NYS Dentistry - Part 61, Commissioner's Regulations

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Regulations of the Commissioner

Part 61, Dentistry, Dental Hygiene, and Certified Dental Assisting

§61.1 Professional study of dentistry. | §61.2 Licensing examination. | §61.3 Limited permits in dentistry. | §61.4 License as a dentist by endorsement. | §61.5 Dental laboratory prescriptions. | §61.6 Professional study of dental hygiene. | §61.7 Licensing examination for dental hygienist. | §61.8 License as a dental hygienist by endorsement. | §61.9 Practice of dental hygiene. | §61.10 Dental anesthesia certification. | §61.11 Professional study of certified dental assisting. | §61.12 Licensing examination for certified dental assistant. | §61.13 Practice of certified dental assisting. | §61.14 Limited permits in certified dental assisting. | §61.15 Continuing education for dentists. | §61.16 Continuing education for dental hygienists. | §61.17 Dental hygiene restricted local infiltration anesthesia/nitrous oxide analgesia certificate. | §61.18 Residency program requirement for dental licensure. | §61.19 Dental requirement for cardiopulmonary resuscitation certification.

§61.1 Professional study of dentistry.

To meet the professional education requirement, the applicant shall present evidence of the completion of not less than 60 semester hours of pre-professional education including courses in general chemistry, organic chemistry, biology or zoology and physics and a program of professional education consisting of either:
1. the completion of a program of dental education of not less than four academic years, or the equivalent thereof, registered by the department or accredited by an accrediting organization acceptable to the department; or
2. the completion of not less than four academic years of dental education satisfactory to the department, culminating in a degree, diploma or certificate in dentistry recognized by the appropriate civil authorities of the country in which the school is located as acceptable for entry into practice in the country in which the school is located.
Where a program of dental education is completed in an unregistered and unaccredited foreign dental school as provided in paragraph (a)(2) of this section, the applicant shall complete not less than two academic years of study satisfactory to the department in a registered or accredited dental school program including such subjects as may be necessary for certification by such registered or accredited school that the candidate has achieved the level of knowledge and clinical proficiency expected of a graduate of the school.
Courses failed in a school of dentistry, for which credit has been granted toward meeting the requirements of another school of dentistry may not be counted toward meeting the requirements of this Part.
A program of dental education shall be considered completed upon certification of completion by the school in which such program was taken and proof that the applicant has been awarded the appropriate dental degree, diploma or certificate.

§61.2 Licensing examination.

Individuals, who on or before December 31, 2006 have completed all the education requirements for licensure and by that date have submitted an application for licensure and the required application fee, shall meet the examination requirements of this subdivision. Individuals who do not meet these conditions shall meet the examination requirements of subdivision (b) of this section.
1. Content. The examination shall consist of three parts:
  1. Parts I and II. Designed to sample knowledge from all areas related to dentistry.
  2. Part III. An examination in clinical dentistry, the scope and content of which shall be determined by the State Board for Dentistry.
2. The department may accept grades acceptable to the State Board for Dentistry on an examination of the National Board Dental Examinations as meeting the requirements of Parts I and II of the licensing examination, and satisfactory performance on the clinical examination administered by the Northeast Regional Board of Dental Examiners or another acceptable clinical testing agency for Part III of the licensing examination.
3. To be admitted to Part III of the dental licensing examination a candidate who possesses acceptable credentials pursuant to section 61.1(a)(2) of this Part shall provide evidence satisfactory to the department of having passed Parts I and II of the dental licensing examination.
4. Special examination conditions.
  1. An applicant who has completed not less than two academic years in a program of dental education registered by the department, or accredited by an accrediting organization acceptable to the department may be admitted to Part I of the examination. Such applicant shall meet all requirements for admission to the licensing examination, except for the completion of professional education.
  2. An applicant attending a program of dental education registered by the department, or accredited by an accrediting organization acceptable to the department, may be admitted to Parts II and III during the last year of study.
5. Candidates seeking admission to Part III of the dental licensing examination shall be required to show proof of professional liability insurance coverage prior to commencement of the examination.
6. Passing score. The passing score in each subject of each part shall be 75.0, as determined by the State Board for Dentistry.
7. A candidate who fails to pass any subject of Part III shall retain credit for subjects of that Part passed and shall be reexamined in all remaining subjects at each subsequent examination, except that a candidate who fails to pass all subjects during three administrations of Part III shall be required to be examined in the entire Part at a subsequent administration. Before admission to the third administration of Part III may be granted, such candidate shall present evidence satisfactory to the department of the completion of not less than 40 clock hours of instruction acceptable to the State Board for Dentistry in each subject failed twice. Such instruction shall be completed in a dental school registered by the department or accredited by an accrediting organization acceptable to the department and shall be completed subsequent to the second failure.
8. It shall be the responsibility of each candidate to obtain patients for applicable subjects of Part III.
9. In accordance with section 6604(4) of the Education Law, individuals, who on or before December 31, 2006 have completed all the education requirements for licensure and by that date have submitted an application for licensure and the required application fee, may substitute successful completion of a residency program that meets the requirements of section 61.18 of this Title in lieu of successful completion of Part III, the examination in clinical dentistry.
Individuals who do not meet the conditions prescribed in the opening paragraph of subdivision (a) of this section shall meet the examination requirements of this subdivision.
1. Content. The examination shall consist of two parts designed to sample the knowledge from all areas related to dentistry.
2. The department may accept grades acceptable to the State Board for Dentistry on an examination of the National Board Dental Examinations as meeting the requirements of Parts I and II of the licensing examination.
3. Special examination conditions.
  1. An applicant who has completed not less than two academic years in a program of dental education registered by the department, or accredited by an accrediting organization acceptable to the department may be admitted to Part I of the examination. Such applicant shall meet all requirements for admission to the licensing examination, except for the completion of professional education.
  2. An applicant attending a program of dental education registered by the department, or accredited by an accrediting organization acceptable to the department, may be admitted to Part II during the last year of study.
4. Passing score. The passing score in each subject of each part shall be 75.0, as determined by the State Board for Dentistry.

§61.3 Limited permits in dentistry.

Limited permits may be issued in accordance with Education Law, section 6605(1) and (2) to graduates from:
1. registered programs or those accredited by an accrediting organization acceptable to the department; or
2. dental education programs not registered by the department or accredited by an accrediting organization acceptable to the department but who have met all requirements of section 61.1(a)(2) and (b) of this Part.
A hospital or dental facility approved by an appropriate agency as used in subdivision (1) of section 6605 of the Education Law shall mean an institution accredited for teaching purposes by the Commission on Dental Accreditation of the American Dental Association.
Direction or supervision of a licensed dentist as used in section 6605(1) of the Education Law shall mean that a supervising dentist shall be present on the premises at all times when professional services are being rendered by the holder of a limited permit and shall exercise that degree of supervision appropriate to the circumstances.
An application for a limited permit in dentistry shall be accompanied by an affidavit from the dentist who will supervise the professional services to be rendered under the limited permit, and the application and affidavit shall be in a form prescribed by the department.

§61.4 License as a dentist by endorsement.

For endorsement of a dental license issued by another jurisdiction of the United States the applicant shall submit satisfactory evidence of:
1. having met all requirements of section 59.6 of this Subchapter; and
2. lawful and reputable practice in dentistry of not less than eight months during the two years next preceding the filing of the application.

§61.5 Dental laboratory prescriptions.

A dental prescription for furnishing, constructing, reproducing or repairing prosthetic dentures or bridges to be used and worn as substitutes for natural teeth, or orthodontic or other appliance used for the correction of malocclusion or deformities of other structures, shall comply with the provision of subdivision (1) of section 6611 of the Education Law, and shall contain the following information:

the name of the laboratory to which the prescription is addressed;
the date on which it is written;
a clear description of the work to be done, with appropriate diagrams if necessary;
a clear specification of the character of materials to be used; and
the signature and license number of the dentist.

§61.6 Professional study of dental hygiene.

To meet the professional education requirement, the applicant shall present evidence of satisfactory completion of a program of education for dental hygienists registered by the department or accredited by an accrediting organization acceptable to the department.

§61.7 Licensing examination for dental hygienist.

Content. The examination shall consist of two parts:
1. Part I. Designed to sample knowledge from all areas related to dental hygiene.
2. Part II. An examination in dental hygiene practice, including both comprehensive and clinical components the scope and content of which shall be determined by the State Board for Dentistry.
The department may accept grades acceptable to the State Board for Dentistry on an examination of the National Board Dental Hygiene Examinations as meeting the requirements of Part I of the licensing examination, and satisfactory performance on the clinical examination administered by the Northeast Regional Board of Dental Examiners or another acceptable clinical testing agency for Part II of the licensing examination.
Candidates seeking admission to Part II of the dental hygiene licensing examination shall be required to show proof of professional liability insurance coverage prior to the commencement of the examination.
Passing score. The passing score in each subject of each part of the examination shall be 75.0, as determined by the State Board for Dentistry.
A candidate who fails any component of Part II shall retain credit for components of that part passed for two subsequent examinations. Before admission to the third administration of Part II may be granted, such candidate shall present evidence satisfactory to the department of completion of instruction subsequent to the second failure, in a school of dental hygiene registered by the department or accredited by an accrediting organization acceptable to the department, in accordance with the following provisions:
1. completion of 20 clock hours of instruction in each subject failed in the Dental Hygiene Comprehensive component of Part II; and
2. completion of 40 clock hours of clinical instruction for failure in the clinical component of Part II.
Special examination conditions.
1. An applicant who has completed not less than one academic year in a program of dental hygiene education registered by the department or accredited by an accrediting organization acceptable to the department may be admitted to Part I of the examination. Such applicant shall meet all requirements for admission to the licensing examination, except for the completion of professional education.
2. An applicant attending a program of dental hygiene education registered by the department, or accredited by an accrediting organization acceptable to the department, may be admitted to Part II during the last year of study and prior to graduation.

§61.8 License as a dental hygienist by endorsement.

For endorsement of a license as a dental hygienist issued by another jurisdiction of the United States, the applicant shall submit satisfactory evidence of:

having met all requirements of section 59.6 of this Subchapter; and
lawful and reputable practice as a dental hygienist of not less than eight months during the two years next preceding the filing of the application.

§61.9 Practice of dental hygiene.

The practice of dental hygiene, in accordance with section 6606 of the Education Law, shall be performed under the supervision of a licensed dentist.

The degrees of supervision by the dentist as defined are follows:
1. General supervision shall mean that a supervising dentist available for consultation, diagnosis and evaluation, has authorized the dental hygienist to perform the services, and exercises that degree of supervision appropriate to the circumstances.
2. Personal supervision shall mean that the dentist in the dental office or facility, personally diagnoses the condition to be treated, personally authorizes the procedure and, before dismissal of the patient, personally examines the condition after treatment is completed.
The following services may be performed under the general supervision of a licensed dentist:
1. removing calcareous deposits, accretions and stains, including scaling and planing of exposed root surfaces indicated for a complete prophylaxis;
2. applying topical agents indicated for a complete dental prophylaxis;
3. removing excess cement from surfaces of the teeth;
4. providing patient education;
5. placing and exposing X-ray films;
6. performing topical anticariogenic agent applications, including but not limited to topical fluoride applications, and performing topical anesthetic applications;
7. polishing teeth, including existing restorations;
8. taking medical history including the measuring and recording of vital signs;
9. charting caries and periodontal conditions as an aid to diagnosis by the dentist;
10. applying pit and fissure sealants; and
11. applying desensitizing agents to the teeth.
The following services may be performed only under the personal supervision of a licensed dentist:
1. placing or removing rubber dam;
2. removing sutures;
3. taking impressions for study casts. Study casts shall mean only such casts as will be used for purposes of diagnosis and treatment planning by the dentist and for the purposes of patient education;
4. placing or removing matrix bands;
5. applying a topical medication not related to a complete dental prophylaxis;
6. placing and removing periodontal dressings;
7. selecting and prefitting provisional crowns;
8. selecting and prefitting orthodontic bands;
9. removing orthodontic arch wires and ligature ties;
10. taking impressions for space maintainers, orthodontic appliances, and occlusal guards;
11. placing and removing temporary separating devices; and
12. placing orthodontic ligatures.
The dental supportive services that a licensed dentist authorizes a certified dental assistant to perform under paragraph (18) of subdivision (b) of section 61.13 of this Part, designated in such paragraph as other dental supportive services, may be performed by a licensed dental hygienist under the personal supervision of a licensed dentist who has delegated such function to the licensed dental hygienist, unless general supervision for such service is otherwise expressly prescribed in this section.
In accordance with section 29.1(b)(9) and (10) of this Title, a licensed dental hygienist is not permitted to provide dental services or dental supportive services that the licensed dental hygienist knows or has reason to know that he or she is not competent to perform, and a licensed dentist is not permitted to delegate to a licensed dental hygienist dental services or dental supportive services that the licensed dentist knows or has reason to know that the licensed dental hygienist is not qualified by training, experience or by licensure to perform.

§61.10 Dental anesthesia certification.

Definitions. For purposes of this section, the following definitions shall apply:
1. Acceptable accrediting body means an accrediting body which is accepted by the department as a reliable authority for the purpose of accrediting educational programs in anesthesia, applying its criteria for granting accreditation in a fair, consistent, and nondiscriminatory manner, and which accredits such programs on a national basis.
2. Conscious sedation means a minimally depressed level of consciousness that retains the patient's ability to independently and continuously maintain an airway and respond appropriately to physical stimulation and verbal command and that is produced by a pharmacologic or non-pharmacologic method or a combination thereof. Patients whose only response is reflex withdrawal from repeated painful stimuli shall not be considered to be in a state of conscious sedation.
3. Deep sedation means an induced state of depressed consciousness accompanied by partial loss of protective reflexes, including the inability to continually maintain an airway independently and/or to respond purposefully to physical stimulation or verbal command, and is produced by a pharmacologic or non-pharmacologic method or a combination thereof.
4. Enteral means a technique of administration in which the agent is absorbed through the gastrointestinal tract or oral mucosa, including but not limited to oral, rectal, and sublingual administration.
5. General anesthesia means an induced state of unconsciousness, accompanied by partial or complete loss of protective reflexes, including the inability to continually maintain an airway independently and respond purposefully to physical stimulation or verbal command, and is produced by a pharmacologic or non-pharmacologic method or a combination thereof.
6. Inhalation means a technique of administration in which a gaseous or volatile agent is introduced into the pulmonary tree and whose primary effect is due to the absorption through the pulmonary bed.
7. Parenteral means a technique of administration in which the drug bypasses the gastrointestinal tract, including but not limited to intramuscular, intravenous, intranasal, submucosal, subcutaneous, and intraocular administration.
Certification requirements.
1. A licensed dentist shall not employ conscious sedation, deep sedation, or general anesthesia in the practice of dentistry, at any location other than a general hospital, unless such dentist possesses a dental anesthesia certificate issued by the department pursuant to this section, except that such certification shall not be required for use of anesthesia as prescribed in subdivision (3) of section 6605-a of the Education Law. For such certification the licensed dentist shall meet the requirements of this section, including the educational and training requirements prescribed in subdivision (c) of this section and the practice requirements prescribed in subdivision (d) of this section. Such certificates shall be issued for a three-year term.
2. Effective January 1, 2001, certificates shall be issued in the titles:
  1. Dental General Anesthesia, which authorizes a licensed dentist to employ conscious sedation (enteral or parenteral route with or without inhalation agents), deep sedation, and general anesthesia; and
  2. Dental Parenteral Conscious Sedation, which authorizes a licensed dentist to employ conscious sedation (enteral or parenteral route with or without inhalation agents); and
  3. Dental Enteral Conscious Sedation, which authorizes a licensed dentist to employ conscious sedation (enteral route only with or without inhalation agents).
3. Certificates to administer general anesthesia and parenteral sedation and to administer parenteral sedation for parenteral conscious sedation only which were issued prior to January 1, 2001 shall continue to be valid until the expiration of their term, at which time the licensed dentist shall be required to apply for a new initial certificate.
4. A licensed dentist who holds a certificate to administer general anesthesia and parenteral sedation may also administer conscious sedation using the enteral or parenteral route with or without inhalation agents, and a licensed dentist who holds a certificate to administer conscious sedation using a parenteral route may also administer conscious sedation using an enteral route with or without inhalation agents.
Educational and training requirements.
1. Initial certification.
  1. Certificate in Dental General Anesthesia. A licensed dentist shall meet the educational and training requirements in this subparagraph for the initial certificate in Dental General Anesthesia, which authorizes the licensed dentist to employ conscious sedation (enteral or parenteral route with or without inhalation agents), deep sedation, and general anesthesia.
    The licensed dentist shall successfully complete:
    1. a course in Advanced Cardiac Life Support (ACLS), or its equivalent as determined by the department, and have current documentation of course completion attesting to this fact; and
    2. either:
      1. for post-doctoral education completed prior to January 1, 2002, at least one year of such education in anesthesia acceptable to the department, which shall include but not be limited to, coursework in anesthesia, anxiety and pain control, establishing and maintaining emergency airway, and use and interpretation of appropriate monitoring; or at least two years of such education in an approved specialty program or residency, which includes acceptable training and experience, including but not limited to, instruction in general anesthesia and parenteral sedation; provided that the candidate has applied to the department for the initial certificate to employ conscious sedation (enteral or parenteral route with or without inhalation agents), deep sedation, and general anesthesia prior to January 1, 2004; or
      2. at least two years of post-doctoral education acceptable to the department and accredited by an acceptable accrediting body, which shall include but not be limited to coursework in anesthesia and anxiety and pain control; and one year devoted exclusively to clinical training in general anesthesia and related subjects such as establishing and maintaining an emergency airway and use and interpretation of appropriate monitoring; or
      3. a graduate level program in oral and maxillofacial surgery acceptable to the department and accredited by an acceptable accrediting body, which shall include but not be limited to instruction in general anesthesia, parenteral sedation, and anxiety and pain control.
  2. Certificate in Dental Parenteral Conscious Sedation. A licensed dentist shall meet the educational and training requirements in this subparagraph for the initial certificate in Dental Parenteral Conscious Sedation, which authorizes the licensed dentist to employ conscious sedation using an enteral or parenteral route, with or without inhalation agents, which certificate shall not authorize the licensed dentist to employ general anesthesia or deep sedation. The licensed dentist shall successfully complete:
    1. a course in Advanced Cardiac Life Support (ACLS), or its equivalent as determined by the department, and have current documentation of course completion attesting to this fact; and
    2. either:
      1. for post-doctoral education completed prior to January 1, 2002, a minimum of 60 clock hours of post-doctoral education acceptable to the department, no fewer than 20 clock hours of which shall consist of the successful use of parenteral conscious sedation on no fewer than 20 patients, the remainder consisting of but not limited to patient evaluation and monitoring, management of emergencies, pharmacology and the control of pain and anxiety; provided that the candidate has applied to the department for the initial certificate to employ conscious sedation using a parenteral or enteral route, with or without inhalation agents, prior to January 1, 2004; or
      2. post-doctoral education acceptable to the department and accredited by an acceptable accrediting body, which shall include at least 60 clock hours of coursework, including but not limited to coursework in patient evaluation and monitoring, management of emergencies, management of the airway, pharmacology, and the control of pain and anxiety; and in addition to the 60 clock hours of coursework, a clinical experience demonstrating the successful use of parenteral conscious sedation on no fewer than 20 patients.
  3. Certificate in Dental Enteral Conscious Sedation. A licensed dentist shall meet the educational and training requirements of clause (a) of this subparagraph, unless such requirements are waived pursuant to clause (b) of this subparagraph, for the initial certificate in Dental Enteral Conscious Sedation, which authorizes the licensed dentist to employ conscious sedation using only an enteral route of administration, with or without inhalation agents, which certificate shall not authorize the licensed dentist to employ conscious sedation using a parenteral route or deep sedation or general anesthesia.
    1. The licensed dentist shall successfully complete:
      1. a course in Basic Life Support (BLS), or its equivalent as determined by the department, and have current documentation of course completion attesting to this fact; and
      2. either:
        
        pre-doctoral education or post-doctoral education consisting of a specialty program or residency, which education is accredited by an acceptable accrediting body and which includes coursework in Basic Life Support (BLS) and additional coursework consisting of at least 18 clock hours, which includes but is not limited to, instruction in nitrous oxide use and emergency management. In addition to the coursework in BLS and the 18 clock hours of coursework, the program shall require 20 clinically-oriented experiences in the use of enteral conscious sedation techniques. Clinically-oriented experiences may include group observations of patients undergoing enteral conscious sedation techniques; or
        
        post-doctoral coursework approved by the department, which has equivalent rigor as coursework approved by an acceptable accrediting body as prescribed in item (i) of this subclause, and which includes coursework in Basic Life Support (BLS) and additional coursework consisting of at least 18 clock hours, which includes but is not limited to, instruction in nitrous oxide use and emergency management. In addition to the coursework in BLS and the 18 clock hours of coursework, the program shall require 20 clinically-oriented experiences in the use of enteral conscious sedation techniques. Clinically-oriented experiences may include group observations of patients undergoing enteral conscious sedation techniques.
    2. For licensed dentists who apply to the department prior to January 1, 2002 for the certificate to employ conscious sedation using only an enteral route with or without inhalation agents, the department shall waive the educational and training requirement prescribed in clause (a) of this subparagraph, provided that such licensed dentist has lawfully employed enteral conscious sedation with or without inhalation agents successfully on at least 30 patients during the period beginning January 1, 1997 and ending December 31, 2000, and that the candidate has never had a mortality or morbidity related to the employment of such sedation, which facts the licensed dentist shall be required to adequately document to the department upon request, except that the licensed dentist shall be required to successfully complete a course in Basic Life Support (BLS), or its equivalent as determined by the department, within one year of the effective date of the certificate to employ conscious sedation using only an enteral route with or without inhalation agents, and have current documentation of BLS course completion attesting to this fact.
2. Renewal of certification. A licensed dentist shall meet the educational and training requirements of this paragraph for the renewal of certification.
  1. For the renewal of certificates in Dental General Anesthesia, which authorizes the licensed dentist to employ conscious sedation (enteral or parenteral route with or without inhalation), deep sedation, and general anesthesia; and for the renewal of certificates in Dental Parenteral Conscious Sedation, which authorizes the licensed dentist to employ conscious sedation (enteral or parenteral route with or without inhalation agents), a licensed dentist shall successfully complete a course in Advanced Cardiac Life Support (ACLS), or its equivalent as determined by the department, and have current documentation attesting to this fact.
  2. For the renewal of certificates in Dental Enteral Conscious Sedation, which authorizes the licensed dentist to employ conscious sedation (enteral route only with or without inhalation agents), the licensed dentist shall successfully complete:
    1. a course in Basic Life Support (BLS), or its equivalent as determined by the department, and have current documentation attesting to this fact; and
    2. an additional six clock hours of education in sedation techniques, including but not limited to, coursework in medications and recognition and management of complications and emergencies.
  3. The coursework required to be completed for the renewal of certification may be creditable toward meeting the dentist's continuing education requirement, provided that it meets all requirements of section 61.15 of this Part.
Practice requirements. All licensed dentists who administer conscious sedation or deep sedation or general anesthesia shall meet the practice requirements of this subdivision.
1. A licensed dentist who employs conscious sedation using a parenteral route with or without inhalation agents or deep sedation or general anesthesia shall have current documentation of course completion in Advanced Cardiac Life Support (ACLS), or its equivalent as determined by the department. A licensed dentist who employs conscious sedation using an enteral route with or without inhalation agents, but who does not employ conscious sedation using the parenteral route with or without inhalation agents or deep sedation or general anesthesia, shall have current documentation of course completion in Basic Life Support (BLS), or its equivalent as determined by the department, except that a licensed dentist who has obtained a waiver of the educational and training requirements for the initial certificate to employ enteral conscious sedation with or without inhalation agents, pursuant to clause (b) of subparagraph (iii) of paragraph (1) of subdivision (c) of this section, shall not be required to have current documentation of course completion in Basic Life Support (BLS), or its equivalent as determined by the department, until one year after initial certification.
2. A licensed dentist shall not administer conscious sedation (enteral or parenteral route with or without inhalation agents) or deep sedation or general anesthesia to more than one patient at a time. A licensed dentist, a licensed physician, a registered professional nurse, or a licensed practical nurse shall personally monitor recovery from conscious sedation or deep sedation or general anesthesia.
3. A licensed dentist who uses conscious sedation (enteral or parenteral route with or without inhalation agents) or deep sedation or general anesthesia for a patient shall be responsible for all aspects of the procedure including life support procedures, monitoring, recovery, and recordkeeping. The following parameters shall be monitored: vital signs, including blood pressure, pulse, and oxygen saturation, which oxygen saturation shall be continuously monitored by the use of a pulse oximeter or an equivalent device, except that oxygen saturation shall not be required to be monitored in cases in which conscious sedation using an enteral route, with or without inhalation agents, is employed and the patient's conduct prohibits the monitoring of oxygen saturation. Ventilation shall be evaluated by observation and/or auscultation. A licensed dentist who uses parenteral conscious sedation or deep sedation or general anesthesia shall also continuously monitor the electrical activity of the heart. A device capable of measuring body temperature shall be readily available during the administration of deep sedation or general anesthesia. When agents implicated in precipitating malignant hyperthermia are utilized, continual monitoring of body temperature shall be performed.
4. Every facility at which conscious sedation (enteral or parenteral route with or without inhalation agents) or deep sedation or general anesthesia is employed in the practice of dentistry shall be equipped and staffed in a manner appropriate for the administration and monitoring of anesthetic drugs or agents and for the treatment of emergencies which may arise. Each facility shall be constructed to permit ready access by emergency equipment. A protocol for handling emergencies, including transport to an emergency facility, shall be posted in each treatment and recovery area. A defibrillator shall be immediately accessible at each facility in which conscious sedation using a parenteral route with or without inhalation agents, or deep sedation, or general anesthesia is employed.
5. Beginning on or after January 1, 2002, the requirements of this paragraph shall be applicable.
  1. During the administration of deep sedation or general anesthesia, a minimum of three individuals shall be present in the operatory. Such individuals shall include a licensed dentist or licensed physician qualified to administer the deep sedation or general anesthesia, who shall be in charge of the administration of the anesthesia care; and two additional individuals, who have current documentation that they have successfully completed a course in BLS, or its equivalent as determined by the department.
  2. During the administration of conscious sedation using the enteral or parenteral route with or without inhalation agents, a minimum of two individuals shall be present in the operatory. Such individuals shall include a licensed dentist or licensed physician qualified to administer the conscious sedation, who shall be in charge of the administration of the anesthesia care; and one additional individual, who has current documentation that he or she has successfully completed a course in BLS, or its equivalent as determined by the department.
6. Specific dietary instructions shall be provided to the patient for whom conscious sedation or deep sedation or general anesthesia has been or will be employed, based on the techniques used and the patient's physical state.
7. Appropriate oral or written instructions shall be provided to the patient and/or the patient's guardian, based on the techniques used and the patient's physical state.
8. Recordkeeping. Licensed dentists who hold certification pursuant to this section shall maintain the records prescribed in this paragraph, which shall be available for review by the department.
  1. The licensed dentist shall maintain records on the administration of conscious sedation (enteral or parenteral route with or without inhalation agents), deep sedation, or general anesthesia, in accordance with the requirements of paragraph (3) of subdivision (a) of section 29.2 of this Title, which shall include but not be limited to:
    1. a medical history of the patient and appropriate informed consent for administration of conscious sedation (enteral or parenteral route with or without inhalation agents), deep sedation, or general anesthesia, prior to the performance of any procedure;
    2. time oriented anesthetic records, based on the level of anesthesia administered, that reflect pre-operative, intra-operative, and pre-discharge monitoring of blood pressure, pulse, and oxygen saturation, except that records of oxygen saturation shall not be required when conscious sedation using an enteral route, with or without inhalation agents, is employed and the patient's conduct prohibits the monitoring of oxygen saturation, in which case the record shall document this fact;
    3. drugs and dosage of these drugs used prior, during and post procedure, including inhalation agents and persons present during the administration of the drugs.
  2. The licensed dentist shall maintain current documentation of successful course completion in Basic Life Support (BLS) or Advanced Cardiac Life Support (ACLS), or their equivalent, as required for the anesthesia certificate held, and current documentation of course completion in BLS, or its equivalent, required to be held by individuals present in the operatory during the administration of anesthesia pursuant to the requirements of paragraph (5) of this subdivision, for six years from the date of completion of the coursework. In addition, a licensed dentist who completes six clock hours of sedation techniques for the renewal of a certification to employ conscious sedation using an enteral route only with or without inhalation agents, shall be required to maintain records documenting completion of such course work for six years from the completion of the coursework. The records shall include the number of clock hours completed, the sponsor's name and any identifying number, and the date and location of the program. If any of the coursework is being used by the licensed dentist to meet his or her continuing education requirement, as prescribed in section 61.15 of this Part, such records shall be maintained in accordance with the requirements of subdivision (f) of section 61.15 of this Part.
9. Mortality or morbidity during or related to the administration of conscious sedation or deep sedation or general anesthesia administered pursuant to this section shall be reported by the certificate holder to the department within 30 days of the occurrence.

§61.11 Professional study of certified dental assisting.

As used in this section, acceptable accrediting agency shall mean an organization accepted by the department as a reliable authority for the purpose of accreditation at the postsecondary level, applying its criteria for granting accreditation in a fair, consistent and nondiscriminatory manner, such as an agency recognized for these purposes by the United States Department of Education.
To meet the professional education requirement for licensure as a certified dental assistant in this State, the applicant shall present satisfactory evidence of:
1. graduation from high school, or its equivalent; and
2. completion of a program in certified dental assisting that is either registered by the department pursuant to Part 52 of this Title, or accredited by an acceptable accrediting agency, or determined by the department to be the equivalent of such a registered or accredited program.

§61.12 Licensing examination for certified dental assistant.

Each candidate for licensure as a certified dental assistant shall pass an examination that the department has determined measures the applicant's knowledge of curricular areas attained in a program prescribed in section 52.26 of this Title and other matters of law, ethics, or practice deemed appropriate by the department.
Passing standard. The passing standard for each examination shall be determined by the State Board for Dentistry.

§61.13 Practice of certified dental assisting.

The practice of certified dental assisting shall be that practice defined in section 6608 of the Education Law. In accordance with section 6608 of the Education Law, the practice of certified dental assisting must be supportive services to a licensed dentist in the dentist's performance of dental services and must be performed under the direct personal supervision of a licensed dentist. For purposes of this section, under the direct personal supervision of a licensed dentist shall mean supervision of dental procedures based on instructions given by a licensed dentist in the course of a procedure who remains in the dental office where the supportive services are being performed, personally diagnoses the condition to be treated, personally authorizes the procedures, and before dismissal of the patient, who remains the responsibility of the licensed dentist, evaluates the services performed by the dental assistant. Such practice shall include the dental supportive service prescribed in subdivision (b) of this section and shall exclude the dental supportive services prescribed in subdivision (c) of this section.
The practice of certified dental assisting shall include the following supportive services to a licensed dentist while under the direct personal supervision of the licensed dentist:
1. providing patient education;
2. taking preliminary medical histories and vital signs to be reviewed by the dentist;
3. placing and removing rubber dams;
4. selecting and prefitting provisional crowns;
5. selecting and prefitting orthodontic bands;
6. removing orthodondic arch wires and ligature ties;
7. placing and removing matrix bands;
8. taking impressions for study casts or diagnostic casts;
9. removing periodontal dressings;
10. removal of sutures placed by a licensed dentist;
11. taking impressions for space maintainers, orthodontic appliances, and occlusal guards;
12. removing temporary cement;
13. applying topical anticariogenic agents to the teeth;
14. applying desensitizing agents to the teeth;
15. placing and removing temporary separating devices;
16. placing orthodontic ligatures;
17. taking x-rays in accordance with the requirements of section 3515(4)(c) of the Public Health Law; and
18. other dental supportive services authorized by the licensed dentist while the certified dental assistant is under the direct personal supervision of the licensed dentist, provided that such other dental supportive services are not excluded in subdivision (c) of this section.
Excluded dental supportive services. The practice of certified dental assisting shall not include the following dental supportive services:
1. diagnosing;
2. performing surgical procedures;
3. performing irreversible procedures;
4. performing procedures that would alter the hard or soft tissue of the oral and maxillofacial area;
5. dental supportive services prescribed in section 61.9 of this Part which are services that a dental hygienist may perform, unless such services are expressly permitted as dental supportive services in paragraphs (1) through (17) of subdivision (b) of this section; and
6. such dental supportive services that a certified dental assistant would not reasonably be qualified to perform based upon meeting the requirements for certification as a certified dental assistant in section 6608-b of the Education Law, and/or obtaining additional legally authorized experience in the practice of certified dental assisting.
In accordance with section 29.1(b)(9) and (10) of this Title, a certified dental assistant is not permitted to provide dental supportive services that the certified dental assistant knows or has reason to know that he or she is not competent to perform, and a licensed dentist is not permitted to delegate to a certified dental assistant dental supportive services the licensed dentist knows or has reason to know that the certified dental assistant is not qualified by training, experience or by licensure to perform.

§61.14 Limited permits in certified dental assisting.

As used in this section, direct personal supervision shall mean supervision by a licensed dentist of dental procedures based on instructions given by a licensed dentist in the course of a procedure who remains in the dental office where the supportive services are being performed, personally diagnoses the condition to be treated, personally authorizes the procedures, and before dismissal of the patient, evaluates the services performed by the limited permittee.
In accordance with section 6608-d of the Education Law, permits limited as to eligibility, practice, and duration shall be issued by the department to eligible applicants as follows:
1. A person who meets all requirements for admission to the licensure examination for certified dental assisting shall be eligible for a limited permit as a certified dental assistant.
2. A certified dental assistant permittee shall be authorized to practice only under the direct personal supervision of a licensed dentist.
3. An application for a limited permit in certified dental assisting shall be submitted on a form provided by the department and shall be accompanied by the statutory fee.
4. Limited permits in certified dental assisting shall expire one year from the date granted, except that such permits may be renewed for one additional one-year period.

§61.15 Continuing education for dentists.

As used in this section, acceptable accrediting agency shall mean an organization accepted by the department as a reliable authority for the purpose of accreditation at the postsecondary level, applying its criteria for granting accreditation in a fair, consistent and nondiscriminatory manner, such as an agency recognized for this purpose by the United States Department of Education.
Applicability of requirement.
1. Each licensed dentist, required under Article 130 of the Education Law to register with the department to practice in New York State, shall comply with the mandatory continuing education requirements as prescribed in subdivision (c) of this section, except those licensees exempt from the requirement or who obtain an adjustment to the requirement pursuant to paragraph (2) of this subdivision.
2. Exemptions and adjustments to the requirement.
  1. Exemptions. The following licensees shall be exempt from the continuing education requirements, as prescribed in subdivision (c) of this section:
    1. licensees for the triennial registration period during which they are first licensed to practice dentistry in New York State, exclusive of those first licensed to practice dentistry in New York State pursuant to an endorsement of a license of another jurisdiction; and
    2. licensees who are not engaged in the practice of dentistry, as evidenced by not being registered to practice in New York State, except as otherwise provided in paragraph (c)(2) of this section to meet the education requirements for the resumption of practice after a lapse in practice for a licensee who has not lawfully practiced continuously in another jurisdiction throughout such lapse period.
  2. Adjustments to the requirement. An adjustment to the continuing education requirement, as prescribed in subdivision (c) of this section, shall be made by the department, provided that the licensee documents good cause that prevents compliance, which shall include, but not be limited to, any of the following reasons: poor health certified by a physician; or a specific physical or mental disability certified by an appropriate health care professional; or extended active duty with the armed forces of the United States; or extreme hardship which in the judgement of the department makes it impossible for the licensee to comply with the continuing education requirements in a timely manner.
Mandatory continuing education requirement.
1. Basic requirements
  1. During each triennial registration period, meaning a registration period of three years' duration, which ends prior to July 1, 2008, an applicant for registration shall complete at least 45 hours of formal continuing education acceptable to the department, as defined in paragraph (4) of this subdivision, provided that no more than 15 hours of such continuing education shall consist of self-study courses.
  2. Any licensed dentist whose registration period begins prior to July 1, 2008 and continues after July 1, 2008, shall complete continuing education hours on a prorated basis at the rate of one and one-quarter hours of acceptable formal continuing education per month for each month from the beginning of that registration period through June 30, 2008 and at the rate of one and two-thirds hours of acceptable formal continuing education per month for each month of that registration period from July 1, 2008 through the end of that registration period.
  3. During each triennial registration period, meaning a registration period of three years' duration, beginning on or after July 1, 2008, an applicant for registration shall complete at least 60 hours of formal continuing education acceptable to the department, as defined in paragraph (4) of this subdivision, provided that no more than 18 hours of such continuing education shall consist of self-study courses.
  4. Beginning with the first registration period for a licensed dentist that occurs on or after January 1, 2002 in which completion of acceptable formal continuing education is required, and before the occurrence of the succeeding registration renewal period following that date, a licensed dentist shall be required to have completed on a onetime basis, as part of the formal continuing education required in this paragraph, no fewer than two hours of formal continuing education acceptable to the department, as defined in paragraph (4) of this subdivision, regarding the chemical and related effects and usage of tobacco and tobacco products and the recognition, diagnosis, and treatment of the oral health effects, including but not limited to cancers and other diseases, caused by tobacco and tobacco products. A licensee returning to the practice of dentistry after a lapse in practice, as prescribed in paragraph (2) of this subdivision, shall be subject to the requirements of this subparagraph and shall complete such formal continuing education in the registration period prescribed in this subparagraph. A licensed dentist shall be deemed to have met the requirements of this subparagraph if the licensee provides to the department satisfactory documentation that the licensee has completed on or after January 1, 1997 and prior to the registration period prescribed in this subparagraph in which such formal continuing education is required to be completed, formal continuing education acceptable to the department, as defined in paragraph (4) of this subdivision, of not less than two hours in the same or substantially similar subject matter as that prescribed in this subparagraph.
  5. During the first registration period for a licensed dentist beginning on or after January 1, 2008 in which completion of acceptable formal continuing education is required, a licensed dentist shall be required to have completed on a one-time basis, as part of the mandatory hours of acceptable continuing education required in this paragraph, no fewer than three hours in a course approved by the department in dental jurisprudence and ethics, which shall include the laws, rules, regulations and ethical principles relating to the practice of dentistry in New York State.
    1. As used in this section, jurisprudence shall mean the application of the principles of law and justice as they relate to the practice of dentistry. A dental mandatory continuing education course in jurisprudence shall be based upon the laws of New York State.
    2. As used in this section, ethics shall mean the principles of conduct relating to dental practice. A dental mandatory continuing education course in ethics shall be based upon ethical principles, such as those of the New York State Dental Association as established pursuant to section 5 of Chapter 987 of the Laws of 1971, or of another dental association approved by the department, or the substantial equivalent thereof, as determined by the department.
    3. Standards for approval of coursework or training. Coursework or training shall include, but need not be limited to, the core elements specified in a syllabus prepared and provided by either a non-profit dental education entity, which has been incorporated or chartered by the New York State Board of Regents for the purpose of providing dental education, or by the New York State Dental Association, which syllabus has been approved by the department. Such non-profit entity shall have knowledge and expertise in New York State Dental Association ethics or the substantial equivalent, as determined by the department.
2. Requirement for lapse in practice. A licensee returning to the practice of dentistry after a lapse in practice, as evidenced by not being registered to practice in New York State shall submit an application for renewal of registration on a form prescribed by the commissioner and evidence of acceptable continuing education as defined in paragraph (4) of this subdivision and in accordance with subparagraphs (i) or (ii) of this paragraph as applicable.
  1. Such licensee who has been lawfully practicing in another jurisdiction and submits such application, shall submit satisfactory evidence of three years of acceptable continuing education completed within the three years immediately preceding the submission of such application. Such continuing education shall be completed at a rate of one and one-quarter hours for each month of such three year period prior to July 1, 2008 and one and two-thirds hours for each month on or after July 1, 2008; or
  2. Such licensee who has not been practicing in another jurisdiction and submits such application, shall submit satisfactory evidence of three years of acceptable continuing education completed within the 12 months immediately preceding the submission of such application. Such continuing education shall be completed at a rate of one and one-quarter hours for each month of such three year period prior to July 1, 2008 and one and two-thirds hours for each month on or after July 1, 2008.
3. Proration. If a registration period is less than three years in duration, a licensed dentist shall complete acceptable formal continuing education at the rate of one and one-quarter hours of continuing education per month for any part of such registration period ending on or before June 30, 2008 and at the rate of one and two-thirds hours of continuing education per month for any part of such registration period from July 1, 2008 through the end of such registration period.
4. To be acceptable to the department, formal continuing education shall be formal courses of learning which contribute to professional practice in dentistry:
  1. in any one or more of the following curricular areas: basic and clinical dental sciences; or behavioral science; or pharmacology of new and developing drugs; or drug interactions; or public health issues; or infection control; or sterile procedures; or legal and regulatory issues; or patient counseling; or other topics which contribute to the professional practice in dentistry as such practice is defined in section 6601 of the Education Law; or other matters of health care, law, and ethics which contribute to the health and welfare of the public; and
  2. obtained from a sponsor approved by the department pursuant to subdivision (h) of this section, provided that for courses taken on or after January 1, 2000, a sponsor that is deemed approved pursuant to paragraph (2) of subdivision (h) of this section shall have at least one full-time employee of any kind, meaning an employee who works at least 30 hours per week, which fact shall be verified by the licensee prior to taking the course and attested to in his or her records as prescribed in subdivision (f) of this section.
Renewal of registration. At each reregistration, licensed dentists shall certify to the department that they have either complied with the continuing education requirements, as prescribed in subdivision (c) of this section; or are subject to an exemption or adjustment to such continuing education requirements, as prescribed in subdivision (b) of this section.
Conditional registration.
1. The department shall issue a conditional registration to a licensee who attests to or admits to noncompliance with the continuing education requirements of this section, provided that such licensee meets the following requirements:
  1. the licensee agrees to remedy such deficiency within the conditional registration period;
  2. the licensee agrees to complete the continuing education requirement for any months of the conditional registration period prior to July 1, 2008 at the rate of one and one-quarter hours of acceptable formal continuing education per month and at the rate of one and two-thirds hours per month for the period beginning July 1, 2008 through the end of such conditional registration period; and
  3. the licensee agrees to complete additional continuing education during such conditional registration period, which the department may require to ensure the licensee's proper delivery of dental care consistent with the licensee's practice of dentistry.
2. The duration of such conditional registration shall not exceed one year and shall not be renewed or extended.
Licensee records. Each licensee subject to this section shall maintain, or ensure access by the department to, a record of completed continuing education, which includes: the title of the program; the number of hours completed; the sponsor's name and any identifying number; attendance verification; the date and location of the program; and a statement attesting to the fact that for courses taken on or after January 1, 2000 from a sponsor that is deemed approved pursuant to paragraph (2) of subdivision (h) of this section, the licensee, prior to taking the course, has verified that the sponsor has at least one fulltime employee of any kind, meaning an employee who works at least 30 hours per week, and indicating the reasonable basis for this determination. Such records shall be retained for at least six years from the date of completion of the program and shall be available for review by the department in the administration of the requirements of this section.
Measurement of continuing education study. Continuing education credit shall be granted only for formal programs of learning that meet the requirements set forth in subdivision (c) of this section. A minimum of 50 minutes of study shall equal one hour of continuing education credit. For credit-bearing university or college courses, each semester hour of credit shall equal 15 hours of continuing education credit, and each quarter hour of credit shall equal 10 hours of continuing education credit.
Sponsor approval.
1. To be approved by the department, sponsors of continuing education to licensed dentists shall meet the requirements of either paragraph (2) or (3) of this subdivision.
2. The department shall deem approved as a sponsor of continuing education to licensed dentists:
  1. a sponsor of continuing education that is approved by the American Dental Association Continuing Education Recognition Program, or the Dental Society of the State of New York, or an equivalent organization determined by the State Board for Dentistry to have equivalent standards for approving sponsors of continuing education for professionals regulated by Title VIII of the Education Law, including a standard that is equivalent to the standard prescribed in clause (f) of subparagraph (ii) of paragraph (3) of this subdivision, provided that such sponsor shall also meet the requirements of clause (g) of subparagraph (ii) of paragraph (3) of this subdivision as verified by the licensee in accordance with the requirements of subparagraph (ii) of paragraph (4) of subdivision (c) of this section; or
  2. a postsecondary institution for courses in programs that are registered pursuant to the standards in Part 52 of this Title or in equivalent programs that are accredited by an acceptable accrediting agency, which registration standards include a standard that is equivalent to the standard prescribed in clause (f) of subparagraph (ii) of paragraph (3) of this subdivision, provided that such sponsor shall also meet the requirements of clause (g) of subparagraph (ii) of paragraph (3) of this subdivision as verified by the licensee in accordance with the requirements of subparagraph (ii) of paragraph (4) of subdivision (c) of this section.
3. Department review of sponsors.
  1. The department shall conduct a review of sponsors that apply for approval to offer continuing education to licensed dentists and that are not deemed approved pursuant to the requirements of paragraph (2) of this subdivision.
  2. Organizations desiring to offer continuing education based upon a department review under this paragraph shall submit, with the fee as set forth in subdivision (i) of this section, an application for advance approval as a sponsor at least 90 days prior to the date for the commencement of such continuing education that documents that the organization:
    1. will offer courses of study in any one or more of the following curricular areas: basic and clinical dental sciences; or behavioral science; or pharmacology of new and developing drugs; or drug interactions; or public health issues; or infection control; or sterile procedures; or legal and regulatory issues; or patient counseling; or other topics which contribute to the professional practice of dentistry as such practice is defined in section 6601 of the Education Law; or other matters of health care, law, and ethics which contribute to the health and welfare of the public;
    2. is an organized educational entity, including but not limited to, a college of dentistry accredited by an acceptable accrediting agency; or a national, State, or local dental association; or a hospital or health maintenance organization;
    3. provides course instructors who are qualified to teach the courses which will be offered, including but not limited to, faculty of a college of dentistry accredited by an acceptable accrediting agency; or instructors who are authorities in the health sciences specially qualified, in the opinion of the State Board for Dentistry, to conduct such courses;
    4. has a method of assessing the learning of participants, and describes such method;
    5. will maintain records for at least six years from the date of completion of coursework, which shall include, but shall not be limited to, the name and curriculum vitae of the faculty, a record of attendance of licensed dentists in such coursework, an outline of the course of instruction, date and location of the coursework, and the number of hours for completion of the coursework. In the event an approved sponsor discontinues operation, the governing body of such sponsor shall notify the department and shall transfer all records as directed by the department;
    6. for an organization initially approved or reapproved by the department as a sponsor on or after September 3, 1999, has the facilities, equipment and financial and physical resources to provide continuing education courses, meaning facilities shall be appropriate to accomplish the educational method being used and the stated educational objectives, equipment shall be adequate and in such condition that instruction can proceed effectively, and financial and physical resources shall be sufficient to fund and support the services necessary to manage the continuing education programs; and
    7. for an organization initially approved or reapproved by the department as a sponsor on or after September 3, 1999, has at least one full-time employee of any kind, meaning an employee who works at least 30 hours per week.
  3. Sponsors that are approved by the department pursuant to the requirements of this paragraph shall be approved for a three-year term.
  4. The department may conduct site visits of or request information from a sponsor approved pursuant to the requirements of this paragraph to ensure compliance with such requirements, and a sponsor shall cooperate with the department in permitting such site visits and in providing such information.
  5. A determination by the department that a sponsor approved pursuant to the requirements of this paragraph is not meeting the standards set forth in this paragraph shall result in the denial or termination of the approved status of the sponsor.
Fees.
1. At the beginning of each registration period, a mandatory continuing education fee of $45 shall be collected from licensees engaged in the practice of dentistry in New York State, except for those exempt from the requirement pursuant to subparagraph (b)(2)(i) of this section. This fee shall be in addition to the registration fee required by section 6604 of the Education Law.
2. Licensees applying for a conditional registration, pursuant to the requirements of subdivision (e) of this section, shall pay a fee that is the same as and in addition to, the fee for the triennial registration required by section 6604 of the Education Law. In addition, such licensees shall pay the $45 mandatory continuing education fee.
3. Organizations desiring to offer continuing education to licensed dentists based upon a department review, pursuant to paragraph (h)(3) of this section, shall submit an application fee of $900 with its application for the issuance of a permit from the department to become an approved sponsor of a formal continuing education program. Application for a three-year renewal of the permit shall be accompanied by a fee of $900.

§61.16 Continuing education for dental hygienists.

As used in this section, acceptable accrediting agency shall mean an organization accepted by the department as a reliable authority for the purpose of accreditation at the post-secondary level, applying its criteria for granting accreditation in a fair, consistent and nondiscriminatory manner, such as an agency recognized for this purpose by the United States Department of Education.
Applicability of requirement.
1. Each licensed dental hygienist required under Article 130 of the Education Law to register with the department to practice in New York State, shall comply with the mandatory continuing education requirements as prescribed in sub-division (c) of this section, except those licensees exempt from the requirement or who obtain an adjustment to the requirement pursuant to paragraph (2) of this sub-division.
2. Exemptions and adjustments to the requirement.
  1. Exemptions. The following licensees shall be exempt from the continuing education requirements, as prescribed in sub-division (c) of this section:
    1. licensees for the triennial registration period during which they are first licensed to practice dental hygiene in New York State, exclusive of those first licensed to practice dental hygiene in New York State pursuant to an endorsement of a license of another jurisdiction;
    2. licensees whose first registration date following January 1, 1997 occurs prior to January 1, 1998, for periods prior to such registration date; and
    3. licensees who are not engaged in the practice of dental hygiene, as evidenced by not being registered to practice in New York State, except as otherwise provided in paragraph (c)(2) of this section to meet the education requirements for the resumption of practice after a lapse in practice for a licensee who has not lawfully practiced continuously in another jurisdiction throughout such lapse period.
  2. Adjustments to the requirement. An adjustment to the continuing education requirement, as prescribed in sub-division (c) of this section, shall be made by the department, provided that the licensee documents good cause that prevents compliance, which shall include but not be limited to, any of the following reasons: poor health certified by a physician; or a specific physical or mental disability certified by an appropriate health care professional; or extended active duty with the armed forces of the United States; or extreme hardship which in the judgement of the department makes it impossible for the licensee to comply with the continuing education requirements in a timely manner.
Mandatory continuing education requirement.
1. During each triennial registration period, meaning a registration period of three years' duration, an applicant for registration shall complete at least 24 hours of formal continuing education acceptable to the department, as defined in paragraph (4) of this sub-division, provided that no more than 10 hours of such continuing education shall consist of self-instructional coursework. Any licensed dental hygienist whose first registration date following January 1, 1997 occurs less than three years from that date, but on or after January 1, 1998, shall complete continuing education hours on a prorated basis at the rate of one and one-quarter hours of acceptable formal continuing education per month up to a maximum of 24 hours for the period beginning January 1, 1997 up to the first registration date thereafter. Such continuing education shall be completed during the period beginning January 1, 1997 and ending before the first day of the new registration period or at the option of the licensee during any time in the previous registration period.
2. Requirement for lapse in practice.
  1. A licensee returning to the practice of dental hygiene after a lapse in practice, as evidenced by not being registered to practice in New York State, whose first registration date after such lapse in practice and following January 1, 1997 occurs less than three years from January 1, 1997, but on or after January 1, 1998, shall be required to complete:
    1. one and one-quarter hours of acceptable formal continuing education for each month beginning with January 1, 1997 until the beginning of the new registration period, up to a maximum of 24 hours, which shall be completed for a licensee who has not lawfully practiced dental hygiene continuously in another jurisdiction throughout such lapse period, in the 12-month period before the beginning of the new registration period; and for a licensee who has lawfully practiced dental hygiene continuously in another jurisdiction throughout such lapse period, in the new registration period or at the option of the licensee in the period beginning 36 months before the commencement of the new registration period and ending at the conclusion of the new registration period; and
    2. for a licensee who has not lawfully practiced dental hygiene continuously in another jurisdiction throughout such lapse period, at least eight hours of acceptable formal continuing education in each successive 12-month period of the new registration period; and for a licensee who has lawfully practiced dental hygiene continuously in another jurisdiction throughout such lapse period, acceptable formal continuing education at the rate of two-thirds of an hour per month during the new registration period.
  2. Except as prescribed in sub-paragraph (i) of this paragraph for registrations therein specified, the licensee who returns to the practice of dental hygiene after a lapse in practice in which the licensee was not registered to practice in New York State and did not lawfully practice dental hygiene continuously in another jurisdiction throughout the lapse period, shall be required to complete:
    1. the continuing education requirement applicable to the period of time the licensee was registered in the licensee's last registration period;
    2. at least two-thirds of an hour of acceptable formal continuing education for each month of lapsed registration up to a maximum of 24 hours, which shall be completed in the 12 months before the beginning of the new registration period; and
    3. at least eight hours of acceptable formal continuing education in each succeeding 12-month period, after such registration is reissued, until the next registration date.
  3. Except as prescribed in sub-paragraph (i) of this paragraph for registrations therein specified, the licensee who returns to the practice of dental hygiene after a lapse in practice in which the licensee was not registered to practice in New York State but did lawfully practice dental hygiene continuously in another jurisdiction throughout the lapse period, shall be required to complete:
    1. the continuing education requirement applicable to the period of time the licensee was registered in the licensee's last registration period;
    2. at least two-thirds of an hour of acceptable formal continuing education for each month of lapsed registration up to a maximum of 24 hours, which shall be completed in the new registration period, or at the option of the licensee in the period beginning 36 months before the commencement of the new registration period and ending at the conclusion of the new registration period; and
    3. completion of the regular continuing education requirement at the rate of two-thirds of an hour of acceptable formal continuing education per month during the new registration period.
3. Proration. Except as otherwise provided in this section, if a registration period is less than three years in duration, a licensed dental hygienist shall complete acceptable formal continuing education at the rate of two-thirds of an hour of continuing education per month for such registration period.
4. To be acceptable to the department, formal continuing education shall be formal courses of learning which contribute to professional practice in dental hygiene:
  1. in any one or more of the following curricular areas: basic and clinical dental sciences; or behavioral science; or pharmacology of new and developing drugs; or drug interactions; or public health issues; or child abuse reporting instruction; or infection control; or sterile procedures; or legal and regulatory issues; or patient counseling; or other topics which contribute to the professional practice in dental hygiene as such practice is defined in section 6606 of the Education Law; or other matters of health care, law, and ethics which contribute to the health and welfare of the public; and
  2. obtained from a sponsor approved by the department pursuant to sub-division (h) of this section.
Renewal of registration. At each reregistration, licensed dental hygienists shall certify to the department that they have either complied with the continuing education requirements, as prescribed in sub-division (c) of this section; or are subject to an exemption or adjustment to such continuing education requirements, as prescribed in sub-division (b) of this section.
Conditional registration.
1. The department shall issue a conditional registration to a licensee who attests to or admits to noncompliance with the continuing education requirements of this section, provided that such licensee meets the following requirements:
  1. the licensee agrees to remedy such deficiency within the conditional registration period;
  2. the licensee agrees to complete the regular continuing education requirement at the rate of two-thirds of an hour per month during such conditional registration period; and
  3. the licensee agrees to complete additional continuing education during such conditional registration period, which the department may require to ensure the licensee's proper delivery of dental hygiene care consistent with the licensee's practice of dental hygiene.
2. The duration of such conditional registration shall not exceed one year and shall not be renewed or extended.
Licensee records. Each licensee subject to this section shall maintain, or ensure access by the department to, a record of completed continuing education, which includes: the title of the program, the number of hours completed, the sponsor's name and any identifying number, attendance verification, and the date and location of the program. Such records shall be retained for at least six years from the date of completion of the program and shall be available for review by the department in the administration of the requirements of this section.
Measurement of continuing education study. Continuing education credit shall be granted only for formal programs of learning that meet the requirements set forth in sub-division (c) of this section. A minimum of 50 minutes of study shall equal one hour of continuing education credit. For credit-bearing university or college courses, each semester-hour of credit shall equal 15 hours of continuing education credit, and each quarter-hour of credit shall equal 10 hours of continuing education credit.
Sponsor approval.
1. To be approved by the department, sponsors of continuing education to licensed dental hygienists shall meet the requirements of either paragraph (2) or (3) of this sub-division.
2. The department shall deem approved as a sponsor of continuing education to licensed dental hygienists:
  1. a sponsor of continuing education that is approved by the American Academy of Dental Hygiene, Inc., or the American Dental Association Continuing Education Recognition Program, or the Dental Society of the State of New York, or an equivalent organization determined by the State Board for Dentistry to have equivalent standards for approving sponsors of continuing education for professionals regulated by Title VIII of the Education Law; or
  2. a post-secondary institution for courses in programs that are registered pursuant to Part 52 of this Title or in equivalent programs that are accredited by an acceptable accrediting agency.
3. Department review of sponsors.
  1. The department shall conduct a review of sponsors that apply for approval to offer continuing education to licensed dental hygienists and that are not deemed approved pursuant to the requirements of paragraph (2) of this sub-division.
  2. Organizations desiring to offer continuing education based upon a department review under this paragraph shall submit, with the fee as set forth in sub-division (i) of this section, an application for advance approval as a sponsor at least 90 days prior to the date for the commencement of such continuing education that documents that the organization:
    1. will offer courses of study in any one or more of the following curricular areas: basic and clinical dental sciences; or behavioral science; or pharmacology of new and developing drugs; or drug interactions; or public health issues; or child abuse reporting instruction; or infection control; or sterile procedures; or legal and regulatory issues; or patient counseling; or other topics which contribute to the professional practice of dental hygiene as such practice is defined in section 6606 of the Education Law; or other matters of health care, law, and ethics which contribute to the health and welfare of the public;
    2. is an organized educational entity, including but not limited to, a college accredited by an acceptable agency offering dental hygiene or dentistry professional programs; or a national, State, or local dental association; or a hospital or health maintenance organization;
    3. provides course instructors who are qualified to teach the courses which will be offered, including but not limited to, faculty of a college accredited by an acceptable accrediting agency which offers dental hygiene or dentistry professional programs; or instructors who are authorities in the health sciences specially qualified, in the opinion of the State Board for Dentistry, to conduct such courses;
    4. has a method of assessing the learning of participants, and describes such method; and
    5. will maintain records for at least six years from the date of completion of coursework, which shall include, but shall not be limited to, the name and curriculum vitae of the faculty, a record of attendance of licensed dental hygienists in such coursework, an outline of the course of instruction, date and location of the coursework, and the number of hours for completion of the coursework. In the event an approved sponsor discontinues operation, the governing body of such sponsor shall notify the department and shall transfer all records as directed by the department.
  3. Sponsors that are approved by the department pursuant to the requirements of this paragraph shall be approved for a three-year term.
  4. The department may conduct site visits of or request information from a sponsor approved pursuant to the requirements of this paragraph to ensure compliance with such requirements, and a sponsor shall cooperate with the department in permitting such site visits and in providing such information.
  5. A determination by the department that a sponsor approved pursuant to the requirements of this paragraph is not meeting the standards set forth in this paragraph shall result in the denial or termination of the approved status of the sponsor.
Fees.
1. At the beginning of each registration period, a mandatory continuing education fee of $30 shall be collected from licensees engaged in the practice of dental hygiene in New York State, except for those exempt from the requirement pursuant to sub-paragraph (b)(2)(i) of this section. This fee shall be in addition to the registration fee required by section 6609 of the Education Law.
2. Licensees applying for a conditional registration, pursuant to the requirements of sub-division (e) of this section, shall pay a fee that is the same as and in addition to, the fee for the triennial registration required by section 6609 of the Education Law. In addition, such licensees shall pay the $30 mandatory continuing education fee.
3. Organizations desiring to offer continuing education to licensed dental hygienists based upon a department review, pursuant to paragraph (h)(3) of this section, shall submit an application fee of $900 with its application for the issuance of a permit from the department to become an approved sponsor of a formal continuing education program. Application for a three-year renewal of the permit shall be accompanied by a fee of $900.

§61.17 Dental hygiene restricted local infiltration anesthesia/nitrous oxide analgesia certificate.

Definitions. As used in this section:
1. Acceptable accrediting body means an accrediting body which is accepted by the department as a reliable authority for the purpose of accrediting educational programs leading to licensure in dentistry and/or dental hygiene, applying its criteria for granting accreditation in a fair, consistent, and nondiscriminatory manner, and which accredits such programs on a national basis.
2. Under personal supervision of a licensed dentist means that the supervising licensed dentist remains in the dental office or other location where the local infiltration anesthesia or nitrous oxide analgesia services are being performed by the dental hygienist, personally authorizes and prescribes the use of local infiltration anesthesia or nitrous oxide analgesia for the patient and, before dismissal of the patient, personally examines the condition of the patient after the use of local infiltration anesthesia or nitrous oxide analgesia that is administered by the dental hygienist is completed.
General provisions.
1. A licensed dental hygienist shall not administer or monitor nitrous oxide analgesia or local infiltration anesthesia in the practice of dental hygiene without being issued a dental hygiene restricted local infiltration anesthesia/nitrous oxide analgesia certificate in accordance with the requirements of the this section, except that such administration or monitoring of nitrous oxide analgesia or local infiltration anesthesia by a licensed dental hygienist who is certified under this section must be under the personal supervision of a licensed dentist, as defined in subdivision (a) of this section, and in conjunction with the performance of dental hygiene procedures authorized by section 6606 of the Education law.
2. The applicant for certification or the renewal of certification must be a licensed dental hygienist or be concurrently licensed as a dental hygienist at the time of initial certification; and shall meet the additional requirements of this section.
3. The certificate issued pursuant to this section shall be issued for a three-year term and shall be renewable.
Requirements for initial certification.
1. Application requirement. The applicant shall apply for initial certification on forms prescribed by the department and pay the fee prescribed in section 6605-b of the Education Law.
2. Education and training requirement. For initial certification, the applicant shall complete a program registered pursuant to subdivision (b) of section 52.9 of this Title and offered by an institution which has programs that are registered by the department pursuant to Part 52 of this Title as leading to licensure in dentistry and/or dental hygiene; or equivalent educational preparation offered by an institution that has programs leading to licensure in dentistry and/or dental hygiene that are accredited by an acceptable accrediting body.
Requirements for renewal of certification.
1. Each certificate holder shall renew certification with the department triennially on a schedule determined by the department.
2. The certificate holder shall renew certification on forms prescribed by the department and pay the fee prescribed in section 6605-b of the Education Law.

§61.18. Residency program requirement for dental licensure.

Definitions. As used in this section:
1. Acceptable national accrediting body means until December 31, 2006 the Commission on Dental Accreditation of the American Dental Association, and thereafter it means an organization accepted by the department as a reliable authority for the purpose of accreditation of dental residency programs, applying its criteria for granting accreditation in a fair, consistent, and nondiscriminatory manner, such as the Commission on Dental Accreditation of the American Dental Association, its successors, or an equivalent organization as determined by the department.
2. Clinical means relating to or involving the direct examination and treatment of patients.
3. Competent to practice dentistry means the level of knowledge and skills necessary to perform safely and independently the practice of dentistry consistent with the definition of the practice of dentistry in section 6601 of the Education Law.
Residency program. To be acceptable to the department for purposes of licensure under section 6604 of the Education Law, a residency program shall meet the requirements of this section.
1. The residency program shall be a postdoctoral clinical dental residency program in either general dentistry, or a specialty of dentistry as defined in paragraph (2) of this subdivision, of at least one year's duration in a hospital or dental facility accredited for teaching purposes by an acceptable national accrediting body, which is completed successfully by the applicant prior to the submission to the department of the application for licensure.
2. The accredited residency program in a specialty of dentistry shall be in the specialty of endodontics, oral and maxillofacial surgery, orthodontics and dentofacial orthopedics, pediatric dentistry, periodontics, prosthodontics, oral and maxillofacial pathology, oral and maxillofacial radiology, or another specialty of dentistry, as determined by the department, for which at least 50 percent of the CDA accredited residency program consists of clinical training in one or more of the following areas: general dentistry, endodontics, oral and maxillofacial surgery, orthodontics and dentofacial orthopedics, pediatric dentistry, periodontics, prosthodontics, oral and maxillofacial pathology, and oral and maxillofacial radiology.
3. The accredited residency program shall include a formal written outcome assessment which is acceptable to the department.
  1. For an accredited residency program in general dentistry, the formal written outcome assessment used by the residency program shall be acceptable to the department if it includes:
    1. an acceptable notarized written statement by the residency program director attesting that the applicant has completed successfully the accredited residency program and is in the director's judgement competent to practice dentistry; and
    2. acceptable notarized written statement(s) by the residency program director who supervised the dental procedures performed by the applicant, and/or the attending dentist(s) who supervised the dental procedures performed by the applicant if different from the residency program director, attesting that the applicant completed independently, and to generally accepted professional standards for dentistry, two full crowns, two endodontically treated teeth, four restorations (two anterior, two posterior) and one periodontal case during the accredited residency program.
  2. For an accredited residency program in a specialty of dentistry, as defined on paragraph (2) of this subdivision, the formal written outcome assessment used by the residency program shall be acceptable to the department if it includes an acceptable notarized written statement by the residency program director attesting that the applicant has successfully completed the accredited residency program in a specialty of dentistry, as defined in paragraph (2) of this subdivision, and is in the director's judgement competent to practice dentistry.
A residency program that has not met the requirements of this section shall not be acceptable to the department for purposes of licensure under this section. A formal written outcome assessment shall not be acceptable to the department for purposes of licensure under this section if it does not meet the requirements of paragraph (3) of subdivision (b) of this section.

§61.19 Dental requirement for cardiopulmonary resuscitation certification.

Beginning January 1, 2009, each dentist licensed and registered to practice in New York State shall become certified in cardiopulmonary resuscitation by a provider approved by the department and thereafter shall maintain current certification, except as provided for in subdivision (e) of the section. Coursework leading to obtaining and maintaining such certification shall be included in the mandatory hours of continuing education to the extent provided in subdivision (c) of this section.
Cardiopulmonary resuscitation certification providers approved by the department shall include the American Heart Association, the American Red Cross, the National Safety Council and the American Safety and Health Institute. The Department may also approve other providers determined by the Department to offer substantially similar content to courses offered to professionals by such organizations and to have a similar renewal period. Online courses are not acceptable; all courses taken to meet this requirement shall be taken in person. Such coursework shall include, but need not be limited to, content in the following:
1. scene survey;
2. patient assessment;
3. one and two rescuer cardiopulmonary resuscitation;
4. mouth-to-mouth resuscitation;
5. mouth-to-mask resuscitation;
6. conscious choking;
7. unconscious choking;
8. bag-valve-mask resuscitation;
9. recovery position;
10. automated external defibrillator use;
11. infection control matters;
12. recognizing a heart attack; and
13. cardiopulmonary resuscitation and automated external defibrillator scenarios.
For each triennial registration period, a licensee may count up to a maximum of twelve hours of coursework in cardiopulmonary resuscitation, including coursework in advanced cardiac life support and/or pediatric advanced life support.
At the time of his or her registration renewal, each dentist shall attest to having met the cardiopulmonary resuscitation requirement or attest to meeting the requirements for exemption as defined in subdivision (e) of this section.
A licensee may be granted an exemption to the cardiopulmonary resuscitation requirement if he or she is physically incapable of complying with the requirements of subdivision (a) of this section. Documentation of such incapacity shall include a written statement by a licensed physician describing the licensee's physical incapacity. The licensee shall also submit an application to the department for exemption which verifies that another individual will maintain certification and be present in the dental office while the dentist is treating patients.
In accordance with subdivision (f) of section 61.15 of this Part, each licensee shall maintain for review by the department records of compliance with this section, including the licensee's cardiopulmonary resuscitation certification card.

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