Privileges in Dental and Oral & Maxillofacial Surgery

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Rudolph Wells
7 years ago
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1 Privileges in Dental and Oral & Maxillofacial Surgery Education/Training Required Qualifications Successful graduation from an accredited U.S. dental school OR equivalent foreign dental school. Currently practicing in an ambulatory setting as a dentist or oral surgeon. Applicants must be able to demonstrate that they have performed at least 50 dental inpatient, outpatient, emergency service, or consultative procedures in the past 12 months Additional Credentialing Criteria (Initial and Reappointment) Teaching appointment to work in SHC outpatient clinics Membership and privileges at LPCH to admit, treat patients 14 years old and younger In accordance with Hospital Sedation Policy and completion of the SHC sedation exam taken every 2 years Clinical Experience (Initial). Dento-Alveolar Surgery Successful completion of ADA accredited Advanced Education in General Dentistry (AEGD), General Practice Residency (GPR), Oral and Maxillofacial Surgery or Periodontal Surgery training programs, or equivalent foreign training program -OR- Minimum (10) cases documented in the past 2 years. Orthodontics Successful completion of an ADA approved training program in Orthodontics, or certified by the American Board of Orthodontics or equivalent foreign training program. Minimum (10) cases documented in the past 2 years. Maxillofacial Prosthodontics Successful completion of fellowship in maxillofacial prosthodontics required. Minimum (10) cases documented in the past 2 years. Dental Implants Successful completion of ADA accredited Advanced Education in General Dentistry (AEGD), General Practice Residency (GPR), Oral and Maxillofacial Surgery or Periodontal Surgery training programs, or equivalent foreign training program OR Minimum (10) cases documented in the past 2 years. General Oral and Maxillofacial Surgery Successful completion of an ADA approved Oral and Maxillofacial Surgery training program or equivalent foreign training program and documentation from residency training; Board certification Published: 12/11/2013 Page 1 of 6

2 (Tumors, Infections, TMJ); Maxillofacial Trauma; Orthognathic and Craniofacial Surgery by American Board of Oral and Maxillofacial Surgeons preferred. Minimum 10 cases for General Oral and Maxillofacial Surgery (Tumors, Infections, TMJ) documented in the past 2 years. Clinical Experience (Reappointment) FPPE Minimum 10 Core cases seen at SHC with documentation in EMR required during the past 2 years Minimum 10 Core with Operating Room Privilege cases seen in the ER, inpatient, or outpatient at SHC with documentation in EMR required during the past 2 year Minimum 11 cases performed in the Operating Rooms at SHC required during the past 2 years Minimum 5 cases required at SHC during the past 2 years - Dento-Alveolar Surgery; Orthodontics; Maxillofacial Prosthodontics; Dental Implants FPPE CRITERIA LISTED BELOW. FPPE WILL BE ASSIGNED BY THE SERVICE CHIEF DURING THE APPROVAL PROCESS 3 chart reviews - Core; Core with Operating Room Privileges; 1 chart review - Dento-Alveolar Surgery; Orthodontics; Maxillofacial Prosthodontics; Dental Implants 2 chart reviews - Administration of Moderate Sedation; General Oral and Maxillofacial Surgery (Tumors, Infections, TMJ); Maxillofacial Trauma; Orthognathic and Craniofacial Surgery Published: 12/11/2013 Page 2 of 6

3 Provide care on LPCH patients in specific areas of SHC Additional ONLY provide care of patients in the SHC Emergency Department, ASC, Cath Lab, Cancer Center or Endo Unit - requires Active or Courtesy Status at LPCH Core Privileges Privileges included in the Core: Privileges to admit, evaluate, diagnose, consult, and provide treatment to dentistry patients in the inpatient or outpatient setting. General Dentistry includes: General dental diagnoses Treatments and procedures done by general dentists in an ambulatory setting, but which much be done in the hospital in some patients History and physical as it relates to dentistry Biopsy or removal of soft tissue lesions Routine restorative dentistry Cleaning Published: 12/11/2013 Page 3 of 6

4 CORE PRIVILEGES with Operating Room Privileges Privileges to admit, evaluate, diagnose, consult, and provide treatment to dentistry patients in the inpatient or outpatient setting. General Dentistry includes: General dental diagnoses Treatments and procedures done by general dentists in an operating room setting History and physical as it relates to dentistry Biopsy or removal of soft tissue lesions Routine restorative dentistry Exam under anesthesia Cleaning SPECIAL PRIVILEGES FOR DENTISTRY ORAL MAXILLOFACIAL SURGERY Description: Must also meet Required Qualifications for Core Privileges Treatment of patients in outpatient clinics at Stanford Hospital & Clinics Admit, treat, evaluate or provide follow-up care for inpatients ages 14 years or younger Dento-Alveolar Surgery Orthodontics Maxillofacial Prosthodontics Dental Implants Published: 12/11/2013 Page 4 of 6

5 SPECIAL PRIVILEGES FOR ORAL & MAXILLOFACIAL SURGERY Description: (MUST ALSO MEET THE CORE CRITERIA FOR DENTISTRY; OMS WHO ARE RECENT GRADUATES (WITHIN 2 YEARS) OF AN ORAL MAXILLOFACIAL SURGERY RESIDENCY MUST DEMONSTRATE THE SUCCESSFUL PERFORMANCE OF MAJOR ORAL MAXILLOFACIAL SURGERY ON A MINIMUM OF 75 PATIENTS DURING THE OMS RESIDENCY, NO MORE THAN FIVE OF WHOM REQUIRED DENTOALVEOLAR SURGERY) Administration of Moderate Sedation General Oral and Maxillofacial Surgery (Tumors, Infections, TMJ) Maxillofacial Trauma Orthognathic and Craniofacial Surgery Published: 12/11/2013 Page 5 of 6

DENTISTRY CLINICAL PRIVILEGES

DENTISTRY CLINICAL PRIVILEGES Name: Page 1 Initial Appointment Reappointment All new applicants must meet the following requirements as approved by the governing body effective: 4/3/2013. Applicant: Check off the Requested box for