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STATE OF MICHIGAN  
DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
BUREAU OF PROFESSIONAL LICENSING  
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PUBLIC HEARING  
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MONDAY, AUGUST 22, 2022  
AT ABOUT 9:02 A.M.  
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G. MENNEN WILLIAMS BUILDING AUDITORIUM  
525 W. OTTAWA STREET  
LANSING, MICHIGAN  
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RE: Dentistry - General Rules  
(MOAHR #2021-40 LR)  
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HEARING FACILITATOR:  
ANDRIA DITSCHMAN  
Bureau of Professional Licensing  
611 W. Ottawa Street  
Lansing, Michigan 48909  
19 ALSO PRESENT: Stephanie Wysack  
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21 REPORTED BY: Lori Anne Penn, CSR-1315  
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I N D E X  
2 Opening Statement - Andria Ditschman  
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4 COMMENTS:  
5 (None)  
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PAGE  
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7 Closing Statement - Andria Ditschman  
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Lansing, Michigan  
Monday, August 22, 2022  
At 9:02 a.m.  
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(Public hearing commenced pursuant to due notice.)  
MS. DITSCHMAN: We're opening the public  
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hearing. My name is Andria Ditschman, I am the  
department specialist for the Bureau of Professional  
Licensing in the Department of Licensing and Regulatory  
Affairs, and I'll be conducting the hearing today.  
This is a public hearing on proposed  
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Administrative Rules entitled "Dentistry - General  
Rules", and we are conducting this hearing under the  
authority of the Michigan Administrative Procedures Act,  
Public Act 306 of 1969, on behalf of the Department of  
Licensing and Regulatory Affairs, Bureau of Professional  
Licensing.  
We are calling this hearing to order at  
9:02 on August 22, 2022, at the G. Mennen Williams  
Building Auditorium at 525 West Ottawa Street in Lansing,  
Michigan. Publication of the notice of public hearing  
was in three newspapers of general circulation, including  
the Grand Rapids Press, the Flint Journal on July 28,  
2022, and the Mining Journal on August 4, 2022, as well  
as the Michigan Register, Issue #14, published on  
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August 15, 2022.  
We're here today to receive comments on  
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the proposed rules. If you wish to speak, please make  
sure you have signed in and said that you wish to speak.  
You may use the cards provided in the lobby for this  
purpose. If you would like to testify and have not  
signed in, please do so now. For those who do not wish  
to speak or sign in a card, you may speak at the  
microphone once we have exhausted all cards.  
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If you have comments, please make sure  
they relate directly to the proposed rules. If you have  
questions, please include your questions as part of your  
testimony for the Department's review. If you have  
suggested changes to the proposed rules, please include  
the specific reasons why the changes should be in the  
public -- or would be in the public interest.  
For the record, when you testify, please  
give your name by spelling your name and the  
organization, if any, that you may be speaking for today;  
this will help the Department prepare the hearing record  
that will go before the board.  
You can give written statements directly  
to me at the table. The Department will also accept  
written comments and statements that are emailed and  
postmarked until 5:00 p.m. today.  
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Other staff that's here today is  
Stephanie Wysack, including myself.  
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And we have one card from Richard Small,  
so if you would like to take the microphone. It might  
take a minute for that to go on.  
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MR. SMALL: Testing. Can you hear me?  
COURT REPORTER: I can hear you fine.  
MS. DITSCHMAN: I think it is working  
because she can hear you. And if you -- actually, it's  
just for you, right, so if that's not working, you don't  
need to use it.  
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MR. SMALL: I think you'll be able to  
hear me.  
MS. DITSCHMAN: Okay. As long as she can  
hear you, we're good.  
MR. SMALL: Yes. Do you want me to go?  
MS. DITSCHMAN: You want to come up here,  
or you can just stay right there.  
COURT REPORTER: You're fine right there,  
wherever.  
MS. DITSCHMAN: Yeah, just right there so  
she can hear. Yeah, that's great.  
MR. SMALL: Okay. This will work. Well,  
good morning everyone. And my name is Richard Small,  
S-m-a-l-l, and I am executive director and general  
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counsel to a group called the Michigan Society of Oral  
and Maxillofacial, m-a-x-i-l-l-o-f-a-c-i-a-l, Surgeons,  
that's known as the MSOMS. I'll use the acronym because  
it's easier to type for your benefit. The Michigan  
Society represents about 200 of the oral and  
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maxillofacial surgeons in this state.  
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Our request relates to the proposed  
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dental office anesthesia rules in the proposals for  
2021-40-LR, specifically Part 6 on anesthesia, and the  
rules involved are R 338.11601 and 338.11602. The state  
proposals require that dentists providing sedation and  
general anesthesia in an office setting complete a course  
in managing medical emergencies, including monitoring  
guidelines; and the proposals indicate that the course  
should be taken from the ADA, ASA for adults, and for  
children, one of the pediatric groups listed.  
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The MSOMS asks today that they be -- that  
the AAOMS, the parent national organization, be added to  
the list of professional organizations from which these  
courses can be taken either by oral and maxillofacial  
surgeons, their staff, or other dentists, if the state  
feels it's appropriate, and we propose language on  
Exhibit 1, which is attached to the submission that we  
provided, and so, and I've already provided that to  
Andria, so you should have the three-page statement and  
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all the attachments with reference material. I'm here  
today just to try to summarize the key points on behalf  
of my clients, and part of that relates to the regulatory  
impact statement -- I saw that there was a copy of it  
outside -- but there were a couple of points made in that  
statement.  
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(1) It advocates for appropriate  
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training and facilities, but it acknowledges Michigan  
does not use a permit system for general anesthesia like  
the other states in the Great Lakes region, and that's  
found on page 2 to 3. The other statement it made  
pertinent to what I'm asking for today are that the  
proposed rule changes are designed to ensure that  
dentists are properly trained and work in safe  
facilities. And thirdly, the regulatory impact statement  
does list, the agency lists AAOMS as one of the sources  
for information it used, and it cites www.aaoms.org, so  
they're, you know, they're acknowledging they understand  
the role AAOMS plays. But the point is that the goals  
stated in the regulatory impact statement are precisely  
what the AAOMS courses advocate during -- and teach, and  
that education and knowledge is confirmed by a process  
oral surgeons use called the office anesthesia  
evaluation.  
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But why is this important? Well, oral  
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and maxillofacial surgeons provide 78 percent of deep  
sedation and general anesthesia in dental offices  
nationally, and oral surgeons must complete a four- to  
six-year residency after they graduate from dental  
school. So this includes a 32-week rotation with the  
anesthesia and medical services associated with their  
hospital training that's part of their CODA residency,  
they must complete 300 deep sedation cases or general  
anesthesia cases, and 50 on children under 13, so it's  
pretty extensive training in terms of anesthesia with  
physicians and with the American Society of  
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Anesthesiology trained anesthesiologists.  
So courses offered by the groups that are  
in the proposals are good, but oral and maxillofacial  
surgeons rely heavily on courses by AAOMS because they  
reflect standards taught in their CODA residency and  
hospital training programs, and they are regularly  
updated, including managing medical emergencies. AAOMS  
also has a 36-hour anesthesia assistant program called  
DAANCE, D-A-A-N-C-E, and a simulation training called  
OBEAM, O-B-E-A-M, for staff to practice and master  
critical techniques for administering and monitoring  
anesthesia. Oral and maxillofacial surgeons cannot get  
this level of course training specific to their specialty  
from any other source besides AAOMS.  
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So not adding AAOMS will deny oral and  
maxillofacial surgeons who sedate more patients in an  
office setting than any other dental group of critically  
important updates during their mandatory CE on managing  
medical emergencies during anesthesia. It's important to  
note as well that this request will not negatively affect  
any other dentists or any other groups and is consistent  
with the authority the Board of Dentistry and the  
Administrative Rules have as given by the legislature.  
So for details, please see the August 16,  
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2022, paper I just submitted along with the seven  
attachments which are, you know, contain a lot of detail,  
and also a paper that AAOMS submitted, and I resubmitted  
today along with our paper, providing the details as to  
why AAOMS courses are so critical to patient safety,  
advancing patient safety and the kinds of things that the  
regulatory impact statement references and the goals of  
these rules. So if you need any additional information  
or have any questions, please feel to call me or  
Dr. Frank Farbod, who is the current MSOMS president.  
That's F-a-r-b-o-d. And, you know, I'm glad to answer  
any questions or help if I can, so you folks request call  
us, or if you need more information or reference  
material, I know you've got a lot, but please feel free  
to ask. Thank you.  
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MS. DITSCHMAN: Thank you. We're going  
to take -- we'll go off the record, we're going to take a  
15-minute break.  
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(Recess from 9:12 a.m. until 9:28 a.m.)  
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MS. DITSCHMAN: Okay. We're back on the  
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record, and we're going to close the hearing. It doesn't  
look like there's any other comments to be made. As  
there's no further comments at this time, I will hereby  
declare the hearing closed. The record will remain open  
until 5:00 p.m. today for any other comments you may wish  
to share about the proposed rules. Thank you for coming.  
(Public hearing concluded at 9:29 a.m.)  
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1 STATE OF MICHIGAN )  
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2 COUNTY OF MACOMB )  
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I, Lori Anne Penn, certify that this  
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transcript consisting of 11 pages is a complete, true,  
and correct record of the captioned matter held on  
Monday, August 22, 2022.  
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I further certify that I am not  
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responsible for any copies of this transcript not made  
under my direction or control and bearing my original  
signature.  
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I also certify that I am not a relative  
or employee of or an attorney for a party; or a relative  
or employee of an attorney for a party; or financially  
interested in the action.  
August 22, 2022 _____  
Date  
Lo
Nogan  
My Commission Expires June 15, 2025  
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