Statute and Board Rule Updates

Board-Approved Opinions – September 19, 2025

On September 19, 2025, the Board of Dental Examiners of Alabama approved two official opinions to provide clarity for licensees regarding anesthesia practices in dental settings. These opinions address (1) the role of Certified Registered Nurse Anesthetists (CRNAs) in providing anesthesia services and (2) the administration of certain general anesthetic agents. The Board intends to move forward with rulemaking to incorporate these opinions into its regulations. The full text of both opinions is available below.

CRNA Level of Service Opinion

GA Admin Opinion

Board Opinion (Lead Aprons/Thyroid Collars)

On February 1, 2024, the American Dental Association published a new literature review, and updated its recommendations, relating to ionizing radiation exposure in dentistry. See Benavides, et al., Optimizing radiation safety in dentistry: Clinical recommendations and regulatory considerations, Journal of the American Dental Association (February 1, 2024). The new guidance is notable for its new recommendation that lead aprons and thyroid collars are no longer recommended in routine dental practice.

The regulations of the State Department of Public Health require the use of “procedures and engineering controls based upon sound radiation protection principles to achieve occupational doses and public doses that are as low as is reasonably achievable (ALARA).” Ala. Admin. Code r. 420-3-26-.03(5). Those rules also do not necessarily require the use of lead aprons or thyroid collars in routine dental imaging.

The Board of Dental Examiners of Alabama does not have any generally applicable rule that requires licensees to use lead aprons and/or thyroid collars in connection with routine intraoral radiography.

Patients, particularly those accustomed to using lead aprons over an extended period of time, may request that dental practitioners provide them with a lead apron during dental imaging. This is a matter of sound clinical judgment in each particular case.

The Board recommends that all dental practitioners review the updated ADA guidance, available at https://jada.ada.org/article/S0002-8177(23)00734-1/fulltext, and to incorporate the updated recommendations into their clinical judgment and decision-making processes.