Current through Register No. 40, October 3, 2024
(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.
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
