Before administering local anesthesia by inferior alveolar nerve block, a dental hygienist who successfully completed the education requirements and examination for the 28-hour local anesthesia Board-approved course as outlined in Regulation .08 of this chapter before October 1, 2011 shall: Successfully complete a Board-approved refresher course of at least 2 hours on local anesthesia by inferior alveolar nerve block offered by an accredited dental hygiene program; Pass a clinical examination administered by the Board-approved course with an overall passing grade of at least 75 percent; and Submit a letter from an accredited dental hygiene program indicating that the applicant has: Successfully completed the Board-approved course; and Received an overall passing grade of at least 75 percent in the course’s clinical examination. The letter from the accredited dental hygiene program referred to in §A of this regulation shall: Be on the letterhead of the accredited dental hygiene program; Contain a raised embossed school seal; and Contain the original signature of either: The Dean of the accredited dental hygiene program; or The head of the dental hygiene department. A dental hygienist who is subject to this regulation shall receive written permission from the Board before administering local anesthesia by inferior alveolar nerve block. A dental hygienist who is subject to §A of this regulation and who has not received written permission from the Board to administer local anesthesia by inferior alveolar nerve block as described in §C of this regulation may administer local anesthesia by infiltration only.