Dentists giving vaccinations?

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questionasker1071

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What are the rules about a dentist or his hygienists giving a patient a vaccination while he’s there.

For example: your patient comes in sees the hygienist then typically waits 5-10 mins before the dentist comes by if at all. During that time what if they got their flu vaccine administered by either the hygienist or the dentist when he comes by. Get it all done in one visit. Save patient time and headache of going to doctor or pharmacy for their shots.

Is this possible and how would it work out with insurance?
 
Not in the State of Ohio. Its outside the scope of permitted practices. Also if it was permitted you would have to obtain a terminal distributors license
from the Pharmacy Board to store and distribute the vaccines.

4715.01 Dentist - dental hygienist definitions.
Any person shall be regarded as practicing dentistry, who is a manager, proprietor, operator, or conductor of a place for performing dental operations, or who teaches clinical dentistry, or who performs, or advertises to perform, dental operations of any kind, or who diagnoses or treats diseases or lesions of human teeth or jaws, or associated structures, or attempts to correct malpositions thereof, or who takes impressions of the human teeth or jaws, or who constructs, supplies, reproduces, or repairs any prosthetic denture, bridge, artificial restoration, appliance, or other structure to be used or worn as a substitute for natural teeth, except upon the order or prescription of a licensed dentist and constructed upon or by the use of casts or models made from an impression taken by a licensed dentist, or who advertises, offers, sells, or delivers any such substitute or the services rendered in the construction, reproduction, supply, or repair thereof to any person other than a licensed dentist, or who places or adjusts such substitute in the oral cavity of another, or uses the words "dentist," "dental surgeon," the letters "D.D.S.," or other letters or title in connection with his name, which in any way represents him as being engaged in the practice of dentistry. Manager, proprietor, operator, or conductor as used in this section includes any person:

(A) Who employs licensed operators;

(B) Who places in the possession of licensed operators[,] dental offices or dental equipment necessary for the handling of dental offices on the basis of a lease or any other agreement for compensation or profit for the use of such office or equipment, when such compensation is manifestly in excess of the reasonable rental value of such premises and equipment;

(C) Who makes any other arrangements whereby he derives profit, compensation, or advantage through retaining the ownership or control of dental offices or necessary dental equipment by making the same available in any manner for the use of licensed operators; provided that this section does not apply to bona fide sales of dental equipment secured by chattel mortgage. Whoever having a license to practice dentistry or dental hygiene enters the employment of, or enters into any of the arrangements described in this section with, an unlicensed manager, proprietor, operator, or conductor, or who is determined mentally incompetent by a court of competent jurisdiction, or is committed by a court having jurisdiction for treatment of mental illness, may have his license suspended or revoked by the state dental board.

Effective Date: 03-15-1982 .
 
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I do know in some states the recent law change allows Dentists to administer vaccines, as we had a training course at school. However the catch is the vaccine still needs to be prescribed by an MD, which makes it completely pointless (who would get an MD prescription, then go to a Dentist to get it given?)
 
I do know in some states the recent law change allows Dentists to administer vaccines, as we had a training course at school. However the catch is the vaccine still needs to be prescribed by an MD, which makes it completely pointless (who would get an MD prescription, then go to a Dentist to get it given?)

What? Aren't dentists allowed to prescribe any type of med?
 
I do know in some states the recent law change allows Dentists to administer vaccines, as we had a training course at school. However the catch is the vaccine still needs to be prescribed by an MD, which makes it completely pointless (who would get an MD prescription, then go to a Dentist to get it given?)


At least in California, you don’t need a prescription to get a flu shot. I get mine every year from our employee health nurse. I could also get it at the supermarket pharmacy and at Costco. Not sure why a dentist couldn’t administer it. Seems like a good idea.
 
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What? Aren't dentists allowed to prescribe any type of med?
At least in California, you don’t need a prescription to get a flu shot. I get mine every year from our employee health nurse. I could also get it at the supermarket pharmacy and at Costco. Not sure why a dentist couldn’t administer it. Seems like a good idea.

I'm not sure about the logistics of it. But I know for sure that the dentist can't just call in an order or have the vaccine brought to the office here. Might have something to do with the way they're stored? Or just a way to keep the MDs as part of it
 
Relevant (see bold)

403 Dentists Administering Flu Vaccines

A licensed dentist seeking to administer influenza (inactivated influenza vaccine and live attenuated influenza intranasal vaccine) shall be required to complete an additional training course and must comply with all provisions in this Section and Section 54.3 of the Act.

a) Vaccinations shall be limited to patients 18 years of age and older who consent to administration of the vaccine and shall be administered pursuant to a valid prescription or standing order by a physician who, in the course of professional practice, administers vaccines to patients.

b) Prior to being administered a vaccine, those receiving immunizations shall be provided with the relevant vaccine information statements (VIS) that are required to be disseminated by federal law, which may contain information on circumstances in which a vaccine should not be administered.

c) The additional training course shall be given by continuing education providers approved pursuant to Section 1220.440(b)(2).

d) Any course must contain, at a minimum, four hours of training and include:

1) The recognition of contraindications, as well as how to handle adverse reactions;

2) The appropriate methods of storage, handling and disposal of vaccines and all used supplies or contaminated equipment; and

3) Proper administration and maintenance of written policies and procedures that are required by this Section.

e) Reporting Requirements

1) Any adverse events are required to be reported to the Vaccine Adverse Events Reporting System (VAERS) and to the primary care provider named by the patient.

2) Any dentist who administers the influenza vaccine shall enter all patient level data on the vaccines in the immunization data registry (I-Care) maintained by the Department of Public Health.

3) Within 30 days after administration of a vaccine, the dentist must report to the patient's primary care provider that the vaccine has been administered.

4) Additional information, including precautions and contraindications for vaccination, is available from CDC's Vaccines and Immunization online site or by telephone at
 
Question: Why would you want to give vaccines?

Seems like it would take too much chair time to be profitable. Plus if I wanted to give vaccines I’d become a PA or pharmacist.
 
Question: Why would you want to give vaccines?

Seems like it would take too much chair time to be profitable. Plus if I wanted to give vaccines I’d become a PA or pharmacist.

My flu shot only takes about 3 min of actual time with the healthcare provider.


So the dentist would have to do it then, not the hygienist?
 
It’s not the chair time but rather the extra liabilities and potential complications that could occur from vaccinations. You want to be sued by some anti vaxxer/person who claims your storage of materials whatever resulted in complications and supposedly link to disorders.

A lot of people go into dentistry because it is extremely low stress compared to medical speciality.

If you want to push your risk tolerance with iv sedation (risk of death), Botox (risk of severe bruising and other complications) and other things that are borderline out of scope like vaccinations- be my guest.

Simply put, dentists fix teeth. Vaccinations are the mds turf and let it be that way. If you want to vaccinate people go into medicine. In addition the field of medicine has more training in whole body treatment and pharmacology then dentistry does... and likewise we have more training in the oral cavity then medical doctors do. So- to me- it’s clear what boundaries a doc and dentist have.
 
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How much liability is there in actuality?

Probably enough to wipe out any profit you made on the vaccinations and then some. Maybe if I could make several hundred per patient every x month interval, with 45-75+ patients a day all getting vaccinated, then it might be worth it. However, you would then have to get medical insurance involved. I don't want to deal with medical insurance nor have to suffer from a medical insurance audit (especially if it involves government insurance).
 
The liability associated with vaccinating would be minuscule. They're intramuscular injections, its waaaaay less technique sensitive than doing any sort of dental anesthetic.

Think about HPV, something that can directly affect the oral cavity and can be vaccinated against. Wouldn't providing the HPV vaccination just be a preventive measure against contracting HPV (particularly oropharyngeal cancer)? I don't really think that would be outside our scope of practice.
 
The liability associated with vaccinating would be minuscule. They're intramuscular injections, its waaaaay less technique sensitive than doing any sort of dental anesthetic.

Think about HPV, something that can directly affect the oral cavity and can be vaccinated against. Wouldn't providing the HPV vaccination just be a preventive measure against contracting HPV (particularly oropharyngeal cancer)? I don't really think that would be outside our scope of practice.

I think the problem is not so much the administration, but any after effects (real or preceived) which may result in some sort of legal action... especially with antivaxxers gaining some ground. Being subject to legal action is already a hassle and timewaster in itself. Even if it were in the scope of our practice, is there sufficient profit gain v. potential liability? What's the aftercare for vaccines? Do I need to draw blood for titers? Management of potential issues/side effects? Lots of questions to answer, is there enough to gain by being able to manage these questions?
 
Saw on LinkedIn where this bill was just passed in Oregon.
 

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This is a state specific issue from my understanding. Oregon just passed a law that allows dentists to administer vaccines including the HPV vaccine, which in my opinion isn't a terrible idea since we are (or should be) screening for HPV related cancers.

 
That’s the reason I started thinking about this. One of my professors talked about how she felt dentists should be able to give the hpv vaccine
 
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