Meeting of the Dental Board of California

August 19-20, 2021

The Dental Board of California met by virtual platform August 19-20, 2021. The following report summarizes actions and issues coming before the Board pertinent to pediatric oral health and practice delivery.

INFECTION CONTROL EDUCATIONAL REQUIREMENTS FOR UNLICENSED DENTAL ASSISTANTS
Current law requires unlicensed dental assistants in California to complete a Board-approved course in infection control no later than 120 days after employment. In April of this year, the Dental Board’s Dental Assistant Council recommended statute be amended to require the eight-hour course in infection control be successful completed prior to performing any basic supportive dental procedures involving potential exposure to blood, saliva, or other potentially infectious materials. The intent of the proposal would be to increase patient protections in a post-COVID-19 world. The Board agreed and voted to seek legislation that would place such change in the Dental Practice Act.

Comment: The proposal was supported by a broad coalition of dental assisting organizations and vocational training interests. The California Dental Association opposed on the basis that no demonstrated risk to the public exists in the current arrangement, either pre or post COVID. The purpose of infection control education for unlicensed dental assistants is to provide the context for understanding the office procedures and protocols under which they work. The proposed amendment would negatively impact dental workforce recruitment, staffing, and access to care with no demonstrable enhancement of public safety.

ANESTHESIA AND SEDATION PERMITING
Legislation (SB 501 Glazer) signed by the Governor in 2018 and scheduled to become effective January 1, 2022, requires significant change to permitting of General Anesthesia, Conscious Sedation, and Oral Conscious Sedation for Minors in the dental setting. These changes include the introduction of a pediatric endorsement, additional patient monitoring requirements when administering general anesthesia or sedation to a minor dental patient, and the creation a new Pediatric Minimal Sedation (PMS) permit (which replaces the current pediatric Oral Conscious Sedation permit). The PMS permit will be required to administer or order the administration of minimal sedation to a patient under 13 years of age. The Dental Board is required to adopt regulation to implement these changes.

1. The current General Anesthesia Permit will be replaced by a Deep Sedation/General Anesthesia Permit with changes in initial application and renewal requirements, development of standards for PALS equivalency training in pediatric dental anesthesia related emergencies, and new monitoring standards for patients under the age of seven years.
2. The current Conscious Sedation Permit will be replaced by a Moderate Sedation Permit with similar changes to application, renewal, PALS equivalency training courses, and monitoring of patients below seven years of age.
3. Then current Oral Conscious Sedation Permit for Minors will no longer be issued. It will be replaced by a Pediatric Minimal Sedation Permit with specific monitoring requirements for patients under 13 years of age.
4. The current Oral Conscious Sedation Permit for Adults will remain unchanged and there will be revision to the Medical General Anesthesia Permit required of the physician providing deep sedation or general anesthesia in the dental office.

Comment: The Dental Board in May approved regulatory language to implement the legislation and directed initiation of the regulatory approval mechanism. This is normally a 12–18 month process. It is unlikely the Dental Board will be able to complete the rule-making process in time to meet the January 1, 2022, enactment deadline. In that case, legislation will be necessary to extend the deadline.