REVIEW NEW ADMINISTRATIVE RULES
A brief summary of the subject matter and reasons for adopting those rules are found in the following sections as follows:
Aside from the introduction of authorizing dental hygienists and dental assistants duties for administration of nitrous oxide, most of the requirements are not new to sedation and anesthesia permit holders and at the same time reflect the most recent peer reviewed literature for sedation and anesthesia. During the site evaluation process many of the same requirements had to be met in order to become authorized by permit to administer sedation or anesthesia. The addition of new rules address concerns that were not discussed in the site evaluation or permit process. For example, record keeping, requirements for education of auxiliary and their role in assisting the sedation or anesthesia provider, mock code requirements, reporting requirements, emergency management requirements/standards must be provided for patient monitoring. The Board also added provisions for anesthesia providers who are not dentists, e.g., CRNA, or are an “other” dentist providing sedation or anesthesia for a” host” dentist’s patient.
Under new rules, a registered dental assistant (RDA) or a registered dental hygienist (RDH) authorized by permit and under the indirect supervision of a dentist may administer nitrous oxide analgesia to a patient who has not taken sedative medications. Previously the RDA and RDH were strictly authorized to monitor a patient for whom Nitrous Oxide analgesia has been initiated by the dentist or may lower the amount of nitrous. To develop course curriculum requirements, the Board consulted with dental hygiene programs in ND and MN.
20-02-01-06. Continuing dental education for dentists. In this section “clinical” continuing education is stressed and the board further clarifies who may proctor continuing education which qualifies for classroom style or “in person” continuing education. The Board adjusted the number of CE hours for practitioners who are anesthesia/sedation permit holders. Technology for simulated dental emergencies now exists and the Board unanimously moved to require this simulated training every five years for moderate, deep sedation and general anesthesia providers effective January 1, 2026.
Dental assisting duties were also on the radar of the American Teledentistry Association and Smile Direct Club as they opposed supervision levels for the duty of digital scans and intra oral cameras which are used for diagnostic and/or appliance fabrication purposes. The Board responded by deleting the duty for dental assistants that are not qualified or registered and moved to allow qualified and registered dental assistants who have the additional level of training to provide this duty under general supervision which is the broadest level of supervision for auxiliary.
The dental assisting section was reorganized according to level of supervision required to perform duties with consideration given to level of training and education. Four new and very basic duties were added to the section related to a non-registered dental assistant. One new duty was provided for a qualified dental assistant. Duties which may be provided under general supervision for the registered dental assistant were expanded.
Assistants provided comments on use of the slow speed handpiece when providing restorative duties. The consensus of the Board was that the high-speed handpiece has the capability of providing greater damage to tooth structure and therefore opined that the adjustments to amalgam or glass ionomer restorations could be done with less risk to the patient and therefore opted to stay with the slow speed handpiece utilization restriction.
The board may grant a license to practice dentistry to an applicant who has met the requirements of North Dakota Century Code section 43-28-10.1 and all the following requirements:
Requirements of Temporary License for Military Spouses
1. The NDBDE (the board) shall grant on a case-by-case basis exceptions to the board's licensing standards to allow a military spouse to practice the occupation or profession in the state if upon application to the board:
2. The board shall issue a provisional license or temporary permit to a military spouse for which the licensure requirements under subsection 1 have been substantially met. A board may not charge a military spouse any fees for a provisional license or temporary permit under this subsection. A provisional license or temporary permit issued under this subsection may not exceed two years and remains valid while the military spouse is making progress toward satisfying the unmet licensure requirements. A military spouse may practice under a provisional license or temporary permit issued under this subsection until any of the following occurs:
3. The board that may elect to subject the board to this chapter under subsection 1 of section 43-51-01 may issue a license, provisional license, or temporary permit to a military spouse in the same manner as provided under subsections 1 and 2 regardless of whether the board has adopted rules to subject the board to this chapter.
4. A military spouse issued a license under this section has the same rights and duties as a licensee issued a license under the traditional licensure method.
5. If within thirty days of receipt of a completed application under subsection 1 the board does not grant or deny a license under subsection 1 or does not issue a provisional license or temporary permit under subsection 2, the board automatically shall issue a provisional license or temporary permit. A provisional license or temporary permit issued under this subsection remains valid until the board grants or denies the application for licensure under subsection 1 or issues a provisional license or temporary permit under subsection 2.
Both fees are required in order to obtain and maintain a license and registration with the NDSBDE. The initial license application fee is paid to initiate administrative processes and verifications that must be completed by the Board's administrative office. The renewal fee, grants the license for the following two year period. Failure to pay the renewal fee will cause the license to expire.
If a licensee fails to renew the license by December 31st of odd numbered years, the practitioner may not practice dentistry. It is illegal to practice dentistry without a valid license.
Within 60 days after December 31st of the odd-numbered year, an expired license may be renewed by submitting the renewal application, the application fee, late fee and proof of continuing education, the license may not be renewed and the dentist must apply for and meet the requirements for licensure to be granted a license.
If you do not receive a renewal notice in the mail by November 15th of odd numbered years, call the Board immediately.
New license applicants: The Initial License Application must received by the Executive Director of the Board at least thirty days before the Board meeting at which it is considered. The applicant shall enclose with the application a recent autographed picture of the applicant and an application fee as determined by the Board by rule. NDCC § 43-28-11. Application fees are nonrefundable.
Initial applications must be completed within six months and accompanied by the appropriate fee. If an applicant fails to complete the requirements for licensure within six months of the applications post mark, the application and fee are no longer valid. Applications which are not notarized, submitted without the required licensing fee, or without the applicant’s signed photo will be returned. All application fees are non-refundable.
ID: In lieu of applications being notarized, the Board accepts current identification documents issued within the last five years. Acceptable ID means a valid driver's license, U.S. passport, or identification card issued by any branch of the armed forces of the United States. Attach a copy of the valid proof of identification to the application.
The Board investigates a dentist’s fitness, qualification, and previous professional record and performance. The Board may seek information from recognized data sources, including the National Practitioners Data Bank, American Association of Dental Boards, liability insurers, health care institutions, and law enforcement agencies. The Board requires initial license applicants to submit to a statewide and nationwide criminal history check.
Name and address changes may be submitted in writing or by email. Name changes must be accompanied by a copy of the name change document (marriage license, section in the divorce decree, etc.)
The Board charges $50 if you wish to have a new large certificate mailed to you. The Board only signs certificates at quarterly meetings. You must send a request for the certificate and a check or money order for $50 payable to NDBDE.
Subject to the exceptions described in rule 20-02-01-13, prior to the initial prescribing of any controlled substance, including samples, a dentist authorized by the DEA to prescribe, administer, sign for, dispense or procure pharmaceuticals shall authorize an employee to review or personally request and reivew the presription drug monitoring program report for all availale preeescription drug monitoring program data on the patient within the previous twelve months. Please review the rules carefully as well as the 20-02-01-13 - Exceptions to the review requirement.
When submitting a self-report to the Board, submit copies of all supporting documentation. Supporting documents may include a copy of criminal charges, police reports, judgement and disposition of criminal complaint; disposition of the offense; final disposition; any orders or any pending actions; court records, settlement agreements; copies of evaluations or assessments and recommendations for treatment if any were issued.
According to the NDBDE's reporting laws, a licensee must report to the board in writing within sixty days of the event any illegal, unethical, or errant behavior or conduct of the dentist, including malpractice judgements or settlements or final judgment for or against the licensee, a final disposition regarding the surrender of a license, adverse action taken against a license by a licensing agency in another state, territory, or country; all proceedings, or formal or informal actions by a governmental agency; a law enforcement agency; or a court for an act or conduct that would constitute grounds for discipline.
A licensee must also report a mortality or other incident occurring in an outpatient facility of the dentist which results in temporary or permanent physical or mental injury requiring hospitalization of the patient during or as a direct result of a dental procedure or related use of general anesthesia, deep sedation, conscious sedation with a parenteral drug, or enteral sedation within sixty days of the event.
A dentist shall advise the board in a timely manner if the dentist reasonably believes another dentist has committed an illegal or immoral act or has otherwise failed to make a report.
The Board believes that a fundamental component of good dental practice includes the appropriate evaluation and management of pain. While all dentists do not require DEA authorization to practice within their specialty or as general dentists, responsibly prescribed opioid medications and psychological and physical symptoms of opioid abuse may help North Dakota licensees treat their patients' pain safely and effectively.
It is the duty of any licensee prescribing opioid medications to be knowledgeable of both the therapeutic benefits, risks, and potential harm associated with opioid treatment. The Board of Dental Examiners expects any licensee prescribing opioids for the treatment of pain to review Administrative Rule 20-02-01-12 regarding the initial prescribing of any controlled substance, including samples. The Board notes that a failure to provide opioid treatment consistent with Administrative Rules regarding prescribing, may subject a licensee to disciplinary action by the Board.
The publications provided reflect the most current medical and scientific research and recommended practices for prescribers. While these guidelines do not constitute regulations, practitioners may find that these guidelines can provide useful information to licensees related to the appropriate considerations to be made prior to and during treatment plans involving opioids.
CDC Guideline for Prescribing Opioids for Chronic Pain
The CDC has also provided a number of useful resources related to Nonopioid Treatments, Assessing Benefits and Harms, Calculating Dosage, and Tapering.
ONE Rx (Opioid and Naloxone Education) provides North Dakota with a proactive approach to assess opioid-related risks. It's an opportunity to provide upstream prevention of opioid misuse and accidental overdose.To find tools to help equip providers to screen patients prescribing an opioid medication and provide education, resources and support to ensure safe medication use, please visit the following website, you'll be glad you did:
ONE Rx HEALTH PROFESSIONALS and ONE Rx DENTAL RESOURCES to find resources to help dental providers with office-based screening.
