TMA Challenges Dentists' Sleep Apnea Rule

Dentists should not independently diagnose and treat sleep apnea because they are not trained to do so, TMA told officials of the Texas State Board of Dental Examiners.

"It is beyond the scope of practice of dentistry in Texas to diagnose a medical disease or disorder, including a sleep disorder, or to independently treat such disorder once diagnosed," TMA President Stephen L. Brotherton, MD, said in a letter to the board's executive director.

Among TMA's concerns, Dr. Brotherton wrote, is that the dental board is considering adopting a rule that allows dentists to diagnose and treat sleep apnea in collaboration with a physician and that says a "dentist shall ensure that the patient has been evaluated by the physician for a sleep disorder in compliance with the Texas Medical Practice Act and Texas Medical Board rules, and is being monitored by the physician for potential complications of the sleep disorder."

Dr. Brotherton said that language "would not only impose an undue burden on a dentist, but it would require knowledge beyond the scope of a dentist's training or license. A dentist cannot know if a physician is acting in compliance with the Medical Practice Act and Texas Medical Board rules, because a dentist does not practice medicine or have medical training. It would be inappropriate for a dentist to oversee, monitor, or judge a physician's treatment of a patient."

His letter also said other provisions of the rule could be misinterpreted to expand the scope of dentistry.

Supreme Court Lets Scope Ruling Stand 
The Texas Supreme Court decided not to review TMA's case against the Texas State Board of Chiropractic Examiners, in which the association argued that chiropractors are not allowed to diagnose. The ruling leaves standing TMA's successful challenge to the board's manipulation-under-anesthesia and needle electromyography regulations. It also has the effect of allowing chiropractors to make a chiropractic diagnosis limited to their scope of practice, as statutorily defined.

TMA is considering whether to continue with its constitutional challenge when it is remanded back to the trial court.


Action, July 1, 2013


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