Oregon board of dentistry nitrous oxide permit form 2025

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How to use or fill out Oregon Board of Dentistry Nitrous Oxide Permit Form

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your name and Oregon License Number in the designated fields. Ensure that all information is accurate to avoid processing delays.
  3. Fill out your mailing and business addresses, including city, state, and zip code. This information is crucial for correspondence regarding your application.
  4. In Section I, provide detailed descriptions of your formal training in nitrous oxide administration. Include course titles, hours spent in clinic and classroom settings, and sponsoring institutions.
  5. For Section II, outline your pre-operative evaluation procedures and attach any relevant documents such as informed consent forms and health history forms.
  6. Continue with Sections III to V by describing your operative procedures, post-operative standards, and emergency protocols. Be thorough to ensure compliance with board requirements.
  7. Finally, review all entries for accuracy before signing and dating the form at the bottom. Submit the completed form along with the $40 fee as instructed.

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Dental. CE Requirements: ​40 hours of CE related to direct clinical patient care or the practice of dental public health every renewal cycle. three hours of medical emergencies every renewal cycle.
Either code D1120 or D1110 may report a prophy performed on a patient with transitional dentition, that is, a mix of primary and permanent dentition. For instance, a child with transitional dentition can be reported with D1110 the Adult Prophy code.
Classes of Anesthesia Permit The Board shall issue the following classes of permits: (1) A Nitrous Oxide Permit authorizes a dental hygienist or a dentist to induce nitrous oxide sedation. (2) A Minimal Sedation Permit authorizes a dentist to induce minimal sedation and nitrous oxide sedation.
D9222 -- Deep sedation/general anesthesia - first 15 minutes. D9223 -- Deep sedation/general anesthesia - each subsequent 15-minute increment. D9239 -- Intravenous moderate (conscious) sedation/analgesia - first 15 minutes. D9243 -- Intravenous moderate (conscious) sedation/analgesia - each subsequent 15-minute
Providers are required to indicate inhalation of nitrous oxide using CDT (Current Dental Terminology) procedure code D9230 (Inhalation of nitrous oxide/analgesia, anxiolysis) on all PA (prior authorization) requests and claims.

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Code D9230 is to be used for inhalation of nitrous oxide/analgesia, anxiolysis.
(1) A business that makes retail sales of nitrous oxide canisters from which an individual may directly inhale nitrous oxide, or an employee of the business, may not sell or deliver a nitrous oxide canister from which an individual may directly inhale nitrous oxide to an individual who is under 18 years of age.

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