ARC 0611D

ARC 0611D

INSPECTIONS, APPEALS, AND LICENSING DEPARTMENT[481]

Notice of Intended Action

Proposing rulemaking related to fees, licensure, registration, renewal, reactivation, reinstatement, sedation, and nitrous oxide and providing an opportunity for public comment

    The Department of Inspections, Appeals, and Licensing hereby proposes to amend Chapter 571, “Dental Board Fees,” Chapter 572, “Dental Licensure, Registration, Renewal, Reactivation and Reinstatement,” and Chapter 579, “Sedation and Nitrous Oxide,” Iowa Administrative Code.

Legal Authority for Rulemaking

    This rulemaking is proposed under the authority provided in Iowa Code chapter 147; chapter 153 as amended by 2026 Iowa Acts, House File 648; and chapter 272C.

State or Federal Law Implemented

    This rulemaking implements, in whole or in part, Iowa Code chapter 147; chapter 153 as amended by 2026 Iowa Acts, House File 648; and chapter 272C.

Purpose and Summary

    This proposed rulemaking updates the Dental Board’s rules to implement 2026 Iowa Acts, House File 648. This proposed rulemaking will allow the Board to issue a licensed sedation provider host permit to a dentist who completes a course approved by the Board within the 12 months immediately preceding the submission of the application or who provides evidence that the dentist holds a substantially similar permit issued in another state. This proposed rulemaking will allow the host permit holder to employ a licensed sedation provider, or a dentist who holds a current moderate sedation or general anesthesia permit issued by the Board, to administer moderate sedation on an outpatient basis to a patient who is at least 13 years of age on whom the dentist is performing a dental procedure or monitor a patient who is at least 13 years of age who is under moderate sedation.

    All references to Iowa Code chapter 153 are to that Iowa Code chapter as amended by 2026 Iowa Acts, House File 648.

Regulatory Analysis

    A Regulatory Analysis for this rulemaking was published in the Iowa Administrative Bulletin on July 22, 2026. A public hearing was held on the following date(s):

     ?   August 12, 2026

    Members of the public attended the public hearing and made comments in support of the proposed amendments.

Fiscal Impact

     This rulemaking has no fiscal impact to the State of Iowa.

Jobs Impact

    After analysis and review of this rulemaking, no impact on jobs has been found.

Waivers

    Any person who believes that the application of the discretionary provisions of this rulemaking would result in hardship or injustice to that person may petition the Board for a waiver of the discretionary provisions, if any, pursuant to 7—Chapter 2504.

Public Comment

     Any interested person may submit written or oral comments concerning this proposed rulemaking, which must be received by the Department no later than 4:30 p.m. on October 20, 2026. Comments should be directed to:

Public Hearing

     No public hearing is scheduled at this time. As provided in Iowa Code section 17A.4(1)“b,” an oral presentation regarding this rulemaking may be demanded by 25 interested persons, a governmental subdivision, the Administrative Rules Review Committee, an agency, or an association having 25 or more members.

Review by Administrative Rules Review Committee

    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rulemaking by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rulemaking at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).

    The following rulemaking action is proposed:

    ITEM 1.  Amend subrule 571.2(7) as follows:

    571.2(7) Anesthesia and sedation permits. The fees for an anesthesia or sedation permit are as follows:

    a.  The application fee for a local anesthesia permit is $70.

    b.  The application fee for a moderate sedation permit is $500.

    c.  The application fee for a general anesthesia permit is $500.

    d.   The application fee for a licensed sedation provider host permit is $500.

    ITEM 2.  Renumber subrules 571.3(5) to 571.3(11) as 571.3(6) to 571.3(12).

    ITEM 3.  Adopt the following new subrule  571.3(5):

    571.3(5) Licensed sedation provider host permit. The renewal fee for a licensed sedation provider host permit is $125.

    ITEM 4.  Amend subrule 572.2(3) as follows:

    572.2(3) Following board review and consideration of an application, the board will:

    a.  Authorize the issuance of the license, permit, registration or qualification; or

    b.  Initiate other action in accordance with rule 481—572.22 481—572.23(147,153,272C).

    ITEM 5.  Amend paragraphs 572.3(2)“d” and 572.3(2)“h” as follows:

    d.  Evidence of successful passage of a board-approved clinical examination pursuant to rule 481—572.14 481—572.15(147,153) and a statement of all other clinical examinations taken by the applicant with an indication of pass/fail for each.

    (1) and (2) No change.

    h.  Evidence of successful completion of a jurisprudence examination pursuant to rule 481—572.15 481—572.16(147,153).

    ITEM 6.  Amend subparagraph 572.3(3)“a”(2) as follows:

    (2)  Has less than three consecutive years of practice immediately prior to the filing of the application and evidence of successful passage within the previous five-year period of a board-approved clinical examination pursuant to rule 481—572.14 481—572.15(147,153).

    ITEM 7.  Amend paragraph 572.5(1)“c” as follows:

    c.  Evidence of successful completion of board-approved examination in the areas of infection control, hazardous materials, and jurisprudence as specified in rules 481—572.15(147,153) and 481—572.16(147,153) and 481—572.17(147,153), and dental radiography, if the applicant is also applying for a qualification in dental radiography.

    ITEM 8.  Amend paragraph 572.6(2)“c” as follows:

    c.  Evidence of successful completion a board-approved examination in the area of dental radiography in accordance with rule 481—572.16 481—572.17(147,153).

    ITEM 9.  Amend paragraph 572.7(1)“d” as follows:

    d.  Evidence of successful completion of a board-approved jurisprudence examination, pursuant to rule 481—572.15 481—572.16(147,153).

    ITEM 10.  Amend paragraph 572.9(2)“g” as follows:

    g.  Evidence of successful completion of a jurisprudence examination pursuant to rule 481—572.15 481—572.16(147,153).

    ITEM 11.  Amend subrule 572.9(4) as follows:

    572.9(4) A faculty permit may be renewed in accordance with rule 481—572.20 481—572.21(147,153,272C) and 481—Chapter 573.

    ITEM 12.  Amend subparagraph 572.10(1)“b”(2) as follows:

    (2)  Successful completion, within the previous 36 months, of a clinical examination in the administration of local anesthesia by a testing center approved by the board in accordance with rule 481—572.14 481—572.15(147,153); or

    ITEM 13.  Amend subrule 572.11(4) as follows:

    572.11(4) Applications for a moderate sedation or general anesthesia permit will be reviewed by the ACC or the board as deemed necessary to ensure compliance with this rule and 481—Chapter 579. Following review of an application, the ACC or the board may take action, in accordance with rule 481—572.22 481—572.23(147,153,272C).

    ITEM 14.  Renumber rules 481—572.12(153) to 481—572.22(147,153,272C) as 481—572.13(153) to 481—572.23(147,153,272C).

    ITEM 15.  Adopt the following new rule  481—572.12(153):

481—572.12(153) Requirements for issuance or renewal of a licensed sedation provider host permit. Pursuant to 481—Chapter 579, a dentist who wishes to employ a licensed sedation provider, or a dentist who holds a current moderate sedation or general anesthesia permit issued by the board, to administer moderate sedation on an outpatient basis to a patient who is at least 13 years of age on whom the dentist is performing a dental procedure in Iowa must possess a current permit issued by the board.

    572.12(1) Applications for a licensed sedation provider host permit must include the following:

    a.  The fee specified in 481—Chapter 571.

    b.  Evidence of having successfully completed, within the 12 months immediately preceding application, a board-approved training course.

    (1)  The course will provide instruction and an assessment of knowledge and skill in the following:

    1.  Preoperative patient assessment.

    2.  Emergency scenarios and rescue.

    3.  Respiratory complication.

    4.  Patient safety and monitoring.

    5.  Airway assessment and management.

    6.  Anesthetic drugs.

    7.  Recovery.

    (2)  The course will ensure the course participant can do all of the following:

    1.  Identify a high-risk patient.

    2.  Differentiate between different levels of sedation.

    3.  Monitor a patient receiving moderate sedation.

    4.  Rescue a patient from a deeper level of sedation than intended.

    (3)  The board shall review courses for approval on an annual basis and shall only approve a course for which the director of the course has submitted documentation indicating that the course meets the requirements of this subrule. The board may require the director of a course to participate in an interview as part of the approval process.

    c.  Evidence of current Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) certification.

    572.12(2) Prior to issuance of a new permit, all facilities where the applicant intends to provide sedation services must have passed inspection by the board or designated agent pursuant to 481—Chapter 579.

    572.12(3) Applications for a licensed sedation provider host permit will be reviewed by the ACC or the board as deemed necessary to ensure compliance with this rule and 481—Chapter 579. Following review of an application, the ACC or the board may take action in accordance with rule 481—572.23(147,153,272C).

    572.12(4) Licensed sedation provider host permits will expire on August 31 of every even-numbered year. A permit may be renewed by submitting an application for renewal, maintaining an active Iowa dental license or faculty permit, and complying with the following:

    a.  Payment of the renewal fee as specified in 481—Chapter 571;

    b.  Evidence of current ACLS or PALS certification; and

    c.  Evidence of a minimum of six hours of continuing education in the area of sedation. These hours may also be applied toward the renewal of a dental license or faculty permit.

    572.12(5) Failure to renew the permit prior to November 1 following its expiration will cause the permit to lapse and become invalid for practice. Permits that have lapsed may be reactivated upon submission of a new application in compliance with this rule. Applications for reactivation of a lapsed permit within six months may be administratively approved, so long as the application satisfies the requirements of this rule.

This rule is intended to implement Iowa Code sections 147.10, 147.11 and 272C.3 and chapter 153.

    ITEM 16.  Amend renumbered subrule 572.22(1) as follows:

    572.22(1) A registered dental assistant or licensed nurse whose radiography qualification has lapsed may have the radiography qualification reactivated at the discretion of the board. In addition to the application requirements specified in rule 481—572.20 481—572.21(147,153,272C), applicants for reactivation must also submit evidence of the following:

    a. and b. No change.

    ITEM 17.  Renumber rules 481—579.6(153) to 481—579.11(153) as 481—579.7(153) to 481—579.12(153).

    ITEM 18.  Adopt the following new rule  481—579.6(153):

481—579.6(153) Licensed sedation provider host permit standards.

    579.6(1) A dentist who does not meet the requirements of rule 481—572.12(153) will not employ a licensed sedation provider, or a dentist who holds a current moderate sedation or general anesthesia permit issued by the board, to administer moderate sedation on an outpatient basis to a patient who is at least 13 years of age on whom the dentist is performing a dental procedure.

    579.6(2) A dentist with a licensed sedation provider host permit must maintain current ACLS certification.

    579.6(3) A dentist with a host permit may monitor a patient who is at least 13 years of age who is under moderate sedation.

    ITEM 19.  Amend renumbered subrules 579.9(2) to 579.9(4) as follows:

    579.9(2) A dentist may only administer moderate sedation or anesthesia or use another licensed sedation provider or permit holder in a facility that is permanently and properly equipped. A dentist is required to be trained in and maintain, at a minimum, the following equipment:

    a. to j. No change.

    k.  Emergency drugs, in accordance with subrule 579.8(3) 579.9(3);

    l. to p. No change.

    579.9(3) Pursuant to paragraph 579.8(2) 579.9(2)“k,” a dentist providing sedation at a dental facility is required to maintain on site emergency drugs that meet the needs of the following categories. At a minimum, a dentist providing moderate sedation shall maintain emergency drugs specified in paragraphs 579.8(3) 579.9(3)“a” through “f.” A dentist providing deep sedation or general anesthesia shall maintain emergency drugs for all of the following categories:

    a. to m. No change.

    579.9(4) The board or its designated agents may conduct facility inspections. A facility inspection may be required before a sedation permit or host permit is issued or before sedation services are provided at a new or updated facility. The actual costs associated with the on-site evaluation of the facility are the primary responsibility of the licensee. The cost to the licensee will not exceed the fee specified in 481—Chapter 571.

    ITEM 20.  Amend renumbered rule 481—579.10(153) as follows:

481—579.10(153) Use of another licensed sedation provider or permit holder.

    579.10(1) A dentist may only use the services of a licensed sedation provider or another permit holder to administer moderate sedation, deep sedation or general anesthesia in a dental facility if the following requirements are met:

    a.  The dentist holds a current moderate sedation or general anesthesia permit or a licensed sedation provider host permit. A permit holder who does not meet the training requirement to administer moderate sedation to pediatric or ASA III or IV patients as stipulated in 481—subparagraph 572.11(1)“b”(3)  may use another licensed sedation provider or qualified permit holder to administer moderate sedation to pediatric or ASA III or IV patients.

    (1)   A moderate sedation or general anesthesia permit holder who does not meet the training requirement to administer moderate sedation to pediatric or ASA III or IV patients as stipulated in 481—subparagraph 572.11(1)“b”(3) may use another licensed sedation provider or qualified permit holder to administer moderate sedation to pediatric or ASA III or IV patients.

    (2)   A licensed sedation provider host permit holder may employ a licensed sedation provider, or a dentist who holds a current moderate sedation or general anesthesia permit issued by the board, to administer moderate sedation on an outpatient basis to a patient who is at least 13 years of age, on whom the dentist is performing a dental procedure.

    b.  The dentist remains present in the treatment room for the duration of any dental treatment.

    c.  The facility is a permanently and properly equipped facility pursuant to the provisions of this chapter.

    d.  The permit holder assesses the need and patient suitability for sedation services. A permit holder may will not interfere with any independent assessment performed by a licensed sedation provider.

    579.10(2) When a licensed sedation provider or another permit holder is used to administer moderate sedation, deep sedation or general anesthesia, that provider constitutes one patient monitor for the purpose of complying with rule 481—579.6 481—579.7(153).

    579.10(3) A dentist who does not hold a sedation permit or a licensed sedation provider host permit is prohibited from using a licensed sedation provider or permit holder to provide moderate sedation, deep sedation or general anesthesia.