HAWAII STATE BOARD OF DENTISTRY
GUIDELINES: CERTIFICATION FOR ADMINISTRATION OF INTRA-ORAL BLOCK ANESTHESIA
EDUCATIONAL REQUIREMENTS
Approved by the Board as Guidance: January 22, 2024
Page 1 of 3
CERTIFICATION FOR ADMINISTRATION
INTRA-ORAL BLOCK ANESTHESIA
NOTE: Individuals should first apply and be approved for their general dental hygiene license in Hawaii
before applying for Certification for Administration of Intra-Oral Block Anesthesia.
If you are approved for your general dental hygiene license and do not wish to apply for the additional
intra-oral block Certification, you may only administer intra-oral infiltration anesthesia pursuant to HAR
§16-79-76(b).
I. Dental Anesthesia Injection Requirements*
An applicant for certification to administer intra-oral block anesthesia shall show proof that the
applicant successfully completed a course of study that shall include the following categories of intra-
oral infiltration local anesthesia and intra-oral block anesthesia. Refer to the table below.
Categories of Intra-Oral Infiltration Local
Anesthesia & Intra-Oral Block Anesthesia
Injections
Total Number of
Injections
Completed *
Completed
(Yes/No)
Date Requirement
Completed
(1) Maxillary mandibular infiltration
anesthesia
(2) Long buccal nerve block anesthesia
(3) Mental nerve block
(4) Inferior alveolar/lingual nerve block
(Minimum 10)
(5) Incisive nerve block
(6) Posterior superior alveolar nerve
block (Minimum 5)
(7) Middle superior alveolar nerve block
(8) Anterior superior alveolar nerve
block
(9) Nasopalatine (incisive canal) nerve
block
(10) Greater (anterior) palatine nerve
block
*Minimum of 50 successful injections required.
Page 2 of 3
GUIDELINES: CERTIFICATION FOR ADMINISTRATION
INTRA-ORAL BLOCK ANESTHESIA
II. Dental Anesthesia Course of Study Requirements
A course of study shall also include didactic studies and clinical experience, and for intra-oral block
anesthesia categories as pertinent to the required dental anesthesia injections, at least thirty-nine
hours, and a minimum of fifty successful injections of which ten shall be “inferior alveolar/lingual
nerve” intra-oral block and five in “posterior superior alveolar nerve” intra-oral block.
The curriculum of the course of study shall include as follows:
(1) Cardiopulmonary resuscitation certification;
(2) Medical history evaluation procedures;
(3) Physical evaluation procedures;
(4) Anatomy of head, neck, and oral cavity as it relates to administering local anesthetic
agents;
(5) Pharmacology of local anesthetics and vasoconstrictors;
(6) Indications and contraindications for administration of local anesthetics;
(7) Prevention, diagnosis, and management of medical emergency;
(8) Recognition and management of post-injection complications and management of
reactions to injections;
(9) Medical and legal management complications;
(10) Selection and preparation of the armamenteria and recordkeeping for administering
various local anesthetics;
(11) Methods of administering local anesthetics with emphasis on technique, which includes
aspiration and slow injection, in addition to minimum effective dosage; and
(12) Proper infection control techniques with regard to local anesthesia and the proper
disposal of sharps.
As part of the course of study, the applicant or licensed dental hygienist shall be required to pass an
examination to determine if the applicant or licensed dental hygienist has acquired the necessary
knowledge and clinical proficiency to administer intra-oral block anesthesia.
III. Documentation for Certification to Administer Intra-oral Block Anesthesia
A licensed dental hygienist may apply to the board for certification to administer intra-oral block
anesthesia by providing to the board documentation which shall include:
(1) A certificate of completion from a CODA accredited dental hygiene school or by a
certification program approved by the board; and
(2) Program documentation or transcript listing the intra-oral block anesthesia categories, the
course content, and number of injections that are consistent with section 447-3.5, HRS.
Note: An applicant can fulfill the minimum dental anesthesia injection requirements by submitting
more than one certificate from a CODA accredited hygiene school or certification program approved
by the board.
Page 3 of 3
GUIDELINES: CERTIFICATION FOR ADMINISTRATION
INTRA-ORAL BLOCK ANESTHESIA
IV. Hawaii Statutory References
• Hawaii Revised Statutes §447-3.5
• Hawaii Administrative Rules §16-79-76
Disclaimer: This document offers general guidance on intra-oral block anesthesia certification
requirements. For specific statutory references, consult Hawaii Revised Statutes §447-3.5 and Hawaii
Administrative Rules §16-79-76.
Frequently Asked Questions:
1. I graduated from a CODA-accredited dental hygiene program, but the program did not offer
certification/training in intra-oral block and/or intra-oral infiltration anesthesia. How do I apply for
the Certification to Administer Intra-Oral Block Anesthesia?
To meet Hawaii’s statutory requirements, you should identify a CODA-accredited dental hygiene
program that meets the requirements for Certification as outlined in HRS §447-3.5 and contact
the Board for approval. Upon Board approval and subsequent completion of the course, you can
submit your application for Certification.
2. I graduated from a CODA-accredited dental hygiene program, but my program was “short” one or
more of the injection requirements of HRS §447-3.5 (e.g. short 1 of the 10 IA/IL injections). How
do I remediate?
To remediate, you should identify a CODA-accredited dental hygiene program that, in the course
of study, you will be able to “make-up” the injections you are short in. You should contact the
Board for approval of the course before enrolling.
3. Can I remediate injection requirements I am “short” by submitting a letter from my employer that I
perform injections as part of my dental hygiene work?
No. If you need to remediate injection requirements, you must enroll in a formal course approved
by the Board.
