N.H. Admin. Code § Den 301.01 - Application for Dental Hygienist Licensure
(a) Each applicant
for a license to practice dental hygiene in the state of New Hampshire shall
complete and submit the "Universal Application for Initial Licensure" as
required by Plc 304.01(a)(1).
(b)
In addition to the information required by (a) above the applicant for
licensure shall provide and submit the following information on the "Dental
Hygienist Addendum to the Universal Application for Initial Licensure":
(1) Any other names by which the applicant
has ever been known; and
(2)
Whether the applicant has taken and passed the following examinations of the:
a. Joint Commission on National Dental
Examinations; and
b. American Board
of Dental Examiners (ADEX) dental hygiene examination or other equivalent U.S.
regional or state board which includes clinical procedure components or manikin
examination.
(c) The applicant for licensure as a dental
hygienist shall provide the following with the application for licensure:
(1) One of the following:
a. An original or certified copy of the
applicant's birth certificate written in English or translated to
English;
b. A certified copy of the
applicant's valid passport written in English or translated to English;
or
c. A driver's license or other
state issued identification;
(2) At least 3 "Statement of Professional
Character" forms completed by at least one licensed dentist in good standing
and at least one licensed dental hygienist in good standing if the applicant
has previous dental employment. The dentist or dental hygienist shall sign and
complete the "Statement of Professional Character" form within 4 months of the
date of submission of the initial application which shall include:
a. Placing that applicant's name within the
following statement:
"I am personally acquainted with ________________________________ and attest that to the best of my knowledge they are of good professional character and recommend them for licensure in the State of New Hampshire."
b.
Signature of the individual attesting to the statement in a. above;
c. Address of the individual attesting to the
statement in a. above;
d. Printed
name of the individual attesting to the statement in a. above;
e. Occupation, license number, state of
licensure, and the length of time the individual attesting to the statement in
a. above has known the applicant; and
f. The applicant's name and complete address
in the "Return this completed form to:" section;
(3) Signed certification of graduation or, if
not more than 3 months prior to the date the degree will be conferred, a
certification of completion by the dean or registrar of the school of dental
hygiene granting the applicant a degree;
(4) Proof of current basic life support for
healthcare providers (BLS-HCP), if applicable;
(5) A criminal offender record check provided
in accordance with Plc 304.01(b);
(6) An official copy of the applicant's
school of dental hygiene transcript bearing the registrar's original signature
and the school's seal;
(7) The
applicant's original grade card denoting successful completion of the
examination of the Joint Commission on National Dental Examinations and the
American Board of Dental Examiners (ADEX) or other equivalent examination
described in (b)(2)b., above;
(8) A
certified statement from the dental examining board of each state in which the
applicant has been licensed as to whether the applicant's license to practice
in that state, based on the records of the board;
a. Has been subject to disciplinary
action;
b. Has disciplinary action
pending;
c. Has been under stayed
probation; or
d. Is under
investigation; and
(9)
The fee required pursuant to Plc 1002.11.
(d) Applicants shall have successfully passed
their regional boards and provide verification directly to OPLC from the CDCA
or equivalent regional or state board showing that they have taken and passed
the examination, including a clinical procedure component, within the 3 years
immediately prior to submitting the application.
(e) Applicants for endorsement certification
shall have taken and passed the ADEX dental hygiene examination, or other
similar U.S. regional or state board for dental hygienists examination,
including a clinical procedure component or manikin examination, with a passing
score on each part of the examination and have documentation of successful
completion sent directly to OPLC's office.
(f) An applicant shall be a graduate of a
dental hygiene program which:
(1) Is of at
least 2 academic years in duration;
(2) Is accredited by a national accrediting
agency recognized by the United States Department of Education and the CODA;
and
(3) Awards the minimum degree
of Associates in Science with a major in dental hygiene.
(g) When the required materials have been
approved by the OPLC, the applicant shall take a jurisprudence exam on the
contents of RSA 317-A Dental Practice Act, administrative rules Den 100 through
Den 500, the American Dental Association's Principles of Ethics and Code of
Professional Conduct, and the American Dental Hygienists' Association Code of
Ethics for Dental Hygienists.
(h)
The passing score on the jurisprudence exam shall be 75% or higher.
(i) After passage of the jurisprudence exam
in (g) above, an active New Hampshire dental hygiene license shall be
issued.
Notes
Editorial Addition; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91; ss by #5755, eff 12-14-93; amd by #6186, eff 2-17-96; ss by #6909, eff 12-9-98; amd by #7557, eff 9-20-01; amd by #7661, eff 3-13-02; amd by #7778, eff 10-10-02; amd by #7929, eff 8-6-03; amd by #7970, eff 10-10-03; amd by #8260, eff 1-19-05; amd by #8584, eff 3-16-06; amd by #8694, eff 7-27-06; ss by #8838, eff 3-9-07; amd by #8963, eff 8-16-07; amd by #9256, eff 9-10-08; amd by #9408-B, eff 3-10-09; amd by #10068, eff 1-10-12; amd by #10328-B, eff 5-7-13
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
(a) Each applicant for a license to practice dental hygiene in the state of New Hampshire shall provide the following on the "Dental Hygienist Application for Licensure":
(1) Applicant's name;
(2) Applicant's date of birth;
(3) Applicant's place of birth;
(4) Applicant's social security number, as required by RSA 161-B:11, VI-a;
(5) Any other name by which the applicant has been known;
(6) Applicant's current business and residential addresses, telephone numbers, and primary email address either business or personal;
(7) Applicant's educational background, including the name of the school of dental hygiene attended with date of graduation;
(8) Whether the applicant has taken and passed the following examinations of the:
a. Joint Commission on National Dental Examinations; and
b. American Board of Dental Examiners (ADEX) dental hygiene examination or other similar U.S.regional or state board including clinical procedure components or manikin examination;
(9) A listing of the following:
a. All places where the applicant has possessed a license to practice dental hygiene, including the state and license number, issue date, whether active or inactive, and dates of practice; and
b. Professional employment history including the names of the employing dentists, the dates, and locations;
(10) Whether the applicant:
a. Has been convicted of a felony, misdemeanor, or driving under the influence of alcohol or drugs which has not been annulled;
b. Has been convicted of illegally practicing dental hygiene;
c. Has ever been denied dental hygiene licensure;
d. Currently has or ever has had any professional license subjected by any professional licensing body in any jurisdiction or state to any investigation, sanction, or disciplinary action, including but not limited to revocation, suspension, probation or stayed probation, limitation or restriction, fine, reprimand, denied renewal, voluntary or involuntary relinquishment, or required submission to care, counseling, supervision, or further education; or
e. Has ever been or is currently named as a party in any malpractice or professional liability claim or lawsuit or has any pending;
(11) Whether the applicant has been advised by a health practitioner or mental health practitioner that a physical or mental illness impairs the ability to practice dental hygiene;
(12) Whether the applicant has a physical or mental illness, or other condition, or addiction to alcohol, narcotics, or other mind altering drugs which impairs the applicant's ability to practice dental hygiene;
(13) A listing of the dental continuing education courses taken during the last 2 years;
(14) At least 2 signed certifications of good professional character, at least one of which is by a licensed dentist in good standing if the applicant has previous dental employment;
(15) Signed certification of graduation or, if not more than 3 months prior to the date the degree will be conferred, a certification of completion by the dean or registrar of the school of dental hygiene granting the applicant a degree; and
(16) Whether the applicant's basic life support for healthcare providers (BLS-HCP) is current, and if so, provide proof.
(b) An unmounted passport-type photograph of the applicant shall be:
(1) Attached to the;
(2) Taken not more than 6 months before the date on the application;
(3) No smaller than 2 and 1/2 inches square; and
(4) Impressed or stamped by a portion of the seal of the dental hygiene school from which the applicant graduated.
(c) The shall be signed by the applicant, notarized, and filed with the office of professional licensure and certification. Deceptive or false statements, knowingly made by the applicant, shall result in denial of license. By signing the, the applicant shall waive any confidentiality regarding disclosure to the board from any other jurisdiction about any pending complaints or action being taken against the applicant's license to practice dental hygiene and consents to a criminal background check.
(d) The shall be accompanied by the following documents:
(1) A certified check or money order made payable to the "Treasurer, State of New Hampshire" for the application fee specified in Den 301.08;
(2) Either of the following:
a. An original or certified copy of the applicant's birth certificate written in English or translated to English; or
b. A certified copy of the applicant's valid passport written in English or translated to English; and
(3) A completed criminal history records check and fingerprint card, seeking both a New Hampshire and a federal records check, in accordance with the procedure and payment requirements specified by the NH department of safety at Saf-C 5700, and if the federal criminal history records check shows the existence of a criminal record in another state, the applicant shall obtain a detailed criminal record check directly from that state and provide it to the board;
(e) The following documents shall be filed with the board directly by the issuing agency:
(1) An official copy of the applicant's school of dental hygiene transcript bearing the registrar's original signature and the school's seal;
(2) The applicant's original grade card denoting successful completion of the examination of the Joint Commission on National Dental Examinations; and
(3) A certified statement from the dental examining board of each state in which the applicant has been licensed as to whether the applicant's license to practice in that state, based on the records of the board;
a. Has been subject to disciplinary action;
b. Has disciplinary action pending;
c. Has been under stayed probation; or
d. Is under investigation.
(f) The board shall verify directly with the CDCA or similar regional or state board that the applicant has taken and passed the board examination, including a clinical procedure component, within the 3 years immediately prior to submitting the application, and deposits the required credentials with the board. Applicants who have successfully passed other regional boards shall provide verification directly to the board.
(g) Endorsement certification shall be considered for any person holding a current, unsuspended, unrestricted license to practice dental hygiene in another state and who has practiced clinical dental hygiene in one or more states for not less than 3 years immediately prior to submitting the application, and deposits the required credentials with the board.
(h) Applicants for endorsement certification shall have taken and passed the American Board of Dental Examiners (ADEX) dental hygiene examination, or other similar U.S.regional or state board for dental hygienists examination, including a clinical procedure component, with a passing score on each part of the examination.
(i) The education requirements, specified in RSA 317-A:21 shall apply to all applicants for licensure under this section.
(j) Pursuant to RSA 317-A:8, an applicant shall be a graduate of a dental hygiene school general dentistry program which:
(1) Is of at least 2 years duration;
(2) Is accredited by CODA; and
(3) Awards the minimum degree of Associates in Science with a major in dental hygiene.
(k) When the required materials have been approved by the board, the applicant shall take a test on the contents of RSA 317-A Dental Practice Act, administrative rules Den 100 through Den 500, the American Dental Association's Principles of Ethics and Code of Professional Conduct, and the American Dental Hygienists' Association Code of Ethics for Dental Hygienists.
(l) After passage of the test in (k) above, the board shall issue an active New Hampshire dental hygiene license upon payment of the full registration fee adopted in Den 301.08.
(m) Required materials that are subject to change shall be updated if more than 4 months old at time of completion of application.
(n) After 6 months, the board shall discard the applications of applicants who choose not to complete the application process.
Notes
Editorial Addition; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91; ss by #5755, eff 12-14-93; amd by #6186, eff 2-17-96; ss by #6909, eff 12-9-98; amd by #7557, eff 9-20-01; amd by #7661, eff 3-13-02; amd by #7778, eff 10-10-02; amd by #7929, eff 8-6-03; amd by #7970, eff 10-10-03; amd by #8260, eff 1-19-05; amd by #8584, eff 3-16-06; amd by #8694, eff 7-27-06; ss by #8838, eff 3-9-07; amd by #8963, eff 8-16-07; amd by #9256, eff 9-10-08; amd by #9408-B, eff 3-10-09; amd by #10068, eff 1-10-12; amd by #10328-B, eff 5-7-13