Kentucky requires special registration for dental hygienists to administer local anesthesia, practice under general supervision, insert intravenous access lines, perform laser debridement, and practice as public health hygienist. Pursuant to KRS 313.060 and 201 KAR 8:563, hygienists can only perform these duties if they have the appropriate experience and are formally registered with the Board. These requirements are in excess of those necessary to obtain a standard dental hygiene license.
All special privileges are identified on the hygienist's license and must be renewed during the dental hygiene license renewal process to remain active. Except for General Supervision and Public Health, special privileges do not require ongoing continuing education to maintain an active registration.
Please use the following form to apply for all special registration privileges:
Local Anesthesia
A licensed dental hygienist who desires to administer block and infiltration anesthesia and/or nitrous oxide analgesia in Kentucky must receive 46 hours of formal training from a dental or dental hygiene school accredited by the Commission on Dental Accreditation (CODA) that meets the following requirements:
- A minimum of 32 hours covering anesthesia topics, including anatomical considerations, basic injunction technique, basic placement technique, nitrous oxide administration, recordkeeping, armamentarium exercise, local anesthesia and nitrous oxide, techniques of maxillary anesthesia, techniques of mandibular injections, partner injections and partner administration of nitrous oxide, neurophysiology, pharmacology, pharmacology of vasoconstrictors, physical and psychological evaluation, and contraindications;
- A minimum of two hours of clinical education for nitrous oxide administration with successful completion of administration, monitoring, and removal of nitrous oxide on at least two patients;
- A minimum of 12 hours demonstrating mastery of local anesthesia applications and successful completion of at least three injections each of all maxillary and mandibular injection sites; and
- A passing score of at least 75% on a written examination administered after coursework and clinical training.
A dental hygienist holding a local anesthesia registration from the Board who has not administered block anesthesia, infiltration anesthesia, or nitrous oxide analgesia for one year must complete a board-approved refresher course prior to resuming practice of that specific technique.
General Supervision
To qualify to practice under General Supervision in Kentucky, a dental hygienist must document at least two years and 3,000 hours of practice experience, and complete a live three hour course approved by the Board in the identification and prevention of potential medical emergencies.
On the hygienist's registration application, the supervising dentist must affirm by signature that the employed dental hygienist has the skills necessary to perform dental hygiene services under General Supervision. A separate application and fee is required for each supervising dentist for which the hygienist wishes to practice under General Supervision.
Once a dental hygienist is registered to practice under General Superivision, the supervising dentist shall provide a written order prescribing the dental service or procedure to be performed for each patient and shall retain the order in the dental record. The oral examination of the patient by the supervising dentist shall have been completed within the seven months preceding treatment by the dental hygienist practicing under general supervision.
The supervising dentist shall also provide a written protocol addressing the medically compromised patients who may or may not be treated by the dental hygienist. The dental hygienist shall only treat patients who are in the ASA Patient Physical Status Classification of ASA I or ASA II as listed in Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students, 2007 Edition, American Dental Association.
To maintain general supervision privileges, dental hygienists must complete a three-hour board-approved course on medical emergencies every two years. These hours may be included as part of the 30 overall hours required for dental hygiene license renewal.
See KRS 313.040(7) and 201 KAR 8:563 for complete details.
Intravenous Access Lines
To start IV access lines, a dental hygienist must complete a course approved by the Board that addresses patient safety techniques, anatomy and physiology, and techniques for starting and maintaining IV lines. A copy of the course completion certificate and any other supporting documentation should accompany the registration application.
Once registered, a dental hygienist may only start IV lines under the supervision of a licensed dentist who holds a moderate sedation or deep sedation/general anesthesia permit.
Public Health
To qualify for Public Health registration in Kentucky, a dental hygienist must document at least two years and 3,000 hours of practice experience, and complete a live three hour course approved by the Board in the identification and prevention of potential medical emergencies.
Pursuant to KRS 313.040(8)(c), a public health registered dental hygienist may practice in a government-created public health program at the following sites:
- Local health departments;
- Public or private educational institutions under the jurisdiction of the State Board of Education that have an affiliation agreement with the health department of jurisdiction;
- Mobile and portable dental health programs under contract with a governing board of health; and
- Public or private institutions under the jurisdiction of a federal, state, or local agency.
A public health registered dental hygienist shall perform dental hygiene services only under the supervision of the governing board of health, as required by KRS 313.040(3)(b), as established in KRS 313.040(8), and as identified by the Department for Public Health Practice Reference. These services shall be limited to preventative services.
The public health registered dental hygienist shall only treat a patient who is in the ASA Patient Physical Status Classification of ASA I or ASA II as established in the current edition of Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students, American Dental Association.
To maintain public health privileges, dental hygienists must complete five hours of continuing education in the area of public health as well as a three-hour board-approved course in medical emergencies every two years. These hours may be included as part of the 30 overall hours required for dental hygiene license renewal.
See KRS 313.040(8) and 201 KAR 8:563 for complete details.
Laser Debridement
In order to perform laser debridement in Kentucky, a dental hygienist must show successful completion of a course that meets or exceeds the Academy of Laser Dentistry’s Category II Standard Proficiency level certification course as described in the Curriculum Guidelines and Standards for Dental Laser Education.
The Category II Standard Proficiency course, in brief includes a minimum of 12 hours of specific educational activity, which should include hands-on training on the specific device the practitioner intends to use and a measured outcome learning verification exercise.
The completion certificate issued by the course provider must include the type of laser(s) and wavelengths on which the participant was trained. A copy of this certificate and any other supporting documentation should accompany the registration application.
Frequently Asked Questions
Q: Do special registration privileges require additional continuing education for renewal?
A: In most cases, no. Laser Debridement and Intravenous Access Line registration have no ongoing CE requirements. Local Anesthesia registration requires a refresher course to be completed if the hygienist has not administered anesthesia in the previous year. Only General Supervision and Public Health registration have a CE requirement that must be completed during every two-year renewal period.
Q: How do I know if my training qualifies for registration?
A: Each special privilege has its own set of training requirments. In some instances, the qualifying training may already be contained within the curriculum of a dental hygiene degree program. In other cases, a special board-approved course may need to be taken in order to qualify. The specific requirements for each priviledge are described above.
Q: Does my training for a registration privilege count toward my general CE requirement?
A: Yes. Any classes taken to qualify for a special registration can be counted toward the 30 hours of continuing education required for dental hygiene license renewal.
Q: Do I need to renew my special registration every two years like I do with my license?
A: Yes. Special registrations operate on the same two-year cycle as dental hygiene licenses, meaning they expire at the end of every even numbered year. Registration holders will be prompted to renew or retire their active registrations during the license renewal process.