Dental Hygienist - Local Anesthesia Specialty

To obtain a Local Anesthesia specialty you must have completed the following:

• Completion of an accredited local anesthesia specialty certification program that meets the requirements under DE 7.05.

• Certificate of Proficiency in Cardiopulmonary Resuscitation/AED through a DHS CPR and AED Approved Program Provider

• Create or log into your LicensE account

• Select Licenses and Applications, then My Licenses. Click the arrow under the Action menu on the right side of the screen and select Add Specialty.

• Enter your Personal Information

Please note: Your name, address, phone number, and e-mail address are available to the public as a licensed professional. You may request to withhold street address/PO Box, phone number, and e-mail address from lists of 10 or more credential holders during the application process.

• Choose your Certification Details

• Submit your License History

• Choose your Specialty level of sedation

• Respond to the Declarations

• Upload your Supporting Documents. You are not required to provide all documents before initial application submission.

Required Documents:

• Form 2457: Local Anesthesia Certificate of Completion

• Certificate of Proficiency in Cardiopulmonary Resuscitation/AED through a DHS approved provider.

Required if Applicable:

• Form 2458: Certificate of Inferior Alveolar Injection

If applicant completed their nitrous oxide course outside of Wisconsin, the following is needed:

• Copy of syllabus or course description that includes the number of nitrous inductions that were completed as part of the course work.

Applicant must provide a copy of their CPR/AED certificate. Certificate must be earned through a program approved by the Wisconsin Department of Health Services. DHS approved program list is linked below. 

Certificate must include the following:

• Applicant name

• Expiration date of certification

• Name of course provider

• Applicant's school will need to verify their dental hygiene education by completion of form 2457.

  • Applicant will complete the application section of the form, and the form will be emailed to applicant's school for completion of remainder of form. School must then upload form directly to applicant's supporting documents.

In addition to completion of form 2457, applicants who completed their local anesthesia coursework in another state will need to submit one or more of the following:

• A course description

• Copy of Syllabus

• Letter from the course provider

The documentation provided must outline the course topics and confirmation of the number of local anesthesia injections completed. This information can be uploaded directly to the applicant's supporting documents.

After you upload all required documents, submit your application, and pay the required fee(s):

1. Preliminary Application Reference Number (PAR)

   1. Your application will be assigned a Preliminary Application Reference number or PAR number. This number allows you and trusted parties to look up the status of your application without logging in. You can also reference this number in any support tickets you submit in regard to your application.

      • A trusted 3^rd party can look up your credential status by visiting LicensE, clicking “Application Status Lookup” and entering the PAR number you have provided to them.

2. Review Timeline

   1. Your materials will be reviewed within approximately 10 days by a member of the credentialing team.

      • Note: Some licenses do take longer to process due to complexity. You can see the performance data on our LicensE Dashboard to see what date we are reviewing for certain application types under "Application Review Times by Profession."

3. Pending Applicant Input Status

   1. After this review, if anything is missing or the credentialing team has any questions on your application, your application will go back into a status called “Pending Applicant Input.”  You will receive an email letting you know your application was moved into this status. You should then log into LicensE and check your application “Due Diligence.”

4. To check your "Due Diligence" 

   1. Your Due Diligence is a checklist of items required for your credential.

   2. The Due Diligence section is how DSPS staff will communicate with you regarding your credential requirements.

   3. Log in to your LicensE account

   4. Click on "Check Application Status" 

   5. Your credential application should be shown on this page. Under “Action” select the button that looks like an upside-down triangle. If you are on mobile, you will need to turn your phone into landscape view. Note: LicensE is best viewed on a desktop or laptop.

   6. After clicking the upside-down triangle, select “View Due Diligences.”

   7. The Due Diligence column lets you know what the requirement is.

   8. The “STATUS” column will you know if the item is “Met”, “Not Met”, or “Not Applicable.”

      • Items listed as “Not Met” are items that are needed by the Department.  

   9. The “NOTES” column of your Due Diligence will provide further written details or instructions about what is still needed.

5. To upload documents

   1. Some applications require additional document uploads.

   2. Log into your LicensE account

   3. Click on "Check Application Status"

   4. Your credential application should be shown on this page. Under "Action" select the button that looks like an upside-down triangle. If you are on mobile, you will need to turn your phone into landscape view. Note: LicensE is best viewed on a desktop or laptop. 

   5. After clicking the upside-down triangle, select "Upload Document."

   6. The document must be an allowable document type. 

   7. After uploading the document, click "submit." If you do not, it will not be sent to a reviewer. 

6. If you have any questions, you can submit a support ticket on LicensE by logging in and clicking "request support" at the top of the page.

LicensE statuses that require action from applicant:

LicensE statuses that indicate the application is with Department staff:

Support Ticket
Submit a support ticket on LicensE and click "request support." Please provide as much detail as possible regarding your concern so we can work to answer your question with a one touch resolution. 

Call
608-266-2112

Email
dsps@wisconsin.gov

Office Hours
7:45am-4:30pm
Department of Safety and Professional Services
4822 Madison Yards Way
Madison, WI, 53705

Note: The in-person office does not process same day.