Apply for a dental hygienist license

Application attachments

We must have these attachments to process your application.

Proof of Graduation

• Either of the following:
  • Original transcript with school seal indicating date of graduation and degree awarded, or
  • Original signed letter from Dean’s or Registrar’s office indicating date of graduation and degree awarded
• Photocopies of transcripts or diplomas are not acceptable

National Board Certification

• An official, original copy of your National Board certificate indicating your passing score on all sections of the exam, or
• Authorization to the National Boards releasing your scores to Massachusetts

Proof of Regional or State Clinical Examination

• Proof of successful completion of a Board-approved exam
  • Regional and State Clinical Exam Requirements (DOCX)
• An official, original copy of your Board-approved exam scores, or
• Authorization to the Board-approved exam releasing your scores to Massachusetts

Physician’s Statement

• Examination and signed statement from your primary care physician, physician’s assistant, or nurse practitioner that you are medically cleared to practice dental hygiene. The exam must have been completed within 12 months of application.

Documentation of certifications

Either one of the following documents:

• Current certification in American Red Cross Cardiopulmonary Resuscitation/Automated External Defibrillation for the Professional Rescuer (CPR/AED), or
• Current certification in American Heart Association Basic Life Support for Healthcare Providers (BLS)

Massachusetts Dental Ethics and Jurisprudence Exam

• Answer sheet only
• Request a copy here

If applicable

Letters of Standing

• Official verification of professional licensure from each state or jurisdiction in which you now hold, or ever have held, a license
• The official letter must include the current status of your license, license number, the official seal and signature of the jurisdiction’s licensing board, and any disciplinary action taken
• Photocopy of a license is not acceptable
• A copy of a screen shot from the jurisdiction’s licensing board website is also not acceptable

Practice History

• If you have ever practiced dental hygiene in another jurisdiction or state, please include an up-to-date resume or practice history

National Practitioner Data Bank Self-Query

• Attach if you have ever held a professional healthcare license in the United States
• To request a self-query please contact the Data Bank at (800) 767-6732 or go to the NPDB website
• The Data Bank will mail the report to you. A copy of the original NPDB report is acceptable.

Criminal Offender Record Information (CORI) Acknowledgment Form

• Only if you have answered “yes” to any of the questions in the Good Moral Character Questions
• This form is attached in the application
• This must be signed in person, and witnessed by either a BHPL employee at the Board's offices or a notary public
  • The BHPL employee or notary public must verify your identity through acceptable identification

Other requirements

A photo of yourself

You will need to attach, where indicated, a color photograph, passport-sized (2” x 2”) or larger.

Good moral standing

On the application, you must include signatures from 2 licensed dentists or dental hygienists who are familiar with your character and quality.

• The dentists and dental hygienists do not need to be licensed in Massachusetts
• Immediate family members or close relatives cannot sign as to your character and quality

Affidavit

You must sign the affidavit on the application and have it witnessed by a Notary Public.