SECTIONS 1646-1646.9 - California Statutes

BUSINESS AND PROFESSIONS CODE

SECTION 1646-1646.9

1646. "General anesthesia," as used in this article, means a
controlled state of depressed consciousness or unconsciousness,
accompanied by partial or complete loss of protective reflexes,
produced by a pharmacologic or nonpharmacologic method, or a
combination thereof.

1646.1. (a) No dentist shall administer or order the administration
of general anesthesia on an outpatient basis for dental patients
unless the dentist either possesses a current license in good
standing to practice dentistry in this state and holds a valid
general anesthesia permit issued by the board or possesses a current
permit under Section 1638 or 1640 and holds a valid general
anesthesia permit issued by the board.
(b) No dentist shall order the administration of general
anesthesia unless the dentist is physically within the dental office
at the time of the administration.
(c) A general anesthesia permit shall expire on the date provided
in Section 1715 which next occurs after its issuance, unless it is
renewed as provided in this article.
(d) This article does not apply to the administration of local
anesthesia or to conscious-patient sedation.

1646.2. (a) A dentist who desires to administer or order the
administration of general anesthesia shall apply to the board on an
application form prescribed by the board. The dentist must submit an
application fee and produce evidence showing that he or she has
successfully completed a minimum of one year of advanced training in
anesthesiology and related academic subjects approved by the board,
or equivalent training or experience approved by the board, beyond
the undergraduate school level.
(b) The application for a permit shall include documentation that
equipment and drugs required by the board are on the premises.

1646.3. Any dentist holding a permit shall maintain medical
history, physical evaluation, and general anesthesia records as
required by board regulations.

1646.4. (a) Prior to the issuance or renewal of a permit for the
use of general anesthesia, the board may, at its discretion, require
an onsite inspection and evaluation of the licentiate and the
facility, equipment, personnel, and procedures utilized by the
licentiate. The permit of any dentist who has failed an onsite
inspection and evaluation shall be automatically suspended 30 days
after the date on which the board notifies the dentist of the
failure, unless within that time period the dentist has retaken and
passed an onsite inspection and evaluation. Every dentist issued a
permit under this article shall have an onsite inspection and
evaluation at least once every five years. Refusal to submit to an
inspection shall result in automatic denial or revocation of the
permit.
(b) The board may contract with public or private organizations or
individuals expert in dental outpatient general anesthesia to
perform onsite inspections and evaluations. The board may not,
however, delegate its authority to issue permits or to determine the
persons or facilities to be inspected.

1646.5. A permittee shall be required to complete 24 hours of
approved courses of study related to general anesthesia as a
condition of renewal of a permit. Those courses of study shall be
credited toward any continuing education required by the board
pursuant to Section 1645.

1646.6. (a) The application fee for a permit or renewal under this
article shall not exceed two hundred fifty dollars ($250).
(b) The fee for an onsite inspection shall not exceed three
hundred fifty dollars ($350).
(c) It is the intent of the Legislature that fees established
pursuant to this section be equivalent to administration and
enforcement costs incurred by the board in carrying out this article.
(d) At the discretion of the board, the fee for onsite inspection
may be collected and retained by a contractor engaged pursuant to
subdivision (b) of Section 1646.4.

1646.7. (a) A violation of this article constitutes unprofessional
conduct and is grounds for the revocation or suspension of the
dentist's permit, license, or both, or the dentist may be reprimanded
or placed on probation.
(b) A violation of any provision of this article or Section 1682
is grounds for suspension or revocation of the physician's and
surgeon's permit issued pursuant to this article by the Dental Board
of California. The exclusive enforcement authority against a
physician and surgeon by the Dental Board of California shall be to
suspend or revoke the permit issued pursuant to this article. The
Dental Board of California shall refer a violation of this article by
a physician and surgeon to the Medical Board of California for its
consideration as unprofessional conduct and further action, if deemed
necessary by the Medical Board of California, pursuant to Chapter 5
(commencing with Section 2000). A suspension or revocation of a
physician and surgeon's permit by the Dental Board of California
pursuant to this article shall not constitute a disciplinary
proceeding or action for any purpose except to permit the initiation
of an investigation or disciplinary action by the Medical Board of
California as authorized by Section 2220.5.
(c) The proceedings under this section shall be conducted in
accordance with Chapter 5 (commencing with Section 11500) of Part 1
of Division 3 of Title 2 of the Government Code, and the Dental Board
of California shall have all the powers granted therein.

1646.8. Nothing in this chapter shall be construed to authorize a
dentist to administer or directly supervise the administration of
general anesthesia for reasons other than dental treatment, as
defined in Section 1625.

1646.9. (a) Notwithstanding any other provision of law, including,
but not limited to, Section 1646.1, a physician and surgeon licensed
pursuant to Chapter 5 (commencing with Section 2000) may administer
general anesthesia in the office of a licensed dentist for dental
patients, without regard to whether the dentist possesses a permit
issued pursuant to this article, if both of the following conditions
are met:
(1) The physician and surgeon possesses a current license in good
standing to practice medicine in this state.
(2) The physician and surgeon holds a valid general anesthesia
permit issued by the Dental Board of California pursuant to
subdivision (b).
(b) (1) A physician and surgeon who desires to administer general
anesthesia as set forth in subdivision (a) shall apply to the Dental
Board of California on an application form prescribed by the board
and shall submit all of the following:
(A) The payment of an application fee prescribed by this article.
(B) Evidence satisfactory to the Medical Board of California
showing that the applicant has successfully completed a postgraduate
residency training program in anesthesiology that is recognized by
the American Council on Graduate Medical Education, as set forth in
Section 2079.
(C) Documentation demonstrating that all equipment and drugs
required by the Dental Board of California are possessed by the
applicant and shall be available for use in any dental office in
which he or she administers general anesthesia.
(D) Information relative to the current membership of the
applicant on hospital medical staffs.
(2) Prior to issuance or renewal of a permit pursuant to this
section, the Dental Board of California may, at its discretion,
require an onsite inspection and evaluation of the facility,
equipment, personnel, including, but not limited to, the physician
and surgeon, and procedures utilized. At least one of the persons
evaluating the procedures utilized by the physician and surgeon shall
be a licensed physician and surgeon expert in outpatient general
anesthesia who has been authorized or retained under contract by the
Dental Board of California for this purpose.
(3) The permit of a physician and surgeon who has failed an onsite
inspection and evaluation shall be automatically suspended 30 days
after the date on which the board notifies the physician and surgeon
of the failure unless within that time period the physician and
surgeon has retaken and passed an onsite inspection and evaluation.
Every physician and surgeon issued a permit under this article shall
have an onsite inspection and evaluation at least once every six
years. Refusal to submit to an inspection shall result in automatic
denial or revocation of the permit.