Rule XVII.  Administration of Nitrous Oxide/Oxygen Inhalation
(Amended February 1, 1998; August 11, 2004; October 26, 2006;
April 25, 2007) 

A.   When conscious sedation is accomplished solely by means of nitrous oxide/oxygen inhalation 
       techniques, then this Rule shall apply.
  B.   The administration of nitrous oxide may be delegated to another dentist whose qualifications meet the education and training requirements of Rule XIV, a qualified physician anesthetist, or a certified registered nurse anesthetist.
C.   Education/Training Requirements:
	1.    In order to administer and induce conscious analgesia solely by means of nitrous   oxide/oxygen inhalation techniques, a dentist shall complete a course(s)                                    conducted at an institution accredited by the American Dental Association Commission on Dental Education or certified by the Colorado Department of Higher Education Division of Private Occupational Schools. The course(s) must have a minimum of sixteen (16) hours, including four (4) patient contact hours. As of January 1, 1994, the Board required all dentists who did not meet the requirements of subsection 2. below to submit an application and documentation of training in nitrous oxide/oxygen administration.
2.   A Colorado licensed dentist who has safely administered conscious analgesia solely by means of nitrous oxide/oxygen inhalation techniques within the State of Colorado for the three (3) years prior to October 30, 1987, should be deemed to have satisfied, the education/training specified under this Rule in making a determination on safe administration and inducement of conscious analgesia accomplished solely by means of nitrous oxide/oxygen inhalation techniques, the Board shall consider any and all anesthesia/analgesia related incidents, accidents or complaints filed against the licensee.
3.	The dentist and all personnel, including but not limited to, dental hygienists and dental auxiliaries, who render patient care services in a dental setting where nitrous oxide/oxygen is administered shall have proof of current basic life support (BLS) knowledge and skills.
4.	Upon its determination that the applicant has met the requirements found in either Rule XVII.C.1 or 2, the Board shall issue a permit to administer nitrous oxide/oxygen.  Any violation of this Rule XVII may result in suspension or revocation of the permit to administer nitrous oxide/oxygen.
             D.   Examination: Upon the effective date of this Rule, prior to administration of nitrous oxide/oxygen, the dentist, dental hygienist, or auxiliary shall record, in the patient’s chart, the patient’s medical and pertinent physical findings.
E.   Documentation: Upon the effective date of this Rule, when administering nitrous oxide/oxygen, the dentist, dental hygienist, or auxiliary shall record, in the patient's chart, the treatment given, the dosage administered and the patient's response to treatment.
F.   Emergency Care: Prior to the administration of nitrous oxide/oxygen, the supervising dentist, dental hygienist, and auxiliaries shall have appropriate training to recognize the symptoms and reasonably treat the complications and emergencies incident thereto.
G.   Office Facilities and Equipment: If conscious analgesia is accomplished solely by means of nitrous oxide/oxygen inhalation techniques, then the supervising dentist shall provide and ensure the following:
1.        Fail safe mechanisms in the delivery system and an appropriate scavenging system;
2.	The inhalation equipment must be evaluated for proper operation and delivery of inhalation agents prior to use on each patient;
3.       Determination of adequate oxygen supply must be completed prior to use with each     patient;
4.       Baseline vital signs may be obtained at the discretion of the operator depending on the medical status of the patient and the nature of the procedure to be performed; AND,
5.       Appropriate equipment to monitor vital signs and maintain an adequate airway including but not limited to a blood pressure cuff, stethoscope and a method for administering positive pressure oxygen.
H.         Delegating under direct supervision the monitoring and administration of nitrous oxide/oxygen to appropriately trained personnel pursuant to section 12-35-113 (1) (q), C.R.S.:
     1.      The supervising dentist is responsible for determining the maximum dosage of nitrous     oxide/oxygen analgesia and must record the dosage in the patient's dental chart prior to delegation; AND,  
	2.       The supervising dentist delegating must be approved by the Board under this Rule to administer nitrous oxide/oxygen; AND, 
3.       The dental hygienist or dental auxiliary accepting the delegation of the administration and monitoring of nitrous oxide/oxygen under direct supervision shall ensure that the dentist is approved by the Board to administer nitrous oxide/oxygen; AND, 
4.        Education/Training Requirements for dental hygienists and auxiliaries administering and monitoring nitrous oxide/oxygen under direct supervision;
	a.  In order to administer and induce conscious analgesia solely by means of    nitrous oxide/oxygen inhalation techniques, a dental hygienist or a dental auxiliary shall complete a course(s) conducted at an institution accredited by the American Dental Association Commission on Dental Education or certified by the Colorado Department of Higher Education Division of Private Occupational Schools. The course(s) must have a minimum of sixteen (16) hours, including four (4) patient contact hours. The dental hygienist and dental auxiliary shall certify to the Board, on a form approved by the Board, compliance with the educational requirement.
I. 	 “Monitoring”, as that term is used in Rule XVII means:
1.   The continual observation of the patient to ensure the stable physical condition of the patient and maintenance of a proper level of nitrous oxide/oxygen inhalation as determined by the supervising dentist; OR
2.   The continual observation of the patient to ensure stable physical condition of the patient during recovery from the nitrous oxide/oxygen inhalation.
  3.	Unless a dental hygienist or dental auxiliary has received the training to administer nitrous
oxide/oxygen inhalation, they may only monitor (observe) a patient during the use of nitrous oxide/oxygen inhalation. Monitoring may only be delegated under the direct supervision of a dentist approved/authorized to administer nitrous oxide/oxygen inhalation.
J.  	All equipment, as provided for in this Rule XVII shall be functional and operative at all times.
K.         Morbidity and Mortality Report - A completed written report shall be submitted to the Board by the    supervising dentist and any other person administering the nitrous oxide/oxygen inhalation within fifteen (15) days of any nitrous oxide/oxygen inhalation related incident resulting in patient morbidity or mortality which occurred while the patient was under the care of the dentist, and required hospitalization, emergency facility care, or emergency service response.
	1.  Such report shall include all of the following items:
	a.  Description of dental procedure;
	b.  Description of preoperative physical condition of the patient;
	c.  List of the drugs and dosages administered;
	d.  Detailed description of techniques utilized in administering the nitrous oxide;
	e.  Description of adverse occurrence to include:
	1)  Detailed description of symptoms of any complications including, but 
     not limited to, onset and type of symptoms in patient;
	2)  Treatment instituted on patient; AND, 
	3)  Response of the patient to treatment.
                  f.   Description of the patient's condition on termination of any procedure    undertaken.
	2.  The Board may request inspection of any written records related to this report.
3.  Pursuant to section 12-35-107(1)(d), C.R.S., the Board may request an on-site    evaluation of the dental facility related to this report.

Rule XXVI - Advertising (Effective August 1, 2000)
(Temporarily Expired December 2, 2002)
(Effective July 1, 2003; Amended October 27, 2004)
(Amended October 26, 2006 and Effective December 31, 2006)
(Amended April 25, 2007 and Effective July 1, 2007)

This rule applies to advertising in all types of media that is directed to the public. No dentist or dental hygienist shall advertise in any form of communication in a manner that is misleading, deceptive or false.

A.	Misleading, deceptive, or false advertising includes, but is not limited to the following, and if proven is a violation of Section 12-35-129 (1), C.R.S.: 

	(1)	A known material misrepresentation of fact;

(2)	Omits a fact necessary to make the statement considered as a whole not materially misleading;

(3)	Is intended to be or is likely to create an unjustified expectation about the results the dentist or dental hygienist can achieve;

(4)	Contains a material, objective representation, whether express or implied, that the advertised services are superior in quality to those of other dental or dental hygiene services if that representation is not subject to reasonable substantiation.  For the purposes of this subsection, reasonable substantiation is defined as tests, analysis, research, studies, or other evidence based on the expertise of professionals in the relevant area that have been conducted and evaluated in an objective manner by persons qualified to do so, using procedures generally accepted in the profession to yield accurate and reliable results.  Individual experiences are not a substitute for scientific research.  Evidence about the individual experience of consumers may assist in the substantiation, but a determination as to whether reasonable substantiation exists is a question of fact on a case-by-case basis;

(5)	Claims that state or imply a specialty practice by a general dentist in violation of section (B) hereof;

(6)	The false or misleading use of a claim regarding Board certification, registration, listing, education, or an unearned degree;

(7)	Advertisement that uses patient testimonials unless the following conditions are met:

(A)	The patient's name, address, and telephone number as of the time the advertisement was made must be maintained by the dentist or dental hygienist and that identifying information shall be made available to the Board within ten (10) days of a request for the information by the Board.

(B)	Dentists or dental hygienists who advertise dental or dental hygiene services, which are the subject of the patient testimonial, must have actually provided these services to the patient making the testimonial.

(C)	If compensation, remuneration, a fee, or benefit of any kind has been provided to the person in exchange for consideration of the testimonial, such testimonial must include a statement that the patient has been compensated for such testimonial.  

 (D)	A specific release and consent for the testimonial from the patient shall be obtained from the patient which shall be made available to the Board within ten (10) days of request of that information.

(E)	Any testimonial shall indicate that results may vary in individual cases.

(F)	Patient testimonials attesting to the technical quality or technical competence of a service or treatment offered by a licensee must have reasonable substantiation.

(8)	Advertising that makes an unsubstantiated medical claim or is outside the scope of dentistry, unless the dentist or dental hygienist holds a license or registration in another profession and the advertising and/or claim is within the scope authorized by the license or registration in another profession;

(9)	Advertising that makes unsubstantiated promises or claims, including but not limited to claims that the patient will be cured;

(10)	The use of “bait and switch” in advertisements. “Bait and switch” advertising is defined as set forth in the Colorado Consumer Protection Act, Section 6-1-105, C.R.S.;

(11)	The Board recognizes that clinical judgment must be exercised by a dentist or dental hygienist.  Therefore, a good faith diagnosis that the patient is not an appropriate candidate for the advertised dental or dental hygiene service or product is not a violation of this rule;

(12)	If an advertisement includes an endorsement by a third party in which there is compensation, remuneration, fee paid, or benefit of any kind, the endorsement by the third party must indicate that it is a paid endorsement;

(13)	Inferring or giving the appearance that an advertisement is a news item without using the phrase "paid advertisement";

(14)	Promotion of a professional service which the licensee knows or should know is beyond the licensee’s ability to perform;

(15)	The use of any personal testimonial by the licensed provider attesting to a quality or competence of a service or treatment offered by a licensee that is not reasonably verifiable;

(16)	At the time any type of advertisement is placed the dentist or dental hygienist must in good faith possess information that would substantiate the truthfulness of any assertion, omission or claim set forth in the advertisement;

(17)	A licensed dentist or dental hygienist shall be responsible and shall approve any advertisement made on behalf of the dental or dental hygiene practice.  The dentist or dental hygienist shall maintain a listing stating the name and license number of the dentists or dental hygienists who approved and are responsible for the advertisement and shall maintain such list for a period of three (3) years;  

(18)	Advertising that claims to provide services at a specific rate and fails to disclose that the patient’s insurance may provide payment for all or part of the services.

B.	Specialty practice and advertising.

1.	A licensed dentist has the legal authority to practice in any and all areas of dentistry and also the authority to confine the areas in which he or she chooses to practice.

2.	Dental specialties are recognized as only those defined by the American Dental Association and dental specialists are those dentists who have successfully completed a Commission on Dental Accreditation specialty program.  

3.	Practitioners who have successfully completed a Commission on Dental Accreditation accredited specialty program may advertise the practice of that specialty.  Practitioners who have not completed an accredited specialty program, and have limited their practice to a specific Commission on Dental Accreditation defined specialty, must clearly state in all advertising and/or public promotions, that he or she is a general dentist who has limited his or her practice to that field of dentistry.

4.	It is misleading, deceptive or false for general practitioners to list their names, advertise, or promote themselves in any area or location that implies a specialty.  A general practitioner who advertises in any medium under a specialty heading or section may be considered as having engaged in misleading, deceptive or false advertising and may be in violation of section 12-35-129 (1), C.R.S.   

C.	Practitioners who advertise dentistry or dental hygiene shall not make any misleading, deceptive, or false claims to a patient or the general public in any advertisement, business card, letterhead, or envelope, of any recognition, accomplishments, levels of attainment, diplomate status, fellowship status, teaching credentials, or any other form of recognition from an unaccredited school or organization or continuing education program.  Accreditation relating to dentistry and dental hygiene may only come from the Commission on Dental Accreditation.  Any advertisement stating recognition from an unaccredited school, or organization or continuing education program must include a disclaimer that the school, organization or continuing education program is not accredited by the Commission on Dental Accreditation.