(a) Previous Nitrous Oxide Monitoring Certificate Holders.
  (1) Until September 1, 2019, the State Board of Dental Examiners shall issue a "nitrous oxide monitoring registration" to a dental assistant who holds a current nitrous oxide monitoring certificate issued by the board before that date and who meets the continuing education requirements established by the board under 22 TAC §114.12 (relating to Continuing Education for Certificate Holders). These persons will not be required to meet the requirements of subsection (d) of this section to obtain or renew the nitrous oxide monitoring registration. A nitrous oxide monitoring registration must be renewed biennially in accordance with the requirements of Tex. Occ. Code §265.0017 and 22 TAC §114.2(d) (relating to Registration of Dental Assistants).
  (2) Beginning on September 1, 2019, the board shall cease issuing nitrous oxide monitoring registrations to any person who does not comply with the provisions of subsection (d) of this section. Persons who have obtained a nitrous oxide monitoring registration under paragraph (a)(1) of this subsection may continue to practice and renew their nitrous oxide monitoring registrations. Nitrous oxide monitoring registrations which have been expired more than one year may not be renewed, and instead shall require qualification under subsection (d) of this section.
(b) The following words and terms, when used in this section, shall have the following meanings, unless the context clearly indicates otherwise:
  (1) "Dental industry professional organization" any organization, the primary mission of which is to represent and support dentists, dental hygienists, and/or dental assistants.
  (2) "Didactic education" requires the presentation and instruction of theory and scientific principles.
  (3) "Direct Supervision" requires that the dentist responsible for the procedure shall be physically present during patient care and shall be aware of the patient's physical status and well-being.
(c) A Texas-licensed dentist may delegate the monitoring of the administration of nitrous oxide to a dental assistant, if the dental assistant:
  (1) works under the direct supervision of the licensed dentist; and
  (2) holds a current nitrous oxide monitoring registration granted by the provisions of this rule.
(d) A dental assistant wishing to obtain nitrous oxide monitoring registration under this section must:
  (1) pay an application fee set by board rule; and
  (2) on a form prescribed by the board, provide proof that the applicant has:
    (A) a dental assistant registration issued by the board pursuant to 22 TAC §114.2 that is not expired and is not under probated or enforced suspension;
    (B) successfully completed a current course in basic life support; and
    (C) completed a minimum of 8 hours of didactic education and testing in monitoring the administration of nitrous oxide taken through a CODA-accredited dental, dental hygiene or dental assisting program, approved by the board, whose course of instruction includes:
      (i) Texas jurisprudence, including but not limited to: anesthesia standard of care, anesthesia/analgesia, enteral conscious sedation, and this rule, regarding monitoring the administration of nitrous oxide;
      (ii) dental anatomy and physiology;
      (iii) pharmacology;
      (iv) sedation equipment;
      (v) infection control;
      (vi) patient monitoring; and
      (vii) recognition and management of medical emergencies.
(e) The jurisprudence assessment may be completed to satisfy the requirements set out in subsection (d)(2)(C)(i) of this section.
(f) A program seeking to offer a course in monitoring the administration of nitrous oxide must submit a written request for approval to the board demonstrating that it meets the requirements set forth in subsection (d)(2)(C) of this section. Additionally, all courses must include a mandatory competency evaluation with a minimum of 50 test items. Course documentation must be maintained by the course provider for no less than three years.
(g) Approved courses may be offered at annual meetings of dental industry professional organizations.
(h) Courses taken to satisfy the requirements of this section are valid for five (5) years from the date of course completion for nitrous oxide monitoring registration purposes.
(i) Applicants for nitrous oxide monitoring registration under this rule are ineligible if they are in violation of a board order at the time of application.

Source Note: The provisions of this §114.4 adopted to be effective February 25, 2007, 32 TexReg 627; amended to be effective January 3, 2019, 43 TexReg 8594