NMDA Journal Fall 2019

24 New Mexico Dental Journal, Fall 2019 AMessage fromYour NewMexico Board of Dental Health Care By L. Paul Balderamos, DDS, MS, FACP Vice-Chairman, New Mexico Board of Dental Health Care AMessage from the Office of Oral Health E-cigarette Use in NewMexico By Lesley Meyer, New Mexico Allied Council on Tobacco; Laurel McCloskey, Chronic Disease Prevention Council; Denise Delic, DDS, Albuquerque Delicate Dentistry SENATE BILL 221 & DENTISTRY The Governor has signed into law SB 221 that states that Dentist’s shall “…Advise patients on the Risks of Overdose and Opioid Reversal Medication and to Co-prescribe an Opioid Antagonist…” Simply put: 1. If a dentist prescribes an opioid to a FIRST TIME PATIENT, the dentist must advise the patient on the risk of overdose. 2. If a dentist prescribes an opioid to a SEC- OND TIME PATIENT, the dentist must advise on the risks of overdose and the availability of an opioid antagonist. 3. If a dentist prescribes and opioid for 5 DAYS OR GREATER DURATION, the dentist must co-prescribe an opioid antagonist. The prescription must include a warning to call 911 after administering the opioid antagonist. This new law will be on the NMBDHC website. You may check with your pharmacist on avail- ability of the opioid antagonist. Please edu- cate yourself so you can serve your patients. Please review the following statutes 61-5A-3 definitions. The dentist is responsible for the actions of the dental team members! Defini- tive, final, and master impressions must be made by the dentist. The EFDA may impress single teeth under direct supervision of the dentist. 61-5A-3 DEFINITIONS N. "Direct supervision" means the process under which an act is performed when a dentist li- censed pursuant to the Dental Health Care Act: 1. Is physically present throughout the per- formance of the act. 2. Orders, controls and accepts full professional responsibility for the act performed. 3. Evaluates and approves the procedure performed before the patient departs the care setting. O. "Expanded-function dental auxiliary" means a dental assistant, dental hygienist or other dental practitioner that has received education beyond that required for licensure or certification in that individual's scope of practice and that has been certified by the board as an expanded-function dental auxil- iary who works under the direct supervision of a dentist. P. "General supervision" means the authoriza- tion by a dentist of the procedures to be used by a dental hygienist, dental assistant or den- tal student and the execution of the proce- dures in accordance with a dentist's diagnosis and treatment plan at a time the dentist is not physically present and in facilities as des- ignated by rule of the board. Q. "Indirect supervision" means that a dentist, or in certain settings a dental hygienist or dental assistant certified in expanded func- tions, is present in the treatment facility while authorized treatments are being performed by a dental hygienist, dental assistant or den- tal student. Keep up the good work as you serve the people of New Mexico. Thank you to the diligent and conscientious dentists and support staff who treat our New Mexico patients with dignity and respect. Remember the Golden Rule! The e-cigarette epidemic is a serious emerging public health problem. Since e- cigarette’s fabrication in China in 2002 and later distribution to the U.S. in 2009, use has steadily increased in the past decade espe- cially among millennials. E-cigarettes are now the most used tobacco product among middle and high school students, surpass- ing conventional cigarettes. 1 In 2017, 24.7% of New Mexico high school students were e-cigarette users; 8.2% smokeless tobacco; 10.2% cigar; 10.6% smoke cigarettes. 2 New Mexico youth use e-cigarettes at a higher rate than the national average. Furthermore, e-cigarette use increased 78% among high school students (11.7% to 20.8%) and 48% among middle school students (3.3% to 4.9%) from 2017 to 2018.3 E-cigarettes include a diverse group of de- vices that allow users to inhale an aerosol, which typically contains nicotine, flavorings, and other additives. E-cigarettes vary widely in design, appearance, and also nomencla- ture for the devices. Consumers and compa- nies themselves use a wide range of names including “e-cigarettes,” “e-cigs,” “cigalikes,” “e-hookahs,”“mods,”“vape pens,” “vapes,”“tank systems,” and “juuls.”The timely introduction of e-cigarettes was a direct response to the FDA banning flavored cigarettes, other than menthol, due to flavored cigarettes appeal to youth. It is a common misperception among e- cigarette users that vaping is less harmful or is without health risk. Though it is acknowl- edged that e-cigarette aerosols contain less harmful constituents compared to combus- tible tobacco products, the data suggests e-cigarettes produce viscous aerosols that change surface characteristics and have biological consequences.⁴ Often mislabeled as “vapor,” or “water vapor,” the cloud contains much more harmful components including ultrafine particles that can be inhaled deep into the lungs. The aerosol contains harmful and potentially harmful chemicals including nicotine, ultrafine particles, flavorings such as diacetyl that is a chemical linked to severe