NY hygienists can give nitrous oxide, local anesthesia

Dental hygienists in New York now can administer local infiltration anesthesia and nitrous oxide to patients while assisting dentists with all dental procedures, thanks to a bill that was recently signed into law.

On May 9, New York Governor Kathy Gochul signed AB 9478A into law. The law removes the restriction of hygienists administering anesthesia and nitrous oxide only during dental hygiene procedures. The law went into effect immediately.

Under the law, hygienists still must obtain a local infiltration anesthesia/nitrous oxide analgesia certificate and administer the substances under the supervision of a dentist. Supervision of a dentist means the clinician must be in the dental office where the sedation is being administered.

Additionally, dentists still must authorize and prescribe the use of these sedatives and must personally examine patients after the use of the agents is completed. Dentists who fail to supervise the administration as noted will face penalties, according to the law.

As of March 2021, 35 states in the U.S. allowed dental hygienists to administer nitrous oxide to patients, according to data from the American Dental Hygienists' Association (ADHA). The specifics surrounding the administration vary by state.

Texas, North Dakota, and six other states only allow hygienists to monitor nitrous oxide, and the remainder of the states in the U.S., including Alabama and North Carolina, are silent on the issue, according to the ADHA.

As for the administration of local infiltration anesthesia by dental hygienists, all states and Washington, D.C., permit it. However, certification and supervision rules vary for each locale according to data last updated in October 2020 by the ADHA.