Hey Texas dental peeps!

I’m going to share something with you about nitrous oxide monitoring. This ‘something’ is bound to ruffle some feathers…

There is a VERY fine line between ‘monitoring’ and ‘administering’ Nitrous Oxide.

The fine line is the difference between an administrative violation for supervising dentists and a felony criminal violation for dental hygienists and dental assistants.

Here it is:

If you have an N2O monitoring certificate issued by the Texas Dental Board you are allowed to monitor a patient during nitrous oxide/oxygen administration once the dentist has placed the N2O on the patient, set the flow rate and verified the patient is ‘stable’.

If it becomes necessary to adjust the concentration, the dentist must make the changes. If you (non-dentist) make the adjustment you are ‘administering’, which outside your scope of practice; it is a felony (Practicing Dentistry Without a License) punishable by up to 10 years in prison and a $10,000 fine.

So, what can you do if it becomes necessary to adjust the nitrous? Simple, notify the dentist or turn the nitrous O-F-F. Restated, you cannot turn the nitrous on, up or down – period.

It is like pulling teeth to get information from the state board about cases they work, but I hear rumors that there are a couple recent State Board cases that specifically speak to the very points I have outlined.

Dentists, don’t put your staff in precarious situations.

Hygienists and Dental Assistants, just say, “No!” if instructed to do something you know you cannot do.

Sure, everybody in the office may be okay with the status quo today, but when things go south and your office relationships sour… odds are the hygienist(s) and assistants won’t actually face prosecution, but the dentist will surely get a sound slap on their dental license by way of sanctions, which are reported to the National Practitioner Data Base (NPDB).

Professional liability carriers and insurance companies reference the NPDB to see who’s on fleek and who is not. This is the equivalent of Santa’s Naughty and Nice list. Trust me when I tell you that you don’t want to be on the Naughty list.

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