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Dental Hygiene Anesthetic Permit

Dental Hygiene Anesthesia Application Instructions:

1. Submit an application online at MyLicense.IN.gov with the application fee of $25.00. The paper application is available if necessary. You must hold an current dental license in Indiana prior to submission

2. An Official Documents From the School:

Applicants must submit an official document, directly from the school or program, showing the date that the diploma was issued by the educational institution or certificate with the date the course was given. An applicant for a dental hygiene anesthetic permit shall complete a course in local anesthesia administration in an educational program accredited by the Commission on Dental Accreditation of the American Dental Association (CODA) that includes, at a minimum, fifteen (15) hours of didactic instruction and fourteen (14) hours of laboratory work covering the following subject areas:
(1) Theory of pain control.
(2) Selection of pain control modalities.
(3) Anatomy.
(4) Neurophysiology.
(5) Pharmacology of local anesthesia.
(6) Pharmacology of vasoconstrictors.
(7) Psychological aspects of pain control.
(8) Systemic complications.
(9) Techniques of maxillary and mandibular anesthesia.
(10) Infection control.
(11) Local anesthesia medical emergencies.
(12) A demonstration of clinical competency.

Documentation from the school or program must state or list that the applicant has completed a course in anesthesia administration in an educational program that has been accredited by CODA that includes fifteen (15) hours of didactic instruction and fourteen (14) hours of laboratory work in the subject areas listed above.

3. Clinical Examination Requirement: Applicants must submit verification of an official report showing the score attained on the local anesthesia examination. Please have your score report sent directly to the Board from one of the entities listed below:

    8484 Georgia Avenue, Suite 900
    Silver Spring, Maryland 20910
    Telephone: (301) 563-3300
    FAX: (301) 563-3307
    Website: www.nerb.org
    23460 N. 19th Avenue, Suite #210
    Phoenix, Arizona 85027
    Telephone: (602) 944-3315
    FAX: (602) 371-8131
    Website: www.wreb.org
    Email: dentalinfo@wreb.org
    If you have not completed a local anesthesia examination administered by one of the entities listed above but have taken a substantially equivalent regional or state examination, please have the state or regional entity submit verification of the examination administered directly to the Board.

4. Verification of state licensure must be submitted by every state where you hold or have held a license or certification. This form needs to be submitted to the Indiana State Board of Dentistry by the state in which you hold or have held a license or certification.

Verification of State Licensure
Statutes and Rules