License Applications
An individual may apply for a license to practice as a dental hygienist by completing one of the following license applications.
The application for new license is for a dental hygienist that has passed a patient based clinical competency dental hygiene examination within five years preceding the date of application. The examination must meet criteria outlined in ARSD 20:43:03:02 to be accepted for licensure. Verification from the testing agency that the exam meets all requirements may be requested..
Anesthesia & Sedation
Administer Nitrous Oxide
A dental hygienist that would like to administer nitrous oxide sedation and analgesia must hold a nitrous oxide sedation and analgesia permit.
Dental Hygienist - Application to Administer Nitrous Oxide
Administer Local Anesthesia
A dental hygienist that would like to administer local anesthesia must hold a local anesthesia permit.
Dental Hygienist - Application to Administer Local Anesthesia
Monitor Anesthesia
A dental hygienist that monitors patoents under general anesthesia, deep sedation or moderate sedation must hold a permit to monitor.
Dental Hygienist- Application to Monitor
General Anesthesia, Deep Sedation, or Moderate Sedation
All courses that have been approved for a permit to monitor patients under anesthesia are listed in the application. To request approval of a course that is not listed on this application, but meets the requirements in ARSD 20:43:09, please complete the course approval request form.
Collaborative Supervision
A hygienist that would like to utilize collaborative supervision must complete both the application and agreement. These documents must be reviewed and approved by the Board. A complete applicaton and agreement must be returned to our office at least 30 days before the next scheduled Board meeting in order to be considered at that Board meeting.
Collaborative Supervision Application Collborative Supervision Agreement Silver Diamine Fluoride Addendum
Volunteer Registration
Application for Temporary Volunteer Registration
Application Status
You may check the status of your application at any time by clicking on the Application Status link below and logging in with the indicated personal information. If any required documentation is missing or incomplete it will be indicated in the status and/or comment spaces. This information is updated as documents are received, so please check this link prior to calling the office to check on the status of your application. Once your application is complete and processed the link below will no longer work and will return a message of "No record was found with those credentials".
If you have any questions, please contact our office.