1. A. Class I Permit. To qualify for a Class I permit, the dentist who will perform the administration shall pass:

   1. (1) An office inspection evaluation;
   2. (2) A clinical evaluation consistent with the age level of the patients treated by the dentist;
   3. (3) An evaluation of the dentist to safely administer sedation techniques; and
   4. (4) An evaluation of the ability of the dentist to effectively respond to sedation related emergencies.
2. B. The clinical evaluation required in §A of this regulation shall require the participation of the office staff.

3. C. The clinical evaluation required by §A(2) of this regulation shall include evaluating treatment of at least the following:

   1. (1) Laryngospasm;
   2. (2) Foreign body airway obstruction;
   3. (3) Emergency airway management;
   4. (4) Emesis and aspiration;
   5. (5) Acute allergic reaction;
   6. (6) Bronchospasm;
   7. (7) Angina;

   8. (8) Conditions requiring advanced cardiac life support, including:

      1. (a) Bradycardia;
      2. (b) Tachycardia;
      3. (c) Ventricular fibrillation; and
      4. (d) Cardiac arrest;
   9. (9) Hypotension;
   10. (10) Hypoglycemia;
   11. (11) Hypertension;
   12. (12) Seizure; and
   13. (13) Syncope.

4. D. Class II or Class III Permit.

   1. (1) To qualify for a Class II or Class III permit, the dentist who will perform the administration shall pass an administration evaluation that consists of an office inspection and clinical evaluation.

   2. (2) The clinical evaluation required by §D(1) of this regulation shall:

      1. (a) Require the participation of the clinical office staff; and

      2. (b) Evaluate the technical competency of the dentist to:

         1. (i) Safely administer moderate parenteral sedation, deep sedation, or general anesthesia; and
         2. (ii) Effectively respond to anesthesia related emergencies.

5. E. The clinical evaluation required by §D(1) of this regulation shall include evaluating the treatment of at least the following:

   1. (1) Laryngospasm;
   2. (2) Foreign body airway obstruction;
   3. (3) Emergency airway management;
   4. (4) Emesis and aspiration;
   5. (5) Acute allergic reaction;
   6. (6) Bronchospasm;
   7. (7) Angina;

   8. (8) Conditions requiring advanced cardiac life support, including:

      1. (a) Bradycardia;
      2. (b) Tachycardia;
      3. (c) Ventricular fibrillation; and
      4. (d) Cardiac arrest;
   9. (9) Hypotension;
   10. (10) Hypoglycemia;
   11. (11) Hypertension;
   12. (12) Seizure;
   13. (13) Syncope; and
   14. (14) Venipuncture complications.

Authority: Health Occupations Article, §4-205, Annotated Code of Maryland

Effective date: February 11, 1985 (12:3 Md. 245)

Regulation .04 amended effective March 8, 1999 (26:5 Md. R. 392)

Regulation .07B, C amended effective September 23, 1996 (23:19 Md. R. 1376)

Regulation .09 amended effective February 19, 1990 (17:3 Md. R. 300); March 8, 1999 (26:5 Md. R. 392)

Regulation .10C amended effective September 23, 1996 (23:19 Md. R. 1376); March 8, 1999 (26:5 Md. R. 392)

Regulations .01—.13 under General Anesthesia, repealed, and new Regulations .01—.37 under Anesthesia and Sedation, adopted effective January 4, 2010 (36:18 Md. R. 1380)

Chapter revised effective May 11, 2015 (42:9 Md. R. 648)

Regulation .11A amended effective December 30, 2019 (46:26 Md. R. 1165)

Regulation .21G amended effective December 30, 2019 (46:26 Md. R. 1165)