1. (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).

2. (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. (1) Any other names by which the applicant has ever been known; and

   2. (2) Whether the applicant has taken and passed the following examinations of the:

      1. a. Joint Commission on National Dental Examinations; and
      2. 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.

3. (c) The applicant for licensure as a dental hygienist shall provide the following with the application for licensure:

   1. (1) One of the following:

      1. a. An original or certified copy of the applicant's birth certificate written in English or translated to English;
      2. b. A certified copy of the applicant’s valid passport written in English or translated to English; or
      3. c. A driver’s license or other state issued identification;

   2. (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:

      1. 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.”

      2. b. Signature of the individual attesting to the statement in a. above;
      3. c. Address of the individual attesting to the statement in a. above;
      4. d. Printed name of the individual attesting to the statement in a. above;
      5. 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
      6. f. The applicant’s name and complete address in the “Return this completed form to:” section;
   3. (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. (4) Proof of current basic life support for healthcare providers (BLS-HCP), if applicable;
   5. (5) A criminal offender record check provided in accordance with Plc 304.01(b);
   6. (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. (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. (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;

      1. a. Has been subject to disciplinary action;
      2. b. Has disciplinary action pending;
      3. c. Has been under stayed probation; or
      4. d. Is under investigation; and
   9. (9) The fee required pursuant to Plc 1002.11.
4. (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.
5. (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.

6. (f) An applicant shall be a graduate of a dental hygiene program which:

   1. (1) Is of at least 2 academic years in duration;
   2. (2) Is accredited by a national accrediting agency recognized by the United States Department of Education and the CODA; and
   3. (3) Awards the minimum degree of Associates in Science with a major in dental hygiene.
7. (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.
8. (h) The passing score on the jurisprudence exam shall be 75% or higher.
9. (i) After passage of the jurisprudence exam in (g) above, an active New Hampshire dental hygiene license shall be issued.

Source. 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; ss by #10689, eff 10-7-14; ss by #10824, eff 5-6-15; ss by #10991, eff 12-9-15; ss by #12428, eff 12-6-17; amd by #13232, EMERGENCY RULE, eff 7-15-21, EXPIRED: 1-11-22; ss by #13367, eff 4-19-22 (see Revision Note at chapter heading for Den 300); ss by #14187, eff 4-4-25