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Texas Dental Practice: Standard of Care

DENTAL PRACTICE-STANDARD OF CARE

1. Do I need to take a patient’s blood pressure or pulse measurement every time the patient has an appointment at my dental office?

SBDE Rule 108.7(2)(B) states that the initial limited physical examination should include, but shall not necessarily be limited to, blood pressure, and pulse/heart rate as may be indicated for each patient. The SBDE has determined that the minimum standard of care requires the recording of at least an initial baseline blood pressure/pulse reading during the initial limited physical examination of a dental patient. The dental practitioner should also record blood pressure and pulse heart rate as indicated for invasive procedures and as required by Board rules regarding procedures involving sedation and anesthesia.

If the dental practitioner is unable to obtain a patient’s vital signs, the dental practitioner must document in the patient’s record an acceptable reason why the attempt to obtain vital signs was unsuccessful. Also, please note that blood pressure and pulse measurement need not be taken on a patient that is twelve (12) years of age or younger unless there is a specific medical need.

2. Can a dentist issue prescriptions for non-dental purposes (i.e. viagra, birth control pills, etc.)?

All dental prescriptions are required to have a dental purpose. Prescribing for a non-dental purpose is a violation of the DPA and the SBDE’s Rules.

3. Where are rules for the administration of enteral conscious sedation located?

The rules for enteral conscious sedation are found in SBDE Rule Chapter 110. SBDE Rule Chapter 110 can be found on the SBDE’s website at www.tsbde.state.tx.us .

4. Can a dentist delegate the adjustment of a dental appliance to a dental auxiliary?

Under DPA Section 258.001(3)(G) a dentist may not delegate the intraoral adjustment of a fixed or removable appliance to anyone not licensed as a dentist. Also, only a licensed dentist can make final adjustments to dental appliances. Adjustments that arenot finalor are extra-oral can be delegated by the dentist to an assistant.

5. What are the requirements for sterilization monitoring?

Rule 108.24 requires that sterilization equipment and its adequacy shall be tested and verified in accordance with American Dental Association (ADA) recommendations. The ADA recommends the routine and regular use of biological monitors to test and verify the adequacy of sterilization cycles on a weekly basis for most dental practices.

6. Where can I find the SBDE’s rules regarding sanitation and infection control?

The SBDE’s rules regarding sanitation and infection control are found in SBDE Rule Chapter 108, Subchapter B (SBDE Rules 108.20-108.25).

Additional information regarding proper sanitation and infection control procedures can be found at the following websites:

The CDC on Oral Health: http://www.cdc.gov/OralHealth/index.htm The ADA on Infection Control: http://www.ada.org/prof/resources/topics/icontrol/index.asp OSHA standards for Dentistry: http://www.osha.gov/SLTC/dentistry/index.html

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