Dental Hygienist

License Information

Per Wis. Stat. § 440.08 (2), the required renewal date for the Dental Hygienist credential is 09/30/odd years.  Should you receive your initial credential in the months leading up to this date, you are still required to renew your license by the statutorily defined date.

Pre-Credential Education Information

Graduate from a dental hygiene school accredited by the American Dental Association Commission on Dental Accreditation.

Application for Licensure

511Application For Dental Hygiene License
​1463​Dental Hygiene Certificate of Professional Education
​2853​Application for Temporary Permit to Practice Dental Hygiene Without Compensation

Malpractice Suits or Claims Form (if applicable)

​Convictions and Pending Charges
3071​Fax Payment Form

Application to Administer Anesthesia/Conscious Sedation

2455Application For Dental Hygiene Certificate to Administer Local Anesthesia
2458Certification of Inferior Alveolar Injection
​2457​Local Anesthesia Certificate of Completion
3163​Application for Dental Hygiene to Administer Nitrous Oxide
​3164​Nitrous Oxide Certificate of Completion

Renewal Information


  • FEE (See Renewal Dates and Fees)
  • SIG (Signature regarding the completion of Continuing Education, included in on-line renewal and paper form see Continuing Education Information for details)
  • CPR (Current CPR/AED certification is required)
  • If your legal status as a qualified alien or nonimmigrant lawfully present in the United States has changed since the issuance of your credential or your last renewal, please contact the Wisconsin Department of Safety and Professional Services at (608) 266-2112 or

Renewal Methods

  • Online Log In: License Renewal Online
  • Request a Paper Renewal Form: (888) 506‑4239 or (608) 261‑4460 for the Madison area
RDAFRenewal Dates and Fees
R210Active Duty/Discharge Renewal Extension

Wisconsin Act 210 (effective June 1, 2012)

This Act extends the license of a service member if the license expires while they are on active duty from 90 days to 180 days from the date of discharge. The same applies to a spouse of a service member if the spouse does not practice under their license while the service member is on active duty and does not practice because the service member is on active duty.

This Act repeals a provision of prior law that required a service member to meet all of the requirements for license extension or renewal, except for continuing education requirements, in order to have the license extended.

Service members and spouses may request extensions of licenses beyond 180 days from discharge and may request a waiver or extension of time to complete continuing education requirements due to hardship.  Please view Active Duty/Discharge Renewal Extension Form #R210.