Dental hygiene licensure specifications on pain control procedures

State boards of dentistry of the 51 licensure jurisdictions and 51 constituent hygiene presidents were sent identical surveys to obtain current information about dental hygiene licensure specifications for nitrous oxide analgesia, and infiltration, block, and topical anesthesia. The response rate was 72% (N = 37) from boards and 90% (N = 46) from constituent presidents. Results showed that western states are more likely to allow delegation of pain control functions. Of the four functions, topical anesthesia is the most and nitrous oxide analgesia is the least delegated. Most states that allow delegation of pain control procedures did so in the 1970s and 1980s. A majority of states where pain control functions are legal specify direct or indirect supervision and certification through board-approved courses. Percentages of hygienists certified in functions ranged from a low of 0% to a high of 100%. Boards and presidents agreed closely on functions allowed, certification requirements, and year of legalization. Agreement was lower on the type of supervision required for all procedures except nitrous oxide analgesia. No reports of patient reactions to or formal complaints about pain control procedures provided by hygienists were known to state boards or constituent presidents.