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Local Anesthesia & Nitrous Oxide Administration

Public Act No. 423 and Public Act No. 30 allows a registered dental hygienist under the direct supervision of a dentist, the expanded duties to administer intraoral block and infiltration anesthesia or nitrous oxide analgesia to a patient who is 18 years of age or older. In order to administer local anesthesia or nitrous oxide, the hygienist must have completed a Department of Community Health-approved training program, passed a state or regional board administered written exam within 18 months of taking the approved course, and possess current certification in basic or advanced cardiac life support.

Hygienists interested in performing these expanded duties can download the applications for certification at the Michigan Department of Community Health website

The steps for certification in one or both areas are listed below.

Training programs

Current Michigan licensed dental hygienists must complete a Department of Community Health approved training program for local anesthesia. The list of approved continuing education programs for local anesthesia follows.

Approved Dental Hygiene Local Anesthesia CE Programs

  • 2002DHLA01 University of Michigan – School of Dentistry 
  • 2002DHLA02 University of Detroit-Mercy – School of Dentistry 
  • 2002DHLA03 Ferris State University – College of Allied Health Sciences 
  • 2002DHLA04 Grand Rapids Community College (Dental Auxiliary Programs) 
  • 2002DHLA05 Wayne County Community College District – Northwest Campus (Dental Auxiliary Programs) 
  • 2002DHLA06 Delta College – Dental Hygiene Program 2003DHLA07 Lansing Community College Dental Hygiene Program 
  • 2003DHLA08 Mott Community College 
  • 2003DHLA09 Baker College of Port Huron 
  • 2003DHLA10 Kalamazoo Valley Community College 
  • 2004DHLA11 Kellogg Community College 
  • 2005DHLA12 Oakland Community College

Current Michigan licensed dental hygienists must complete a Department of Community Health approved training program for nitrous oxide. The list of approved continuing education programs for nitrous oxide follows.

Approved Dental Hygiene Nitrous Oxide CE Programs

  • 2004DHN001 University of Michigan – Dept of Periodontics 
  • 2004DHN002 Lansing Community College – Dental Hygiene Program 
  • 2004DHN003 Grand Rapids Community College Continuing Education and Professional Development 
  • 2004DHN004 Delta College – Dental Hygiene Program 
  • 2004DHN005 University of Detroit Mercy – School of Dentistry 
  • 2004DHN006 Mott Community College – Dept of Dental Hygiene 
  • 2004DHN007 Kellogg Community College 
  • 2005DHN008 Wayne Community College 2005DHN009 Oakland Community College 
  • 2006DH010 Kalamazoo Valley Community College

Recent graduates of ADA/CODA approved programs

Recent graduates of ADA/CODA approved dental hygiene programs may already have the training necessary to do the procedures without taking additional training. Check with the dental hygiene program to see if the program included the necessary training. You should have your educational program complete the Verification of Local Anesthesia Administration or Nitrous Oxide Analgesia Training to confirm completion of the required training.

Current licensees who wish to administer local anesthesia and/or nitrous oxide

All current licensees have the opportunity to complete an approved continuing education program. Successful completion of the training program is the first requirement. Certificates of completion from an approved continuing education program are acceptable as proof of the training.

For Local Anesthesia: The course should include at least 15 hours of didactic instruction and 14 hours of clinical experience in theory of pain control; selection of pain control modalities; anatomy; neurophysiology; pharmacology of local anesthetics; pharmacology of vasoconstrictors; psychological aspects of pain control; systemic complications; techniques of maxillary anesthesia; techniques of mandibular anesthesia; infection control and local anesthesia medical emergencies.

For Nitrous Oxide: The course should include at least 4 hours of didactic instruction and 4 hours of clinical experience in nitrous oxide analgesia medical emergency techniques; pharmacology of nitrous oxide; and nitrous oxide techniques; also selection of pain control modalities, if available.

Graduates of out-of-state programs

If the dental hygienist trained out of state, s/he will have to review the course requirements listed in the law and compare them to the training received. The law can be viewed at www.michigan.gov/healthlicense under Dentistry. The hygienist can submit the course syllabi to the Department for review. A letter indicating if the coursework was substantially equivalent will be sent to the hygienist. Send the information to:

Department of Community Health
Bureau of Health Professions
P.O. Box 30670
Lansing, MI 48909
ATTN: Board of Dentistry

If you have taken a regional or state examination for certification in another state, please have test scores and examination information sent to the Board address above. This information will be reviewed for equivalency to the NERB examinations in local anesthesia and/or nitrous oxide analgesia administration.

Examination

NERB Local Anesthesia Examination

Upon completion of training, individuals seeking certification in local anesthesia will need to successfully complete the local anesthesia examination offered by the North East Regional Boards (NERB). The Administrative Rules of the Michigan Board of Dentistry require that the examination is passed within 18 months of the completion of the course. Information about the test can be found at www.nerb.org. Information about the test can be found at www.nerb.org. Applications can be obtained by calling the NERB offices at (301) 563-3300 or fax a request for an application to NERB at (301) 563-3307.

Nitrous Oxide Examination

Upon completion of training, individuals seeking certification in nitrous oxide analgesia will need to successfully complete the nitrous oxide examination offered by the North East Regional Boards (NERB). The Administrative Rules of the Michigan Board of Dentistry require that the examination is passed within 18 months of the completion of the course. Information about the test can be found at www.nerb.org. Applications can be obtained by calling the NERB offices at (301)563-3300 or fax a request for an application to NERB at (301) 563-3307.

Maintenance of current certification in
basic/advanced cardiac life support

In order to continue to administer local anesthesia or nitrous oxide, dental hygienists must maintain certification in basic or advanced cardiac life support. (This is also a requirement for renewal of the dental hygiene license.)

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