An applicant for certification in local anesthesia under general supervision must possess the following qualifications and submit the following documentation along with a completed application.

1. A. An applicant must possess the following qualifications:

   1. (1) have a current active license in good standing to practice dental hygiene in New Mexico;
   2. (2) possess a New Mexico certification to administer local anesthesia under the indirect supervision of a licensed dentist; and
   3. (3) have administered 20 cases of local anesthesia under the indirect supervision of a dentist during two consecutive years.

2. B. An applicant must provide the board office with the following documentation:

   1. (1) a copy of a current New Mexico dental hygiene license;
   2. (2) a copy of the applicant’s certificate to administer local anesthesia under indirect supervision; and
   3. (3) a signed affidavit, on a board-approved form, from the supervising dentist attesting to the applicant’s qualifications for a certificate to administer local anesthesia under general supervision. The affidavit is valid for subsequent or additional locations in which the applicant may practice.

[16.5.28.11 NMAC - Rp, 16.5.28.11 NMAC, 5/31/2023]