(1) No licensed dental hygienist shall administer local anesthetic agents during a dental procedure or a dental-surgical procedure unless and until the hygienist possesses a local anesthetic permit issued by the board.

(2) Application for local anesthetic certification by examination shall be made on an application form and must include the following:

(a) verification of successful passage of the Western Regional Examining Board (WREB) local anesthetic examination within the last five years;

(b) a copy of the applicant's current CPR, ACLS, or PALS card;

(c) payment of appropriate fees; and

(d) evidence of having previously received a Montana dental hygiene license, or of being in the process of applying for a Montana dental hygiene license.

(3) Application for a local anesthetic certificate by credentialing shall be made on an application provided by the board and shall include the following:

(a) verification of successful passage of the WREB local anesthetic examination more than five years ago;

(b) a copy of the applicant's current CPR, ACLS, or PALS card;

(c) payment of appropriate fees;

(d) evidence that the applicant is in the process of applying for a Montana dental hygiene license or has previously received a Montana dental hygiene license;

(e) copies of any local anesthetic agent authorization(s) held in other states; and

(f) written verification that the applicant has practiced administering local anesthetic agents within the last five years.

(4) An applicant who wishes to convert an inactive status local anesthesia certification in conjunction with the conversion of an inactive dental hygiene license shall:

(a) verify passage of a WREB local anesthetic examination;

(b) submit an application provided by the board;

(c) submit a copy of the applicant's current CPR, ACLS, or PALS card;

(d) copies of any local anesthetic agent license held in other states; and

(e) written verification from a supervising dentist that the applicant has practiced administering local anesthetic agents within the last five years.

(5) The application remains valid for one year from the time it is received in the office.