State Board of Dentistry
Meeting Summary
July 10, 2015
Regulatory Update
Dental school faculty licenses
Temple University's Kornberg School of Dentistry and one private practitioner submitted
comments regarding the SBOD's proposed rulemaking on issuing faculty licensees to qualified
individuals. Dean Ismail from Temple suggests amending Section 33.119(c)(1) and (2), believing
that it is redundant for both the school and the State Board of Dentistry (SBOD) to review an
applicant's credentials.
The SBOD voted to keep its draft regulations as written. They will be published in the
Pennsylvania Bulletin as proposed rulemaking, initiating the formal regulatory process that
involves the Independent Regulatory Review Commission, the Governor's Policy Office, the
House/Senate Licensure Committees and the public.
Continuing Education Requirement for Recognizing and Reporting Child Abuse
The SBOD discussed PDA's comments on the proposed child abuse regulations for new statutes
that took effect in 2014.
Ms. Montgomery, Regulatory Counsel, reported that the PA General Assembly passed a new
amendment (HB 1276) to the Child Protective Services Act, providing further clarification on
who is required to obtain clearances and background checks. She suggested that PDA and other
stakeholders contact the Department of Human Services for any further clarification that is
needed to determine whether dentists and their staff need to obtain clearances and background
checks if they directly care for children, regardless of the practice setting.
Ms. Montgomery addressed PDA's concern about the requirement that dentists report a
suspected fabrication of a medical condition. She stated that this language is part of the statute
and must be included in the regulations of all licensing boards.
Ms. Montgomery recommended to the SBOD that it accept the following PDA
recommendations:
o
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Under Section 33.256 (a), amending the provision as follows: “Except as provided in
subsection (c), individuals applying to the Board for an initial license or certificate shall
submit proof of completion of 3 hours of training in child abuse recognition and
reporting requirements which has been approved by the Department of Human
Services.”
Under Section 33.256(b), amending the provision as follows: “Except as provided in
subsection (c), licensees and certificate holders seeking renewal of a license or certificate
issued by the Board shall complete, as condition of biennial renewal of the license or
certificate, 2 hours of approved continuing education in child abuse recognition and
reporting, as a portion of the total continuing education required for biennial license
renewal…”
The SBOD voted in approval of the draft regulations, as amended to include PDA's above
suggestions. They will be published as proposed rulemaking in the Pennsylvania Bulletin,
initiating the formal regulatory process.
Regulations for anesthesia permit holders
Ms. Montgomery reported that the SBOD's Anesthesia Committee agreed with the suggestion
made by PSOMS' Anesthesia Review Committee that the regulations require dentists to obtain a
restricted permit level I in order to administer oral sedatives. There is a particular concern about
dentists who "stack" medications. The draft regulations now make explicitly clear that dentists
need a permit to do so.
Ms. Montgomery addressed PSOMS' concern that dentists may still have an active permit even
when they have failed to have the clinical evaluation and office inspection that is required every
six years. Because these inspections take place at different times throughout the year, the
Anesthesia Review Committee's inspectors have encountered situations in which a permit
holder failed to schedule the inspection and evaluation, but his/her permit is still active until the
next licensure renewal period. Ms. Montgomery stated that it is impossible to circumvent the
Dental Practice Act and regulations as they now read, and that these dentists must be
guaranteed their right to due process. The SBOD cannot pull their permit; however, any dentist
who is noncompliant with the evaluation and inspection requirement would be subject to
disciplinary action.
The SBOD's Anesthesia Committee spent a considerable amount of time addressing PSOMS'
concerns about certified registered nurse anesthetists (CRNAs) administering anesthesia in
dental offices. Because CRNAs are not under the SBOD's jurisdiction, Ms. Montgomery had
added a requirement referencing regulations from the State Board of Medicine. However, the
Committee was concerned about allowing CRNAs to be supervised remotely by a physician and
the confusion that may ensure as to whether the physician or dentist is ultimately responsible.
The Committee wants to make clear that the individual held responsible is on the premise the
entire time anesthesia is administered and the patient is treated. Physicians must be on site
when supervising the CRNAs. The board instructed Ms. Montgomery to eliminate Section
33.340(4.1) on page 14 of the draft regulations.
The SBOD approved the draft regulations as amended. They will be published as proposed
rulemaking in the Pennsylvania Bulletin, initiating the formal regulatory process.
Prosecutorial Division Presentation
The SBOD asked representatives from the Prosecutorial Division about who handles the
complaints against dentists who allegedly have not provided treatment up to the standard of
care. The state's investigators review these cases and conduct interviews and site inspections.
Oftentimes they consult with dental experts during the course of the investigation. The state will
notify the complainant via letter when a case is closed and prosecute cases in which the dental
experts found the dentist provided substandard care.
Several SBOD members expressed their belief that dental experts should be used from the very
beginning, working with the investigators to determine which cases warrant investigation. The
SBOD fears that investigators without any clinical expertise are choosing not to investigate some
complaints that warrant further investigation. Several members asked whether a SBOD member
could be part of the initial review process. After the representatives explained that Pennsylvania
has very restrictive laws that would prohibit such, the SBOD suggested that the state use former
SBOD members to work with investigators from the outset. The presentation ended with the
SBOD expressing that it would feel more comfortable if someone with dental expertise is
involved with reviewing complaints when they are first submitted. The representatives
acknowledged this concern but there was no resolution from the discussion.
Committee Reports
Expanded Function Dental Assistant Committee: No report
Licensure Committee: No report
Newsletter: No report
Practice Ownership Committee: No report
Probable Cause Screening Committee: The committee reviewed three cases.
Legislative & Regulatory Review Committee: No report
Anesthesia Review Committee: No report
2015 Meeting Dates
September 11
October 23
December 11