Skip Navigation

Smile Michigan Pro

PART 6. General Anesthesia

Michigan Department of Community Health Director's Office

Dentistry Rules - General Rules

(By authority conferred on the director of the department of community health by sections 16145(3) and 16601 of 1978 PA 368, MCL 333.16145(3) and 333.16601 et seq. and Executive Reorganization Order Nos. 1996-1, 1996-2 and 2003-1, MCL 330.3101, 445.2001 and 445.2011)

PART 6. General Anesthesia, Intravenous Conscious Sedation & Enteral Sedation

R 338.11601 General anesthesia; conditions; violation.
Rule 1. (1) A dentist shall not administer general anesthesia to a dental patient or delegate and supervise the performance of any act, task, or function involved in the administration of general anesthesia to a dental patient, unless all of the following conditions are satisfied:

(a) The dentist has completed a minimum of 1 year of advanced training in general anesthesia and pain control in a program which meets the standards adopted in R 338.11603(l). This subdivision takes effect 1 year after the effective date of this amendatory rule.

(b) The dentist and the delegatee, if any, maintain current certification in basic or advanced cardiac life support from an agency or organization that grants such certification pursuant to standards substantially equivalent to the standards adopted in R 338.11603(3).

(c) The facility in which the anesthesia is administered meets the equipment standards adopted in R 338.11603(4).

(d) The dentist shall be physically present with the patient who is given any general anesthesia until he or she regains consciousness and the dentist shall remain on the premises until such patient is capable of being discharged.

(2) A dentist who does not meet the requirements of subrule (1) of this rule shall not offer general anesthesia services for dental patients unless all of the following conditions are met:

(a) General anesthesia services are directly provided through association with, and by, either of the following individuals:

(i) A physician who is licensed under the provisions of part 170 or 175 of the act and who is a member in good standing on the anesthesiology staff of a hospital accredited by the joint commission on accreditation of hospitals.

(ii) A dentist who meets the requirements of subrule (1)(a) and (b) of this rule.

(b) A person who administers anesthesia, as authorized by the provisions of subdivision (a) of this subrule, shall be physically present with the patient who is given any general anesthesia until he or she regains consciousness and the dentist shall remain on the actual premises where the general anesthesia is administered until the patient anesthetized is capable of being discharged.

(c) The provisions of subrule (1)(b) and (c) of this rule shall be complied with.

(3) A dentist is deemed to have violated the provisions of section 16221(l)(g) of the act if he or she administers general anesthesia to a dental patient or delegates and supervises the performance of any act, task, or function involved in the administration of general anesthesia to a dental patient or offers general anesthesia services for dental patients without being in compliance with the provisions of subrules (1) and (2) of this rule.

History: 1990 MR 7, Eff. July 31, 1990.

R 338.11602 Intravenous conscious sedation; conditions; violations.
Rule 2. (1) A dentist shall not administer intravenous conscious sedation to a dental patient or delegate and supervise the performance of any act or function involved in the administration of intravenous conscious sedation to a dental patient unless 1 of the following conditions is satisfied:

(a) The dentist complies with the provisions of R 338.11601(1) or (2).

(b) The dentist complies with both of the following provisions:

(i) The dentist has completed a minimum of 60 hours of training in intravenous conscious sedation and related academic subjects, including a minimum of 40 hours of supervised clinical instruction in which the individual has sedated not less than 20 cases in a course that is in compliance with the standards adopted in R 338.11603(2).

(ii) The dentist and the delegatee, if any, maintains current certification in basic or advanced cardiac life support from an agency or organization that grants such certification pursuant to standards substantially equivalent to the standards adopted in R 338.11603(3).

(c) The facility in which the anesthesia is administered is in compliance with the equipment standards adopted in R 338.11603(4).

(2) A dentist is deemed to have violated the provisions of section

16221)1)(g) of the act if he or she administers intravenous conscious sedation to a dental patient or delegates and supervises the performance of any act, task, or function involved in the administration of intravenous conscious sedation to a dental patient without being in compliance with the provisions of subrule (1) of this rule.

History: 1990 MR 7, Eff. July 31, 1990; 1997 MR 1, Eff. February 15, 1997.

R 338.11603 Adoption of standards; effect of certification of programs.
Rule 3. (1) The board adopts the standards for advanced training in anesthesia and pain control set forth by the commission on dental education of the American dental association in part 2 of the publication entitled "Guidelines for Teaching the Comprehensive Control of Anxiety and Pain in Dentistry," October 2003 edition. Part 2 of the guidelines may be obtained at no cost from the Commission on Dental Education, American Dental Association, 211 E. Chicago Avenue, Chicago, IL 60611, or on the association's website at http://www.ada.org/prof/resources. A copy of the standards is available for inspection and distribution at cost from the Michigan Board of Dentistry, Department of Community Health, 611 West Ottawa, P.O. Box 30670, Lansing, MI 48909. Certification of programs by the council on dental education as meeting the standards adopted constitutes a prima facie showing that the program is in compliance with the standards.

(2) The board adopts the standards for training in intravenous conscious sedation and related subjects set forth by the council on dental education of the American dental association in part 1 of the publication entitled "Guidelines for Teaching the Comprehensive Control of Anxiety and Pain in Dentistry," October 2003 edition. Part 1 of the guidelines may be obtained at no cost from the Commission on Dental Education, American Dental Association, 211 E. Chicago Avenue, Chicago, IL 60611, or on the association's website at http://www.ada.org/prof/resources. A copy of the standards is available for inspection and distribution at cost from the Michigan Board of Dentistry, Department of Community Health, 611 West Ottawa, P.O. Box 30670, Lansing, MI 48909. Certification of programs by the council on dental education as meeting the standards adopted constitutes a prima facie showing that the program is in compliance with the standards.

(3) The board adopts the standards for credentialing in basic and advanced life support set forth by the American heart association in the guidelines for cardiopulmonary resuscitation and emergency cardiac care for professional providers and published in "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (70-2041). A copy of the guidelines for cardiopulmonary resuscitation and emergency cardiac care may be obtained from the American Heart Association, 7272 Greenville Avenue, Dallas, TX 75231 or at http://www.americanheart.org, at a cost of $20.00 as of the adoption of these rules. A copy of this document is available for inspection and distribution at cost from the Michigan Board of Dentistry, Department of Community Health, 611 West Ottawa, P.O. Box 30670, Lansing, MI 48909.

(4) The board adopts the standards regarding the equipment within a facility set forth by the American association of oral and maxillofacial surgeons in the publication entitled "Office Anesthesia Evaluation Manual," sixth edition. A copy of this manual may be obtained from the American Association of Oral and Maxillofacial Surgeons, 9700 West Bryn Mawr Avenue, Rosemont, IL 60018, or at the association's website at http://www.aaoms.org at a cost of $95 for members and professional/allied staff, $285 for nonmembers, and $190 for institutions as of the adoption of these rules. A copy of this document is available for inspection and distribution at cost from the Michigan Board of Dentistry, Department of Community Health, 611 West Ottawa, P.O. Box 30670, Lansing, MI 48909.

History: 1990 MR 7, Eff. July 31, 1990; 1886 MR 1, Eff: February 15, 1997;

2006 MR 11, Eff. June 9, 2006.

R 338.11604 "Morbidity" and "Mortality" defined; reporting requirements.
Rule 4. (1) As used in this rule:

(a) "Morbidity" means an incident that results in mental or physical impairment which is related to or results from the administration of general anesthesia or intravenous conscious sedation by a dentist, under the delegation and supervision of a dentist, or in a dental facility.

(b) "Mortality" means an incident that results in death related to the administration of general anesthesia or intravenous conscious sedation by a dentist, under the delegation and supervision of a dentist, or in a dental facility.

(2) A dentist shall file a morbidity report with the board within 30 days after the occurrence of an incident.

(3) A dentist shall file a mortality report with the board within 5 days after the occurrence of an incident.

(4) A dentist who fails to file a report as required by this rule is deemed to have violated the provision of section 16221(l)(g) of the act.

History: 1990 MR 7, Eff. July 31, 1990.

R 338.11605 Enteral sedation; requirements for approval of course and instructor.
Rule 11605. (1) A course in enteral sedation shall be approved by the board of dentistry and shall, at a minimum, be consistent with the enteral sedation course as outlined in the American dental association's educational guidelines "Part Three: Teaching the Comprehensive Control of Pain and Anxiety in a Continuing Education Program," October 2003, whose guidelines are adopted by the board. Such a course must provide training in patient assessment, recognition of emergencies and airway management, including the ability to manage an unconscious airway. Part 3 of the guidelines may be obtained at no cost from the American Dental Association, 211 E. Chicago Avenue, Chicago, IL 60611, or on the association's website at http://www.ada.org. A copy of the guidelines is available for inspection and distribution at cost from the Michigan Board of Dentistry, Department of Community Health, 611 West Ottawa, P.O. Box 30670, Lansing, MI 48909.

(2) An instructor of a course in enteral sedation shall be approved by the board of dentistry and shall have at least 3 years experience which includes his or her formal postdoctoral training in anxiety and pain control.

(3) An instructor of an approved enteral sedation course shall certify the competency of a participant upon a participant's satisfactorily completing training in each conscious sedation technique, including instruction, clinical experience, and airway management.

History: 2006 MR 11, Eff. June 9, 2006.

Copyright © 2014 Michigan Dental Association | Privacy Policy
Website design and development by Web Ascender