20:43:09:06. Nitrous oxide sedation and analgesia permit requirements and authorization -- Dental hygienists and registered dental assistants. The State Board of Dentistry may issue a permit to a dental hygienist or a registered dental assistant to administer nitrous oxide sedation and analgesia to dental patients on an outpatient basis under the supervision of a dentist if the dental hygienist or registered dental assistant:
(1) Is certified in administering basic life support by the American Heart Association for the Healthcare Provider, the American Red Cross for the Professional Rescuer, or an equivalent program approved by the State Board of Dentistry; and
(2) Has successfully completed a State Board of Dentistry-approved educational course that substantially meets the objectives and content as described in Part 4 of the Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students and either:
(a) Completed the course within thirteen months prior to application for a permit; or
(b) Completed the course more than thirteen months prior to application for a permit, has legally administered nitrous oxide sedation and analgesia for a period of time during the three years preceding application, and provides written documentation from a dentist who has employed or supervised the applicant, attesting to the current clinical proficiency of the applicant to administer nitrous oxide sedation and analgesia.
A dental hygienist or registered dental assistant who administers nitrous oxide sedation and analgesia shall use equipment with fail-safe features, a thirty-percent-minimum oxygen flow, and a scavenger system.
A dental hygienist or registered dental assistant with a permit to administer nitrous oxide sedation and analgesia may administer nitrous oxide sedation and analgesia to dental patients under the dentist’s indirect supervision, as that term is defined in SDCL 36-6A-1.
A dental hygienist with a permit to administer nitrous oxide sedation and analgesia may administer nitrous oxide sedation and analgesia to dental patients eighteen years and older under the dentist’s general supervision, as that term is defined in SDCL 36-6A-1, if the supervising dentist has authorized the administration and the authorization is included in the patient's record. If there has been a relevant change in the patient's medical history since the authorization, the dental hygienist must consult with the dentist before administering nitrous oxide sedation and analgesia. The dentist shall ensure a written emergency response protocol is in place for patients receiving nitrous oxide sedation and analgesia by the dental hygienist under general supervision.
Source: 19 SDR 32, effective September 6, 1992; 32 SDR 188, effective May 15, 2006; 37 SDR 131, effective January 6, 2011; 42 SDR 19, effective August 17, 2015; 42 SDR 83, effective December 3, 2015; 48 SDR 62, effective December 13, 2021; 50 SDR 12, effective August 8, 2023.
General Authority: SDCL 36-6A-14(10)(20).
Law Implemented: SDCL 36-6A-14(1)(3)(7)(10)(13)(14)(22), 36-6A-40.
Reference: "Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students," 2016 Edition, American Dental Association. Copies may be obtained from the American Dental Association at www.ada.org free of charge.
20:43:09:06.01. Local anesthesia permit requirements and authorization -- Dental hygienists. The State Board of Dentistry may issue a permit to a dental hygienist to administer local anesthesia to dental patients on an outpatient basis under the supervision of a dentist if the dental hygienist has met the following requirements:
(1) Is certified in administering basic life support by the American Heart Association for the Healthcare Provider, the American Red Cross for the Professional Rescuer, or an equivalent program approved by the State Board of Dentistry; and
(2) Has successfully completed a State Board of Dentistry-approved educational course on local anesthesia from an accredited dental or dental hygiene school and either:
(a) Completed the course within thirteen months prior to application for a permit; or
(b) Completed the course more than thirteen months prior to application for a permit, has legally administered local anesthesia for a period of time during the three years preceding application, and provides written documentation from a dentist that has employed or supervised the applicant, attesting to the current clinical proficiency of the applicant to administer local anesthesia.
A dental hygienist with a permit to administer local anesthesia may administer local anesthesia to dental patients under the dentist’s indirect supervision, as that term is defined in SDCL 36-6A-1.
A dental hygienist with a permit to administer local anesthesia may administer local anesthesia to dental patients eighteen years and older under the dentist’s general supervision, as that term is defined in SDCL 36-6A-1, if the supervising dentist has authorized the administration and the authorization is included in the patient's record. If there has been a relevant change in the patient's medical history since the authorization, the dental hygienist must consult with the dentist before administering local anesthesia. The dentist shall ensure a written emergency response protocol is in place for patients receiving local anesthesia by the dental hygienist under general supervision.
Source: 37 SDR 131, effective January 6, 2011; 42 SDR 83, effective December 3, 2015; 50 SDR 12, effective August 8, 2023.
General Authority: SDCL 36-6A-14(10)(20).
Law Implemented: SDCL 36-6A-14(1)(3)(7)(10)(13)(14)(22), 36-6A-40.
20:43:09:06.02. Minimal sedation. If a patient is 12 years or older, a dentist may administer an oral drug to achieve a state of minimal sedation without a permit. A dentist administering minimal sedation must have appropriate access to oxygen and suction and emergency drugs and must meet the standards of the Guidelines for the Use of Sedation and General Anesthesia by Dentists. If a patient is 12 years or older, a dentist may administer to the patient or prescribe for patient self-administration up to the maximum recommended dose of a single enteral drug per visit, to achieve a state of minimal sedation without a general anesthesia and deep sedation permit or moderate sedation permit.
Source: 37 SDR 131, effective January 6, 2011; 42 SDR 83, effective December 3, 2015; 48 SDR 62, effective December 13, 2021.
General Authority: SDCL 36-6A-14(20).
Law Implemented: SDCL 36-6A-14(1)(3)(13)(14)(22).
Reference: "Guidelines for the Use of Sedation and General Anesthesia by Dentists," 2016 Edition, American Dental Association. Copies may be obtained from the American Dental Association at www.ada.org free of charge.
