4715-3-01 Definitions.

 

 

 

4715-3-01                    Definitions.

 

 

Definition of terms are listed by category. Categories are listed alphabetically.

 

(A)  Advertising terms

 

(1)   "Invasion of privacy" - to encroach upon or violate a person's personal, intimate, and/or private space.

 

(2)   "Misrepresentation" - to represent falsely, wrongly, or misleadingly.

 

(3)   "Overreach" - to get the better of, especially by deceit or trickery; to outwit; to reach too far; to cheat others.

 

(4)   "Reasonably dignified" - possessing distinction, poise, honor, esteem.

 

(5)   "Reasonably restrained" - moderation in action or expression.

 

(6)     "Undue  influence"  -  using  power  in  an  excessive  or  unreasonable  way  to produce effects, either, directly, indirectly, or through an intermediary.

 

(7)   "Unreasonable interference" - to unreasonably come between so as to impede, hinder or obstruct

 

(B)  Anesthesia/sedation terms

 

(1)  "Analgesia" - the diminution or elimination of pain.

 

(2)   "Anxiolysis" - the diminution or elimination of anxiety.

 

(3)   "Enteral/oral conscious sedation" - The use of a single drug administered orally or sublingually at one time on a given treatment day, or combination of drugs administered concomitantly orally or sublingually at one time on a given treatment day, in order to provide sedation or anxiolysis for dentistry. If the dosage is determined to be inadequate and an increased dosage is required to sufficiently provide sedation or anxiolysis, the practitioner must reschedule

the  patient  for

may  consider  using  an  increased  dosage  at  a  subsequent

appointment on a different day. All enteral/oral sedatives shall be administered at the same time and only once during any given treatment day unless the administering dentist is permitted to provide intravenous conscious sedation or general anesthesia.

(4)       "Combination inhalation-enteral conscious sedation (combined conscious sedation)" - conscious sedation using enteral agents, as indicated in Section 4715-3-01(B)(3), and nitrous oxide/oxygen inhalation sedation. Nitrous oxide/oxygen used in combination with sedative agents may produce conscious or deep sedation or general anesthesia.

(5)     "Conscious sedation" - 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 or verbal command, and that is produced by a pharmacologic or non-pharmacologic method, or a combination thereof.

In accord with this particular definition, the drugs and/or techniques used should carry a margin of safety wide enough to render unintended loss of consciousness unlikely. Further, patients whose only response is reflex withdrawal from repeated painful stimuli would not be considered to be in a state of conscious sedation.

(6)   "Continual" - repeated regularly and frequently in a steady succession.

(7)   "Continuous" - prolonged without any interruption at any time.

(8)   "Deep sedation" - 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 combination thereof.

(9)     "Enteral" - any technique of administration in which the agent is absorbed through the gastrointestinal (GI) tract or oral mucosa [i.e., oral, rectal, sublingual].

(10)    "General anesthesia" - 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 combination thereof.

(11)    "Immediately available" - on site in the facility and available for immediate use.

(12)    "Inhalation" - a technique of administration in which a gaseous or volatile

agent is introduced into the pulmonary tree and whose primary effect is due to absorption through the pulmonary bed.

(13)   "Local anesthesia" - the elimination of sensation, especially pain, in one part of the body by the topical application or regional injection of a drug.

(14)    "Parenteral" - a technique of administration in which the drug bypasses the gastrointestinal (GI) tract [i.e., intramuscular (IM), intravenous (IV), intranasal (IN), submucosal (SM), subcutaneous (SC), intraocular (IO)].

(15)   "Time-oriented anesthesia record" - documentation at appropriate intervals of drugs, doses and physiologic data obtained during patient monitoring.

(16)   "Transdermal/transmucosal" - a technique of administration in which the drug is administered by patch or iontophoresis.

(C)  Dental personnel

(1)   "Licensed dentist" - a graduate of an accredited or a foreign dental school who has successfully passed all examinations, completed all application requirements for licensure in Ohio as set forth in section 4715.10 of the Revised Code and the agency level rules of this board, and holds a current license to practice dentistry in Ohio which is not suspended or revoked by board action.

(2)    "Unlicensed dentist" - a graduate of an accredited dental school who has not successfully passed all examinations or completed the application requirements for licensure in Ohio as set forth in section 4715.10 of the Revised Code and the agency level rules of this board; or the holder of a license to practice dentistry in Ohio which has been suspended or revoked by board action.

(3)   "Unaccredited foreign dental college graduates" - a graduate of a dental school that is not accredited by the American dental association commission on dental accreditation.

(4)   "Dental student" - a student in good standing currently enrolled in an accredited dental school.

(5)   "Licensed dental hygienist" - a graduate of an accredited dental hygiene school or program who has successfully passed all examinations, completed all application requirements for licensure in Ohio as set forth in section 4715.21

of the Revised Code and the agency level rules of this board, and holds a current license to practice dental hygiene in Ohio which is not suspended or revoked by board action.

(6)     "Unlicensed dental hygienist" - a graduate of an accredited dental hygiene school or program who has not successfully passed all examinations or completed the application requirements for licensure in Ohio as set forth in section 4715.21 of the Revised Code and the agency level rules of this board; or the holder of a license to practice dental hygiene in Ohio which has been suspended or revoked by board action.

(7)       "Certified dental assistant" - a dental assistant who maintains current certification by completion of the continuing education requirements upon successfully passing the certification examination of the Dental assisting national board (DANB) or the Ohio commission on dental assistant certification (OCDAC).

(8)    "Basic qualified personnel" - basic qualified personnel are those persons who are adjudged by the licensed dentist to be capable and competent of performing basic remediable intra-oral and extra-oral dental tasks and/or procedures under his direct supervision and full responsibility. These persons must be trained directly via an employer-dentist, via a planned sequence of instruction in an educational institution or via in-office training.

(9)    "Advanced qualified personnel" (hereinafter referred to as expanded function dental auxiliaries or EFDA's) - those persons who have passed the Ohio state dental board designated examination for expanded function dental auxiliaries who may perform advanced remediable intra-oral dental tasks and/or procedures under the direct supervision and full responsibility of a licensed dentist.

Upon submitting proof of successful completion of acceptable training on a form prescribed by the board and signed by the chief administrative officer of the program at the accredited institution, the following applicants shall be admitted to the state board designated examination for expanded function dental auxiliary:

(a)   "Unlicensed dentist" - a graduate of an accredited dental school unless his license is under suspension or revocation by the board.

(b)   "Dental student" - a dental student in good standing and currently enrolled in an accredited institution, upon recommendation of the dean.

(c)      "Unaccredited foreign dental college graduate" - a graduate of a non-accredited dental school after admission to an accredited educational institution or program.

(d)     "Certified dental assistant" - a certified dental assistant if she has satisfactorily completed training in advanced remediable intra-oral dental tasks and/or procedures through an accredited educational institution or program whose educational standards are recognized and/or accredited by the American dental association commission on dental accreditation. The curriculum must include clinical experience.

(e)    "Licensed dental hygienist" - a graduate of an accredited dental hygiene program if she has satisfactorily completed training in advanced remediable intra-oral dental tasks and/or procedures through an accredited educational institution or program whose educational standards are recognized and/or accredited by the American dental association commission on dental accreditation, unless her license is under suspension or revocation. The curriculum must include clinical experience.

(f)   "Unlicensed dental hygienist" - a graduate of an accredited dental hygiene program if she has satisfactorily completed training in advanced remediable intra-oral dental tasks and/or procedures through an accredited educational institution or program whose educational standards are recognized and/or accredited by the American dental association commission on dental accreditation. The curriculum must include clinical experience.

(10)   "Dental auxiliaries" - dental auxiliaries are all persons, not licensed to practice dentistry in Ohio, who assist in the dental practice.

(a)    Subject to those more specific laws or rules regulating the functions of basic qualified personnel, expanded function dental auxiliaries and hygienists, a dental auxiliary may, under the personal supervision and full responsibility of a licensed dentist, assist in the concurrent performance of supportive procedures, and may assist with the administration of drugs, medications, and inhalation anesthetic agents, including nitrous oxide.

(b)    Further, parenteral injections for the administration of drugs, including local anesthetic agents may not be delegated to dental auxiliaries unless they are appropriately licensed in the state of Ohio.

(11)    "Dental health care workers" - dental health care workers are all personnel utilized by a licensed dentist who assist in a dental practice and who may be exposed to body fluids such as blood or saliva.

(D)  Disciplinary terms

(1)   "Revocation" - permanent loss of license to practice in Ohio with no ability to apply for licensure in this state in the future.

(2)   "Suspension" - loss of license to practice for a specific period of time (definite suspension) or until specific conditions are met (indefinite suspension). In the case of indefinite suspension, the board may specify a minimum period of time during which the licensee may not practice, in addition to other conditions for reinstatement of license.

(3)    "Restriction" - license to practice is restricted in some way (eg., licensee is prohibited from practicing a certain specialty or procedure or prescribing, etc.) or is subject to terms and conditions specified by the board. The restriction can be permanent or temporary.

(4)     "Probation" - a specific type of restriction wherein the license to practice remains dependent upon compliance with terms and conditions specified by the board (eg., periodic appearances, drug logs, reports by treating practitioners, etc.). The probation period may be for a definite or indefinite period of time. In the case of indefinite probation, the board may establish a minimum probationary period, with provisions for termination of probation at the board's discretion thereafter.

(5)    "Censure/reprimand" - the licensee is formally and publicly reprimanded in writing.

(E)  Educational terms

(1)    "Accreditation" - a procedure for recognizing or certifying that an educational institution or program meets prescribed standards that qualify its graduates for entitlement to take the state board designated examination.

(2)    "Accredited educational institution or program" - an educational institution or program accredited by one or more of the following:

(a)       American   dental   association   commission   on   dental   accreditation;

responsible for the accreditation of dental and dental-related education within the United States and Canada.

(b)       Accreditation council for graduate medical education (ACGME); responsible for the accreditation of post-doctoral medical training programs within the United States.

(c)    Joint commission on accreditation of healthcare organizations (JCAHO); responsible for the evaluation and accreditation of health care organizations and programs in the United States. An independent, not-for-profit accrediting organization which sets professionally based standards and evaluates the compliance of health care organizations.

(3)   "Accredited dental school" - a dental school accredited by the American dental association commission on dental accreditation.

(4)   "Accredited dental hygiene program" - a dental hygiene program accredited by the American dental association commission on dental accreditation.

(5)   "Accredited dental assisting program" - a dental assisting program accredited by the American dental association commission on dental accreditation.

(F)   General terms

(1)      "Must/shall"  -  indicates  an  imperative  need  and/or  duty;  an  essential  or indispensable item; mandatory.

(2)    "Should" - indicates the recommended manner to obtain the standard; highly desirable.

(3)   "May" - indicates freedom, or liberty to follow a reasonable alternative.

(4)    "Immediately available" - on site in the facility and available for immediate use/review/inspection.

(5)   "All" - the whole extent or quantity of; every one of; the entire number of.

(G)  Impairment

(1)      "Impairment"  -  means  impairment  of  ability  to  practice  under  accepted standards  of  the  profession  because  of  physical  or  mental  disability,  or

dependence on alcohol or other drugs, or habitual or excessive use or abuse of alcohol, drugs or other substances. Impairment includes inability to practice in accordance with such standards, and inability to practice in accordance with such standards without appropriate treatment, monitoring and supervision.

(2)   "Inability to practice" - means impairment of ability to practice under accepted standards of the profession because of physical or mental disability, dependence on alcohol or other drugs, or excessive use of alcohol or other drugs.

(3)    "No longer drug or alcohol dependent" - means a demonstration of abstinence from alcohol, and from drugs or substances that may impair the ability to practice.

(4)   "Relapse" - means any use of, or obtaining for the purpose of using, alcohol or other drugs or substances that may impair the ability to practice, including a return to the pattern of impairment activities, by one previously diagnosed and treated for drug or alcohol abuse or dependence. This does not apply to substances obtained pursuant to the direction of a treating physician who has knowledge of the patient's history and the disease of addiction, or pursuant to the direction of a physician in a medical emergency.

(H)  Infection control

(1)       "Appropriate disinfectant" - a diluted bleach solution, EPA-registered tuberculocides, sterilants, or products registered against HIV/HBV, provided the surfaces have not become contaminated with agents or volumes of or concentrations of agents for which higher level disinfection is recommended.

(2)   "Chemical sterilization process" - use of a sterilant cleared by the Food and drug administration in a 510 (K) in accordance with the manufacturer's instructions.

(3)    "Overgloving" - placing one disposable glove over another disposable glove between patients when the first glove is contaminated.

(I)  Levels of knowledge

(1)     "Familiarity" - a simplified knowledge for the purpose of orientation and recognition of general principles.

(2)    "In-depth" - a through knowledge of concepts and theories for the purpose of critical analysis and the synthesis of more complete understanding (highest level of knowledge).

(J)   Levels of skill

(1)    "Exposed" - the level of skill attained by observation of or participation in a particular activity.

(2)   "Competent" - displaying special skill or knowledge derived from training and experience.

(3)      "Proficient" - the level of skill attained when a particular activity is accomplished with repeated quality and a more efficient utilization of time (highest level of skill).

(K)  Miscellaneous terms

(1)   Construction

(a)     Where a pronoun of one gender appears in these rules, it shall be interpreted to mean or include the pronoun of the other gender where appropriate.

(2)     "Director of continuing education practicum" - the director of a continuing education practicum must be a dentist licensed to practice in the state of Ohio.

(3)       "Emergency" - a sudden, generally unexpected occurrence or set of circumstances demanding immediate action.

(4)     "Final placement or removal of appliances" - the word "final" as used in paragraphs (B) and (C) of rule 4715-11-064715-11-03 of the Administrative Code means the last step in the therapeutic process concerning the placement, replacement or removal of a removable appliance, or a fixed appliance directly attached to a tooth or teeth by cementation, direct bonding or other similar process, and the same applies to appliances utilized for the correction of malpositions of the teeth. The temporary placement of any appliance is not considered the final placement in the therapeutic process

(5)    "License" - a current valid license, certificate or permit issued pursuant to

sections  4715.01  to  4715.99  of  the  Revised  Code,  which  has  not  been revoked or suspended.

(6)    "Licensee" - the holder of a current valid license, certificate or permit issued pursuant to sections 4715.01 to 4715.99 of the Revised Code, which has not been revoked or suspended.

(7)   "Treatment day" - any portion of any day during which treatment is rendered to a patient constitutes a treatment day.

(L)  Special needs program

(1)   "Special needs program" - a program that is operated through a school district board of education or the governing board of an educational service center; the board of health of a city or general health district or the authority having the duties of a board of health under section 3709.05 of the Revised Code; a national, state, district, or local dental association; or any other public or private entity recognized and approved by the state dental board.

(M)   Supervision

(1)   "Supervision" - acts are deemed to be under the supervision of a licensed dentist when performed in a dental facility wherein a licensed dentist is physically present at all times during the performance of such acts and such acts are performed pursuant to his order, control and full professional responsibility. Such acts shall be performed only after examination and diagnosis by said dentist and in accordance with said dentist's treatment plan for the procedure to be performed by the dental hygienist. This definition is subject to the exceptions noted in section 4715.22 of the Revised Code.

(2)    "Direct supervision" - acts are deemed to be under the direct supervision of a licensed dentist when performed in a dental facility wherein a licensed dentist is physically present at all times during the performance of such acts and such acts are performed pursuant to his order, control and full professional responsibility, and are checked and approved by the licensed dentist before the patient upon whom such act has been performed departs from the dental facility of said dentist.

(3)   "Personal supervision" - acts are deemed to be under the personal supervision of the licensed dentist when the dentist is personally operating on a patient and authorizes an auxiliary to aid treatment by concurrently performing supportive procedures.

(N)  Tasks and/or procedures categories

(1) "Basic remediable intra-oral and extra-oral dental tasks and/or procedures" - those dental tasks and/or procedures which do not create irreparable changes within the oral cavity and/or the contiguous structures and which are set forth in Ohio Administrative Code 4715-11-01.

(1) "Basic remediable intra-oral and extra-oral dental tasks and/or procedures" - those dental tasks and/or procedures which do not create irreparable changes within the oral cavity and/or the contiguous structures. Basic remediable intra-oral and extra-oral tasks and/or procedures include the following, but do not include any advanced remediable intra-oral tasks and/or procedures as defined by agency-level 4715 of the Administrative Code.

(a) Aspiration  and  retraction,  excluding  placement  of  gingival  retraction materials.

(b) Intra-oral instrument transfer.

(c) Preliminary charting of missing and filled teeth.

(d)Elastomeric impressions for diagnostic models and models to be used for opposing models in the construction of appliances and restorations.

(e) Taking  impressions  for  the  construction  of  custom  athletic  mouth protectors/mouthguards, and trays for application of medicaments.

(f)Application of disclosing solutions.

(g) Caries susceptibility testing.

(h) Demonstration of oral hygiene procedures, including, but not limited to, use of toothbrushes and dental floss.

(i) Shade selection for fabrication of appliances or restorations.

(j) Application of topical anesthetics.

(k) Pulp testing.

(l) Fluoride application.

(m) Topical applications of desensitizing agents to teeth.

(n) Application and removal of periodontal dressings.

(o) Suture removal.

(p) Placement of rubber dam over preplaced clamp, and removal of clamp and rubber dam.

(q) Application of cavity varnish.

(r) Impression,   fabrication,   cementation   and   removal   of   provisional restorations, not to include palliative or sedative restorations.

(s) Preliminary selection and sizing of stainless steel crowns.

(t)Preliminary selection and sizing of orthodontic bands and arch wires.

(u) Checking for and removal of loose orthodontic bands and loose brackets.

(v) Intra-oral bite registrations for diagnostic model articulation, restorations, and appliances.

(w)Irrigation and drying of canals during endodontic procedures.

(x) Placement of medication in the pulp chamber(s) of teeth with non-vital pulp or instrumented root canals.

(y) Placement and removal of surgical dressings.

(z) Placement and removal of orthodontic arch wires, auxiliary arch wires, and ligation of same to orthodontic bands and/or brackets.

(aa) Placement and removal of orthodontic separators and ties.

(bb) Polymerization of light-activated restorative or bonding materials.

(cc) All supportive services necessary to the maintenance of a hygienic practice environment, including, but not limited to, all sterilizing procedures.

(dd) All supportive services or procedures necessary to protect the physical well-being of the patient during routine treatment procedures and during periods of emergencies, including, but not limited to:

(i) Physical positioning of the patient;

(ii) Monitoring of vital signs;

(iii) Assistance during administration of life-support activities; and

(iv) Any other non-invasive procedures deemed necessary by the supervising dentist to maintain the health and safety of the patient.

(ee) All non-invasive supportive services and procedures necessary to the gathering and maintaining of accurate and complete medical and dental history of the patient, including but not limited to:

(i) Taking photographs;

(ii) Recording patient treatment;

(iii) Measurement of blood pressure and body temperature; and

(iv) Other common tests deemed necessary by the supervising dentist.

(ff) All extra-oral supportive laboratory procedures, including, but not limited to:

(i) Repair, construction and finishing of metallic and plastic prosthetic devises; and

(ii) Compilation of radiographic data for interpretation by the dentist, i.e., tracings, etc.

(gg) The preparation of materials, drugs and medications for use in dental procedures, including, but not limited to:

(i) Palliative materials;

(ii) Impression materials; and

(iii) Restorative materials.

(hh) All patient education services, including, but not limited to:

(i) Progress reports;

(ii) Consultations (oral or written);

(iii) Oral hygiene instructions;

(iv) Use of intra-oral hygiene devices;

(v) Normal nutrition information as it relates to dental health;

(vi) Behavioral modification;

(vii) Self adjustment of orthodontic appliances; and

(viii) All other post-operative and post-insertion instructions, as deemed appropriate by the supervising dentist.

(ii) All non-invasive supportive services normally utilized in conjunction with the treatment by the dentist of fascia pain or tmj syndrome.

(jj) Preparing the teeth for restorations or for the bonding of orthodontic brackets by treating the supragingival coronal surfaces of the teeth to be bonded with a conditioning or etching agent and by the placement of a bonding agent adhesive.

(kk) Impressions for removable or fixed orthodontic appliances.

(2)    "Advanced remediable intra-oral dental tasks and /or procedures" - all tasks and/or procedures involved in the art orof placement of preventive or restorative materials limited to the following:

(a)   Placement of sealants;

(b)   Amalgam restorative materials; and

(c)     Non-metallic  restorative  materials,  including  direct-bonded  restorative materials.

(3)    "Irremediable tasks and/or procedures" - irremediable tasks and/or procedures are those which, when performed, may create irreparable changes within the oral cavity or contiguous structures. Further, parenteral injections for the administration of drugs, including local anesthetic agents, are considered to be irremediable tasks under agency-level 4715 of the Administrative Code.

Effective:                                06/21/2004

R.C. 119.032 review dates:    02/13/2004 and 02/14/2009

CERTIFIED ELECTRONICALLY

Certification

06/09/2004

Date

Promulgated Under:   119.03

Statutory Authority:   4715.03, 4715.23

Rule Amplifies:           4715.03

Prior Effective Dates: 4-7-00, 4-12-02, 5-15-03