificate in dental parenteral conscious
(moderate) sedation for patients 12 years old and younger. The licensed dentist
shall successfully complete:
(a) a course in
advanced cardiac life support (ACLS), or its equivalent as determined by the
department, and have current documentation of course completion attesting to
this fact;
(b) a course in
pediatric advanced life support (PALS), or its equivalent as determined by the
department, and have current documentation of course completion attesting to
this fact; and
(c) pre-doctoral or
post-doctoral education accredited by an acceptable accrediting body, which
shall include a formal course consisting of at least 60 clock hours of
coursework that is provided through didactic instruction and/or an anesthesia
rotation, which has been previously approved by the department. Simulation
experiences can be part of the coursework which shall include but not be
limited to, coursework in patient evaluation and monitoring, management of
emergencies, rescue of patients from deep sedation, management of the pediatric
and adult airways, pediatric and adult cardiac and pulmonary anatomy and
physiology, pediatric and adult pharmacology, and the control of pain and
anxiety; and in addition to the 60 clock hours of coursework, a clinical
experience, acceptable to and previously approved by the department,
demonstrating the successful use of dental parenteral conscious (moderate)
sedation by the intravenous route on no fewer than 15 live dental patients who
shall be 12 years old or younger and five live dental patients who shall be 13
years old or older in a 1 doctor/student to 1 patient ratio. Provided, however,
that the Department, in its discretion, may accept a clinical experience
demonstrating the successful use of dental parental conscious (moderate)
sedation by the intravenous route on no fewer than 12 live dental patients who
shall be 12 years old or younger and three live dental patients who shall be 13
years old or older and up to five Objective Structured Clinical Examinations
(OSCE's), for a total of 20 patients, all in a 1 doctor/student to 1 patient
ratio to meet the live dental patient requirement of this clause if such
requirement cannot be met due to the State of Emergency declared by the
Governor pursuant to an Executive Order for the COVID-19 crisis. The
student/licensed dentist enrolled in the course shall have his or her name
listed on the anesthesia record and shall be the individual administering the
medications and documenting said administration, as well as the physiologic
findings required on the anesthesia record. The patients shall be monitored, at
a minimum, pursuant to the practice requirements as set forth in subdivision
(d) of this section. If the clinical portion of the course is given outside a
teaching institution, a formal memorandum of understanding (MOU) between the
teaching institution and the clinical teaching center (facility) shall be in
place attesting that the clinical facility is held to the same practice
standards as the teaching institution.
(iv) Certificate in dental enteral conscious
(moderate) sedation for patients 13 years old and older. A licensed dentist
shall meet the educational and training requirements of this subparagraph for
the initial certificate in dental enteral conscious (moderate) sedation for
patients 13 years old and older. The licensed dentist shall successfully
complete:
(a) a course in advanced cardiac
life support (ACLS), or its equivalent as determined by the department, and
have current documentation of course completion attesting to this fact;
and
(b) pre-doctoral education or
post-doctoral education accredited by an acceptable accrediting body, and which
shall include a formal course consisting of at least 60 clock hours of
coursework that is provided through didactic instruction and/or an anesthesia
rotation, which has been previously approved by the department. Simulation
experiences may be part of the required coursework which shall include but not
be limited to, coursework in patient evaluation and monitoring, management of
emergencies including IV access, rescue of patients from deep sedation,
management of the pediatric and adult airways, pediatric and adult cardiac and
pulmonary anatomy and physiology, pediatric and adult pharmacology, and the
control of pain and anxiety; and in addition to the 60 clock hours of
coursework, a clinical experience, acceptable to and previously approved by the
department, demonstrating the successful use of dental enteral conscious
(moderate) sedation on no fewer than 10 live clinical dental patients who shall
be 13 years old or older and who are physically present in the same location as
the students. Provided, however, that the Department, in its discretion, may
accept a clinical experience demonstrating the successful use of dental enteral
conscious (moderate) sedation on no fewer than eight live clinical dental
patients who shall be 13 years old or older and who are physically present in
the same location as the students and up to two Objective Structured Clinical
Examinations (OSCE's) for a total of 10 patients to meet the live clinical
dental patient requirement of this clause if such requirement cannot be met due
to the State of Emergency declared by the Governor pursuant to an Executive
Order for the COVID-19 crisis. The students may be in groups no larger than
five. The patients shall be monitored, at a minimum, pursuant to the practice
requirements as set forth in subdivision (d) of this section. If the clinical
portion of the course is given outside a teaching institution, a formal
memorandum of understanding (MOU) between the teaching institution and the
clinical teaching center (facility) shall be in place attesting that the
clinical facility is held to the same practice standards as the teaching
institution.
(v)
Certificate in dental enteral conscious (moderate) sedation for patients 12
years old and younger. A licensed dentist shall meet the educational and
training requirements in this subparagraph for the initial certificate in
dental enteral conscious (moderate) sedation for patients 12 years old and
younger. The licensed dentist shall successfully complete:
(a) a course in advanced cardiac life support
(ACLS), or its equivalent as determined by the department, and have current
documentation of course completion attesting to this fact;
(b) a course in pediatric advanced life
support (PALS), or its equivalent as determined by the department and have
current documentation of course completion attesting to the fact; and
(c) pre-doctoral or post-doctoral education
acceptable to the department and accredited by an acceptable accrediting body,
which shall include a formal course consisting of at least 60 clock hours of
coursework that is provided through didactic instruction and/or an anesthesia
rotation, which has been previously approved by the department. Simulation
experiences can be part of the coursework which shall include but not be
limited to coursework in patient evaluation and monitoring, management of
emergencies, including IV access, rescue of patients from deep sedation,
management of the pediatric and adult airways, pediatric and adult cardiac and
pulmonary anatomy and physiology, pediatric and adult pharmacology, and the
control of pain and anxiety; and in addition to the 60 clock hours of
coursework, a clinical experience demonstrating the successful use of dental
enteral conscious (moderate) sedation on no fewer than 15 live clinical dental
patients 12 years old or younger and five live clinical dental patients 13
years old or older in a 2:1 doctor/student to patient ratio. For the purpose of
this section, a 2:1 doctor/student to patient ratio means the doctor/student
providing dental care to the patient and a second doctor/student monitoring and
documenting the sedation care can receive credit for the procedure as it
relates to the minimum number of sedations required for certification. Both of
these doctors/students shall be with the patient during the entire time of
treatment and cannot be involved with any other activities or responsibilities.
Only the two doctors/students involved in direct patient care/monitoring can
receive credit for treating the patient undergoing the procedure and sedation.
The student/licensed dentist enrolled in the course shall have his or her name
listed on the anesthesia record and shall be the individual administering the
medications and documenting said administration, as well as the physiologic
findings required on the anesthesia record. The patients shall be monitored, at
a minimum, pursuant to the practice requirements set forth in subdivision (d)
of this section. If the clinical portion of the course is given outside a
teaching institution, a formal memorandum of understanding (MOU) between the
teaching institution and the clinical teaching center (facility) shall be in
place attesting that the clinical facility is held to the same practice
standards as the teaching institution.
(2) Certification through endorsement.
For endorsement of a dental anesthesia certificate from
another jurisdiction of the United States or Canada, the applicant shall submit
to the department a certificate of good standing from said jurisdiction and
currently be registered to practice dentistry in the State of New York, and
shall submit satisfactory evidence of having met the following requirements for
the requested certificate:
(i) General
anesthesia:
Certificate of completion of a Commission on Dental
Accreditation (CODA) accredited oral and maxillofacial surgery program or a
CODA accredited dental anesthesia program.
(ii) Dental parenteral conscious (moderate)
sedation for patients 13 years old and older:
(a) if the applicant has ever had any
patients with irreversible morbidity or mortality due to the sedation provided
by him or her, the applicant must provide an explanation of the incident(s) to
the department for review, in a form prescribed by the department. Depending on
the circumstances, the department may require remediation before a dental
parenteral conscious (moderate) sedation for patients 13 years old and older
certificate will be issued;
(b)
provide 20 anesthesia records of patients that the applicant has administered
parenteral conscious (moderate) sedation (by the intravenous route) in the
licensed jurisdiction, within the three years immediately preceding the
applicant's submission of his or her application to the department for review
with no patients having had irreversible morbidity or mortality due to the
sedation provided by the applicant. These records shall include monitoring that
is required by clause (b) of subparagraph (ii) of paragraph (4) of subdivision
(d) of this section for the administration of parenteral conscious (moderate)
sedation; and
(c) provide current
documentation of completion of a course in advanced cardiac life support (ACLS)
from a department approved course sponsor, or its equivalent as determined by
the department.
(iii)
Dental parenteral conscious (moderate) sedation for patients 12 years old and
younger:
(a) if the applicant has ever had
any patients with irreversible morbidity or mortality due to the sedation
provided by him or her, the applicant must provide an explanation of the
incident(s) to the department for review, in a form prescribed by the
department. Depending on the circumstances, the department may require
remediation before a dental parenteral conscious (moderate) sedation for
patients 12 years old and younger certificate will be issued;
(b) have a certificate to provide parenteral
conscious (moderate) sedation for, at least, the 3 years immediately preceding
the applicant's submission of his or her application to the department for
review;
(c) pre-doctoral or
post-doctoral education acceptable to the department and accredited by an
acceptable accrediting body, which shall include a formal course consisting of
at least 60 clock hours of coursework that is provided through didactic
instruction and/or an anesthesia rotation, which has been previously approved
by the department. Simulation experiences can be part of the coursework which
shall include but not be limited to coursework in patient evaluation and
monitoring, management of emergencies, including IV access, rescue of patients
from deep sedation, management of the pediatric and adult airways, pediatric
and adult cardiac and pulmonary anatomy and physiology, pediatric and adult
pharmacology, and the control of pain and anxiety; and in addition to the 60
clock hours of coursework, a clinical experience demonstrating the successful
use of dental enteral conscious (moderate) sedation on no fewer than 15 live
clinical dental patients 12 years old or younger and five live clinical dental
patients 13 years old or older in a 2:1 doctor/student to patient ratio.
Provided, however, that the Department, in its discretion, may accept a
clinical experience demonstrating the successful use of dental enteral
conscious (moderate) sedation on no fewer than 12 live clinical dental patients
12 years old or younger and three live clinical dental patients 13 years old or
older in a 2:1 doctor/student to patient ratio for both age groups, as well as
up to five Objective Structured Clinical Examinations (OSCE's) in a 1
doctor/student to 1 OSCE ratio for a total of 20 patients to meet the live
clinical dental patient requirement of this clause if such requirement cannot
be met due to the State of Emergency declared by the Governor pursuant to an
Executive Order for the COVID-19 crisis. For the purpose of this section, a 2:1
doctor/student to patient ratio means the doctor/student providing dental care
to the patient and a second doctor/student monitoring and documenting the
sedation care can receive credit for the procedure as it relates to the minimum
number of sedations required for certification. Both of these doctors/students
shall be with the patient during the entire time of treatment and cannot be
involved with any other activities or responsibilities. Only the two
doctors/students involved in direct patient care/monitoring can receive credit
for treating the patient undergoing the procedure and sedation. The
student/licensed dentist enrolled in the course shall have his or her name
listed on the anesthesia record and shall be the individual administering the
medications and documenting said administration, as well as the physiologic
findings required on the anesthesia record. The patients shall be monitored, at
a minimum, pursuant to the practice requirements set forth in subdivision (d)
of this section. If the clinical portion of the course is given outside a
teaching institution, a formal memorandum of understanding (MOU) between the
teaching institution and the clinical teaching center (facility) shall be in
place attesting that the clinical facility is held to the same practice
standards as the teaching institution.
(d) provide current documentation of
completion of a course in advanced cardiac life support (ACLS) from a
department approved sponsor, or its equivalent as determined by the department;
and
(e) provide current
documentation of completion of a course in pediatric advanced life support
(PALS) from a department approved sponsor, or its equivalent as determined by
the department.
(iv)
Dental enteral conscious (moderate) sedation for patients 13 years old and
older:
(a) if the applicant has ever had any
patients with irreversible morbidity or mortality due to the sedation provided
by him or her, the applicant must provide an explanation of the incident(s) to
the department for review, in a form prescribed by the department. Depending on
the circumstances, the department may require remediation before a dental
enteral conscious (moderate) sedation for patients 13 years old and older
certificate will be issued;
(b)
provide 20 anesthesia records of patients that the applicant has administered
enteral conscious (moderate) sedation in the licensed jurisdiction, within the
three years immediately preceding the applicant's submission of his or her
application to the department for review, in a form prescribed by the
department. These records shall include monitoring that is required by clause
(b) of subparagraph (ii) of paragraph (4) of subdivision (d) of this section
for the administration of enteral conscious (moderate) sedation; and
(c) provide current documentation of
completion of a course in advanced cardiac life support (ACLS) from a
department approved course sponsor, or its equivalent as determined by the
department.
(v) Dental
enteral conscious (moderate) sedation for patients 12 years old and younger:
(a) if the applicant has ever had any
patients with irreversible morbidity or mortality due to the sedation provided
by him or her, the applicant must provide an explanation of the incident(s) to
the department for review, in a form prescribed by the department. Depending on
the circumstances, the department may require remediation before a dental
enteral conscious (moderate) sedation certificate for patients 12 years old and
younger will be issued;
(b) have a
certificate to provide enteral conscious (moderate) sedation for at least the 3
years immediately preceding the applicant's submission of his or her
application to the department for review;
(c) provide 15 anesthesia records of patients
12 years old and younger and five anesthesia records of patients 13 years old
and older, that the applicant has administered enteral conscious (moderate)
sedation in the licensed jurisdiction, within the three years immediately
preceding the applicant's submission of his or her application to the
department for review. These records shall include monitoring that is required
by clause (b) of subparagraph (ii) of paragraph (4) of subdivision (d) of this
section for the administration of enteral conscious (moderate)
sedation;
(d) provide current
documentation of completion of a course in advanced cardiac life support (ACLS)
from a department approved sponsor, or its equivalent as determined by the
department; and
(e) provide current
documentation of completion of a course in pediatric advanced life support
(PALS) from a department approved sponsor, or its equivalent as determined by
the department.
(3) Renewal of certification. A licensed
dentist shall meet the educational and training requirements of this paragraph
for the renewal of certification.
(i) For the
renewal of certificates in dental general anesthesia, a licensed dentist shall
successfully complete:
(a) a course in
advanced cardiac life support (ACLS), or its equivalent as determined by the
department, and have current documentation attesting to this fact;
(b) a course in pediatric advanced life
support (PALS), or its equivalent as determined by the department and have
current documentation of course completion attesting to the fact if the dentist
with the general anesthesia certificate is providing conscious (moderate)
sedation, deep sedation or general anesthesia to patients 12 years old or
younger; and
(c) an additional
twelve clock hours of education (exclusive of the ACLS and PALS requirements
contained in clauses (a) and (b), respectively, of this subparagraph) in
anesthesia/sedation techniques approved by an acceptable accrediting body and
the department, including but not limited to, coursework in medications and
recognition and management of complications and emergencies including rescue
from deeper levels of sedation as may occur in both the pediatric and adult
patient populations.
(ii) For the renewal of certificates in
dental , parenteral conscious (moderate) sedation for patients 12 years old and
younger, and dental enteral conscious (moderate) sedation for patients 12 years
old and younger, the licensed dentist shall successfully complete:
(a) a course in advanced cardiac life support
( ACLS), or its equivalent as determined by the department, and have current
documentation attesting to this fact; and
(b) a course in pediatric advanced life
support (PALS), or its equivalent as determined by the department and have
current documentation of course completion attesting to this fact;
and
(c) an additional twelve clock
hours of education (exclusive of the ACLS and PALS requirements contained in
clauses (a) and (b), respectively, of this subparagraph) in anesthesia/sedation
techniques, approved by an acceptable accrediting body and the department,
including but not limited to, coursework in medications and recognition and
management of complications and emergencies including rescue from deeper levels
of sedation as may occur in both the pediatric and adult patient
populations.
(iii) For
the renewal of certificates in dental parenteral and enteral conscious
(moderate) sedation for patients 13 years old and older the licensed dentist
shall successfully complete:
(a) a course in
advanced cardiac life support (ACLS), or its equivalent as determined by the
department, and have current documentation attesting to this fact;
and
(b) an additional twelve clock
hours of education (exclusive of the ACLS requirement contained in clause (a)
of this subparagraph) in anesthesia/sedation techniques, approved by an
acceptable accrediting body and acceptable to and previously approved by the
department, including but not limited to, coursework in medications and
recognition and management of complications and emergencies, including rescue
from deeper levels of sedation as may occur in both the pediatric and adult
patient populations.
(iv) The coursework required to be completed
for the renewal of certification may be creditable toward meeting the dentist's
continuing education requirement, provided that it meets all requirements of
section
61.15
of this Part.