††††† 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 patientís name;

††††† (2) The patientís date of birth;

††††† (3) The patientís medical history;

††††† (4) The patientís dental history;

††††† (5) The patientís 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 patientís 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 boardís Web site at http://dentistry.ky.gov. (37 Ky.R. 1931; 2378; eff. 5-6-2011.)