201 KAR 8:581. Charity dental practices.

 

      RELATES TO: KRS 313.254(8)

      STATUTORY AUTHORITY: KRS 313.021, 313.060(1),

313.254(8)

      NECESSITY, FUNCTION, AND

CONFORMITY: KRS 313.021(1) requires the board to exercise all of the administrative

functions of the Commonwealth in the regulation of the profession of dentistry,

KRS 313.060(1) requires the board to promulgate administrative regulations

relating to dental practices, and KRS 313.254(8) requires the board to

promulgate administrative regulations relating to the charitable practice of

dentistry. This administrative regulation establishes requirements for

charitable dental practices.

 

      Section 1. Minimum Documentation

Standards for All Dental Patients of a Charitable Dental Practice. Each patient

record for a dental patient of a charitable dental practice in the Commonwealth

of Kentucky shall include at a minimum:

      (1) The patient’s name;

      (2) The patient’s date of birth;

      (3) The patient’s medical history;

      (4) The patient’s dental history;

      (5) The patient’s current

medications from all healthcare providers;

      (6) The date of current treatment;

      (7) The diagnosis;

      (8) The treatment options presented

to the patient;

      (9) The tooth number and surfaces

to be treated, which shall be included in the progress notes;

      (10) The patient’s current blood

pressure reading;

      (11) Informed consent by the

patient; and

      (12) Signature or initials of the

provider.

 

      Section 2. Documentation of

Infection Control Procedures. All charitable dental practices in the

Commonwealth of Kentucky shall adhere to the universal precautions outlined in

the Guidelines for Infection Control in Dental Health-Care Settings published

by the Centers for Disease Control and Prevention and shall retain documentation

proving that:

      (1) All workers have been educated

in the charitable dental practice or post-disaster clinic procedures for

infection control;

      (2) All workers involved in patient

treatment of have received a Hepatitis B vaccination or have signed a waiver;

      (3) A policy is in place requiring

all staff involved in clinical patient care to wear a fresh set of gloves for

each patient;

      (4) A policy is in place to assure

all staff change gloves between patients;

      (5) A policy is in place to assure

all staff wears protective clothing during patient care;

      (6) A policy is in place to assure

all staff wear masks during procedures that may involve spatter;

      (7) The charitable dental practice

contains the necessary supplies to comply with this administrative regulation;

      (8) All hand-pieces are sterilized

following each patient treatment by one (1) of the following means:

      (a) Autoclave;

      (b) Dry heat; or

      (c) Heat or chemical vapor;

      (9) There is routine verification

that sterilization methods are functioning properly;

      (10) Individual burs, hand instruments,

and rotary instruments are either discarded or sterilized following each use;

      (11) A policy is in place that

addresses the disinfection of all operatory equipment and surfaces between

patients;

      (12) All surfaces that are

difficult to disinfect shall be covered with a non-penetrable barrier;

      (13) A policy is in place requiring

that all non-penetrable surfaces are changed between patients;

      (14) Disinfectant is used,

including the name and type of the disinfectant;

      (15) A policy is in place that

describes a separate place for the cleaning, disinfecting, and sterilization of

items, with a mechanism of separation from the patient treatment area that may

be:

      (a) An enclosed instrument table;

      (b) Curtains or wall separation; or

      (c) Bagging of the instruments;

      (16) A policy is in place that

provides for the protection of dental records, charts, and radiographs from

biohazards while those items are in the patient treatment area, or if no

protection exists, charts shall be readily reproducible with limited effort;

and

      (17) An agreement exists with an

agency to properly dispose of all medical waste and bio-hazardous material,

including sharps, instruments, and human tissue.

 

      Section 3. Infection Control

Inspections. (1) The board or its designee may perform an infection control

inspection of a charitable dental practice utilizing the Infection Control

Inspection Checklist.

      (2) A charitable dental practice

that is found deficient upon an initial infection control inspection shall not

be allowed to continue until the clinic coordinator provides proof to the board

that the charitable dental practice is in compliance.

 

      Section 4. General Requirements for

Charitable Dental Practices. All charitable dental practices in the

Commonwealth shall comply with the following requirements:

      (1) The clinic coordinator, who

shall supervise and oversee all charitable dental practice functions, shall be

a Kentucky licensed dentist;

      (2) There shall be a functional

radiograph machine on site;

      (3) Follow-up care provisions shall

be in place for each patient requiring follow-up care;

      (4) A written blood-borne pathogen

exposure control plan shall be kept on site;

      (5) A sharps stick protocol shall

be followed in which:

      (a) The entity that will collect

specimens shall be identified prior to the start of the event; and

      (b) The laboratory that will

perform blood work analysis shall be identified prior to the start of the event;

      (6) Post-operative instructions

shall be delivered to the patient prior to the patient leaving;

      (7) A dentist shall not supervise

more than six (6) students in a charitable dental practice or post-disaster

clinic;

      (8) All procedures shall be

concluded by the end date of the charitable dental practice unless a Kentucky

licensed dentist has stated in writing that the licensee shall complete the procedure

in a timely manner at his practice;

      (9) All charitable dental practices

shall notify the board no less than thirty (30) days prior to the start of an

event of the dates, locations, and host of the event;

      (10) A charitable dental practice

shall provide the names and license numbers of all participating dentists and

dental hygienists no later than fifteen (15) days post-event;

      (11) A prescription for a narcotic

shall not be written during an event unless approved by a designated dental

prescription coordinator who shall hold a full license to practice dentistry in

the Commonwealth of Kentucky. The prescription shall be approved if it is medically

appropriate;

      (12) A written emergency medical

response plan shall be kept on site; and

      (13) All charitable dental

practices larger than forty (40) chairs shall have at least one (1) Basic Life

Support (BLS) ambulance on site for the duration of the event.

 

      Section 5. Registered Dental

Assistants and Auxiliary Personnel. (1) For the purpose of a charitable dental

practice an individual performing a duty in the charity event, other than a licensed

dentist or licensed dental hygienist, shall be restricted to the duties of a

dental auxiliary; and

      (2) A radiograph shall not be taken

unless the person performing the x-ray has met the requirements of 201 KAR 8:571.

 

      Section 6. Incorporation by

Reference. (1) The following material is incorporated by reference:

      (a) "Guidelines for Infection

Control in Dental Health-Care Settings", December 2003; and

      (b) "Infection Control

Inspection Checklist", July 2010.

      (2) This

material may be inspected, copied, or obtained, subject to applicable copyright

law, at the Kentucky Board of Dentistry, 312 Whittington Parkway, Suite 101,

Louisville, Kentucky 40222, Monday through Friday, 8 a.m. to 4:30 p.m. This

material is also available on the board’s Web site at http://dentistry.ky.gov. (37

Ky.R. 1931; 2378; eff. 5-6-2011.)