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Rule Change Officially Expands Who Administers Drugs In Dentist Offices

A new rule officially expands who can administer anesthesia in a dentist’s office. The change was one of many considered by members of the South Dakota legislative rules review committee.

The rule allows a dentist that holds a general anesthesia and deep or moderate sedation permit to authorize a dental hygienist, registered dental assistant or dental assistant to inject medication. That person must take what’s known as a DAANCE class before they can begin administering drugs. This is already happening in practice in some places in South Dakota due to a declaratory ruling in 2007. Proponents say a formal rule is more appropriate. They say allowing hygienists and assistants to administer anesthesia is more efficient. South Dakota State Board of Dentistry President Roger Wilson says the doctor supervises the entire process.
“The drugs that he’s giving consent for have been drawn up by him prior to any order to give the drug,” Wilson says. “So not only is he personally in charge, he’s drawn up the drugs, and he’s absolutely watching what she does. So as I mentioned earlier, this is an extension of his hand.”
The South Dakota State Medical Association opposes the rule. Lawyer Justin Bell says it means someone with no college degree could administer anesthesia.
“What these rules would allow is somebody who takes a DAANCE certification class and practices for six months in a dental office to end up administering and injecting anesthesia, a very dangerous drug, to patients," Bell says. "And we think that’s a bad idea for patient safety.”
Bell also says the change should be made at a legislative level, not a rule level.
The committee voted four to one to uphold the rule change.