A dentist may only delegate the ordering of anesthesia if the dentist possesses the appropriate level of anesthesia permit for the type of anesthesia service being ordered. If the dentist does not possess the appropriate level of permit, the order for anesthesia would need to come from a physician (M.D. or D.O.) qualified to write the order. In an outpatient setting, such as a dentist’s office, the CRNA would also be subject to Board Rule 221.16, unless the office facility was exempt as provided for under that same rule. This CRNA will need to register as an outpatient anesthesia provide and comply with the requirements of Rule 221.16. Please note the exemption regarding CRNAs providing only anxiolysis and analgesia is no longer applicable. If you are providing anxiolysis and analgesia for dental procedures, please be certain to register as an outpatient anesthesia provider with the Texas Board of Nursing.
The Texas State Board of Dental Examiners requires dentists to supervise the CRNA when delegating. It is important to note that there are no Texas Board of Nursing laws or regulations requiring a CRNA to be supervised. In other words, if there is a non-dentist provider who can delegate to the CRNA, then supervision is not required.