1. Home
2. Practitioners
3. Hygienist
4. Hygienist Overview

Hygienist Overview

Scope of Practice | NEW ADMINISTRATIVE RULES | Accepted Clinical Board Examinations | Dental Hygiene Applicant | Coronavirus | Military and Military Spouses | Newly Licensed Hygienists | Name & Address Changes | Expanded Duties - Permits | Reporting or Self-Report 

We Can Help You:

• RDH/RDA/QDA/DA - DUTIES CHART
• Apply for Dental Hygiene License 
• License by Examination
• License by Credential
• Reinstatement of ND License - APPLICATION for reinstatement
• Inactive Status
• Board approved courses for Administration of Nitrous Oxide Inhalation Therapy
•                         ND State College of Science Nitrous Course INFO 
•                         or  Nitrous Oxide Inhalation  
• Local Anesthesia 
• Restorative Functions Permit
• Dental Anesthesia Assistant Permit
• Reporting or Self-Report
• Need 2 CE credits? Take the Jurisprudence Exam
• Check your Application Status
• Check your Continuing Education Status
• SDF - Silver Diamine Fluoride
• Laser technology
• Verify a License
• Change / Update Email or Home Address 
• Purchase a Duplicate License 
• Reporting or Self-report

Scope of Practice

The ND Board of Dental Examiners recognizes that the delivery of dental hygiene duties may be fulfilled in various settings. The Board does not limit the avenue for delivery of care, rather supervision and scope of practice. The dental hygiene license is a privilege granted by the Board to those who demonstrate professional competency and knowledge of ethics and laws governing the profession. Although the dental hygienist provides dental hygiene care under the general supervision of a dentist, the dental hygienist is accountable to be competent for all dental hygiene services provided. Nonetheless, individual competency and experience levels vary among professionals, therefore it is the supervising dentist's prerogative to determine the duties the hygienist will be authorized to provide. A licensed dental hygienist may In accordance with Chapter 43-20-03 provide dental hygiene duties as defined under Admin. Rules Ch. 20-04-01-01, while under the general supervision of a dentist as defined in NDCC 43-28-01(5) and is permitted to provide dental hygiene services as delegated by the supervising dentist that the licensed dental hygienist knows he/she is competent to perform. A licensed dentist is not permitted to delegate to a licensed dental hygienist dental services or dental supportive services that the licensed dentist knows or has reason to know that the licensed dental hygienist is not qualified by training, experience or by licensure to perform. Protocols, services to be performed, and record keeping shall not supersede any law or regulation which require dental hygiene duties to be performed under the indirect or direct supervision of a dentist.     

RDH RDA CHART OF DUTIES - EXPANDED DUTIES 

Accepted Clinical Board Examinations

The applicant has passed, within five years of application, a clinical competency examination administered by one of the following:

• Any regional dental testing service before September 17, 2009.
• Central Regional Dental Testing Service.
• Council of Interstate Testing Agencies.
• Commission on Dental Competency Assessments-Western Regional Examining Board; and
• American Board of Dental Examiners 

New Applicants 

• New license applicants: The application must be received by the Board office before any decision about qualifications can be made. The applicant shall enclose with the application a recent autographed picture of the applicant and an application fee as determined by the Board by rule. NDCC § 43-28-11. Application fees are nonrefundable.
• Initial applications must be completed within twelve months and accompanied by the appropriate fee. If an applicant fails to complete the requirements for licensure within twelve months of the applications post mark, the application and fee are no longer valid. Applications which are not notarized, submitted without the required licensing fee, or without the applicant’s signed photo will be returned. 
• Clinical competency board exams accepted by the NDBDE are CRDTS, CITA, CDCA-WREB and the ADEX exam. Manikin based clinical competency board exams are accepted. 
• The Board investigates an applicant’s fitness, qualification, and previous professional record and performance. The Board may seek information from recognized data sources, including the National Practitioners Data Bank, liability insurers, health care institutions, and law enforcement agencies. The Board requires initial license applicants to submit to a statewide and nationwide criminal history check.
• For information from the ND State College of Science course for ADMINISTRATION of Nitrous Oxide Inhalation Analgesia.

Military Members or Military Spouses

Applicants who meet the criteria of a military member or military spouse may be registered through the process set forth at NDCC  43-51-11.1

New Licensees

Initial Licensure Fee vs. Biennial Renewal Fee: 

• Both fees are required in order to obtain and maintain a license and registration. The initial license application fee is paid to initiate administrative processes and verifications that must be completed by the Board's administrative office. The renewal fee grants the license for the following two-year period. Failure to pay the renewal fee will cause the license to expire.
• If a licensee fails to renew the license by December 31^st of odd numbered years, the practitioner may not practice dental hygiene. It is illegal to practice dental hygiene without a valid license.
• Within 60 days after December 31^st of the odd-numbered year, an expired license may be renewed by submitting the renewal application, the application fee, late fee and proof of continuing education, the license may not be renewed and the dental hygienist must apply for and meet the requirements for licensure to be granted a license.  
• If you do not receive a renewal notice in the mail by November 15th of odd numbered years, call the Board immediately. 

Permits 

All permit applications must be approved by the Board's Executive Director of the Board prior to issue.  

• A dental hygienist may be authorized by permit to provide dental anesthesia assistant duties under the direct supervision of a dentist authorized by permit to provide moderate sedation; or,
• A dental hygienist may be authorized by a permit to provide restorative functions under the direct supervision of a dentist. A permit fee is not required. Once the permit is granted, renewal of the permit is required biennially with 2 hours of continuing education relevant to the permit.
• Effective 7/1/22, a registered dental hygienist may be authorized to ADMINISTER nitrous oxide inhalation analgesia. A permit fee is not required. See Section 20-02-01-05 subsection 1. for requirements.
• Download Application to Administer Nitrous              Nitrous Oxide Course
• Local Anesthesia Endorsement - A dental hygienist is authorized by the application process to provide local anesthesia. A fee is not required. Once the application is reviewed and accepted, the local anesthesia endorsement is posted on the website. The RDH is not required to renew the endorsement.  A hygienist who wishes to administer block and infiltration anesthesia must complete the application for authorization. The expanded function may only be delegated to a hygienist under the direct supervision of a dentist and may only be utilized for a patient who is at least eighteen years old. A hygienist may terminate or reduce the amount of nitrous oxide previously administered by the dentist.     Download Local Anesthesia Permit Application

Restorative Functions 

• The Board may issue a permit authorizing a dental hygienist under the direct supervision to provide restorative duties if the applicant successfully completes the following:

1. Completes a board approved course;
2. Passes a dental testing agency restorative examination or other equivalent examination approved by the Board;
3. The Board may require completion of the restorative function component of the Dental Assisting National Board’s certified restorative functions dental assistant examination; or                                                                                                                                                                                                                                        the applicant has successfully passed a dental testing agency restorative examination or other board-approved exam over five years from the date of application and successfully completed the restorative function component of the Dental Assisting National Board's certified restorative examination and provided evidence from another state or jurisdiction where the appplicant legally is or was authorized to perform restorative functions and certification from the supervising dentist of successful completion of at least 25 restorative procedures within the immediate five years before the date of application .

• Restorative procedures allowed under direct supervision of a dentist are as follows:

1. Place, carve, and adjust amalgam,  glass ionomer or composite restorations with hand instruments or a slow-speed handpiece;
2. Adapt and cement stainless steel crowns;
3. Place, contour, and adjust composite restorations where the margins are entirely within the enamel with hand instruments or a slow-speed handpiece.

• The University of Minnesota offers a ND Board approved course for Restorative Expanded Duties / 80-hour course. Successful completion of this course qualifies a registered dental hygienist or registered dental assistant for application of the Restorative Procedures Permit.

Download Restorative Functions Initial Application 

Dental Anesthesia Assistant

• A dental hygienist may provide anesthesia assistance under the supervision of a dentist authorized by permit to provide sedation or anesthesia services once the applicant successfully completes the following:

1. Board-approved dental anesthesia assistant education and training course;
2. Board-approved competency examination;
3. Completion of a training in intravenous access or phlebotomy;
4. Has proof of current BLS or ACLS or PALS;
5. Provides proof of a general anesthesia permit issued to the OMFS who will be supervising the anesthesia assistant’s services.

• A dental hygienist authorized by permit may provide the following duties under contiguous supervision of a dentist authorized by permit to provide sedation or anesthesia services:

1. Initiate and discontinue an IV line for a patient being prepared to receive IV medication, sedation or general anesthesia; and
2. Adjust the rate of intravenous fluids infusion only to maintain or keep the line patent or open.
3. Prepare anesthesia equipment and perform patient monitoring.
4. Assist with emergency treatment and protocols.

• A dental hygienist authorized by permit may provide the following duties under direct visual supervision of a dentist authorized by permit to provide sedation or anesthesia services:

1. Draw up and prepare medications;
2. Follow instructions to deliver medication into an intravenous line upon verbal command;
3. Adjust the rate of intravenous fluids infusion beyond a keep-open rate; and
4. Adjust an electronic device to provide medications such as an infusion pump upon the verbal command of the supervising dentist.

Anesthesia Assistant Initial Application 

Anesthesia Assistant Courses Accepted by the NDBDE

• The Dental Anesthesia Assistant National Certification Examination (DAANCE) is a two-part 36 hour continuing education program comprised of self-study material and a standardized computer based exam. The course is designed for auxiliary who assist a dentist or OMFS with a valid ND sedation or anesthesia permit. DAANCE certification is valid for five years. To recertify, assistants must retake the DAANCE examination every five years and maintain current BLS and/or ACLS certifications. Note: Online CPR certifications are not accepted. The course meets the requirements for a ND Class I Dental Anesthesia Assistant Permit.  
• Sedation Consult, LLC:  Allan Schwartz, DDS, CRNA provides a 3 day course, Monitoring Sedation/General Anesthesia & I.V. Certification meets the requirements for requirements of ND Class II Dental Anesthesia Assistant Permit.  
• The American Dental Society of Anesthesiology is a two-day, 12 hour CE sedation course for auxiliaries featuring an in depth approach designed especially for those who work in general anesthesia and moderate sedation practices. The course provides a certificate for the completion of the CE but does not provide certification or testing therefore to achieve Permit I, the DAANCE exam would also be required. 

Lasers

The use of lasers continues to be a popular treatment modality in dentistry. It is the position of the Board that any services provided by a licensee, regardless of the device used, must be within the scope of practice for each licensee. Whenever a new treatment modality is brought forward, it is the Board’s policy that the dentist must have equal or greater proficiency and training in the technology. Neither the particular technology utilized nor amendments to scope of practice alter the fact that all licensees are responsible for their individual actions with the dentist ultimately responsible for all care provided in each dental office.  Contact the Board office if you have questions about the regulations governing the practice of dental hygiene in North Dakota. A permit is not required.

Silver Diamine Fluoride (SDF)

Rules authorizing the administration of fluoride are silent on specifics or types of anticariogenic agents and desensitizing solutions. For this reason, dental hygienists are authorized to apply SDF. As with any authorized duty provided by a dental hygienist (or any other practitioner) it is incumbent upon the practitioner to become educated with a product, administration of a product or procedure. As noted with lasers, all licensees are responsible for their individual actions with the dentist being ultimately responsible for all care provided in each dental office. 

Reporting or Self-Reporting    

According to the NDBDE’s reporting laws, a licensee must report to the board in writing within sixty days of the event any illegal, unethical, or errant behavior or conduct of the dentist, including malpractice judgements or settlements or final judgment for or against the licensee, a final disposition by a licensing agency in another state, territory, or country; all proceedings, of formal or informal actions by a governmental agency; a law enforcement agency; or a court for an act or conduct that would constitute grounds for discipline.

If you have a conviction, or any other incident to report as required by application, send with the application supporting documentation and/or certified copies of all court documents related to the matter discussed in the petition. Documentation includes, as applicable, a copy of any assessment or evaluation and recommendations for treatment, criminal charges, reported offenses, police reports, judgments, dispositions of criminal complaint, dispositions of offenses, final dispositions, court orders, actions pending, and deferred judgments. Not doing so may delay the licensing process.

Name and Address Changes - Notice to Board (NDCC 43-20-12.2)

A licensed dental hygienist, registered dental assistant, or qualified dental assistant must notify the board of any new address within 30 days of the address change. The notice required under this section of law must be given by certified mail, return receipt requested.  A licensed dental hygienist, registered dental assistant, or qualified dental assistant may not practice in this state for more than thirty days after the change of address without complying with this section of the North Dakota Century Code. To download the form for name/address changes use this link.  A name or address change cannot be taken by phone and must be submitted to the Board's office in writing. If you need a license mailed to you, please email the Board's office. The Board will no longer mail/send out new certificates. You may also print your registration certificate.

Name changes must be accompanied by a copy of the name change document (marriage license, section of the divorce decree, etc.) Make sure your changes include your current name. Your license/registration number is helpful, but not mandatory. NAME AND ADDRESS CHANGES WILL NOT BE COMPLETED OVER THE PHONE.  Small license certificates are NO LONGER mailed out but may be printed from the Board's website.. 

Reprint of Large License Certificate

The Board charges $50 if you wish to have a new large certificate mailed to you. You must send a request for the certificate and a check or money order for $50 payable to NDSBDE and mail it to the address below. It may take up to 3 months to receive your new certificate.