The Dental Quality Assurance Commission (dental commission) occasionally makes changes to rules. The dental commission determines rule changes are necessary for many reasons including: legislative law changes, request to change a rule, national standards change, and updating outdated rule language. The rules writing process is open to the public. The public is welcome to take part in helping us write rules. Rules are also known as regulations, Washington Administrative Code, or WAC. The rule making process includes public notices and workshops, and usually a public hearing before a rule becomes final.
To get updates about rule making and other topics related to dental professionals, please subscribe. After entering your email address, choose Health Systems Quality Assurance, Health Professions, Dental List.
Dentistry laws and rules are on our Laws webpage
Dentistry rules in progress (proposed rule modifications) are on our Rules in Progress webpage.
Recently Completed Rule Changes
- Dentist Continuing Education
The Dental Quality Assurance Commission is considering rule amendments for the number of hours allowed under self-study methods, WAC 246-817-440.
- CR101 filed on April 6, 2021, as WSR #21-08-076 (PDF)
- CR102 filed on August 26, 2021, as WSR #21-18-073 (PDF)
The rule is effective January 28, 2022.
- Dental retired active status
The Dental Quality Assurance Commission (commission) is proposing amendments to WAC 246-817-230 (PDF), Dentist retired active status, to align with WAC 246-817-440, Dentist continuing education requirements, and update the reference to chapter 246-12 WAC, Part 5 to specific required rules.
- CR102 filed on August 26, 2021, as WSR #21-18-074 (PDF)
The rule is effective January 28, 2022.
- COVID-19 Vaccinations
The Dental Quality Assurance Commission is considering rulemaking to allow dentists to delegate administration of novel coronavirus disease 2019 (COVID-19) vaccination to licensed dental hygienists with close supervision and demonstration of competency.
- CR103 Emergency rule filed on February 19, 2021, as WSR #21-06-012 (PDF)
- CR103 Extended emergency rule filed on June 18, 2021, as WSR #21-13-091 (PDF)
- CR103 Extended emergency rule filed on October 15, 2021, as WSR #21-21-052 (PDF)
The emergency rule will be withdrawn January 22, 2022, when the permanent rule is effective.
- CR101 filed on March 8, 2021, as WSR #21-07-020 (PDF)
- CR102 filed on August 18, 2021, as WSR #21-18-005 (PDF)
The rule is effective January 22, 2022.
Frequently Asked Questions for the amended rule WAC 246-817-440, effective January 1, 2019
- How many hours of continuing education do I need to renew my dental license?
Sixty-three hours every three years. State law details continuing education requirements for dentists (WAC 246-817-440).
- Do I need to send copies of certificates of completion when I renew?
No. You must sign an affidavit of compliance every three years. You'll find the affidavit on your annual renewal notice. You must renew your license annually.
- May I count continuing education hours I accumulate for other sources, (i.e., national certification with specialty organizations, etc.) toward this requirement?
Yes, as long as the hours are within the appropriate reporting period. Proof of completion of continuing education hours must meet WAC 246-817-440 (5).
- May I count continuing education hours from one reporting period to the next reporting period?
No. You may not carry over continuing education in excess of the required hours earned in a reporting period to the next reporting period (WAC 246-12-230).
- Explain the volunteer services category - what types of volunteer services are acceptable?
The commission recognizes the value of dentists providing volunteer services to targeted populations. The dentist and recipient both benefit. Up to 21 continuing education hours can be accumulated every three years. Examples of this type of continuing education would be working with the Special Olympics, working with the Smilemobile or ABCD programs, etc. It isn't the intention for continuing education hours to be granted for routine pro-bono work.
- May I complete all 63 hours of continuing education in the first or last year of my reporting period?
Yes. The 63 hours of continuing education can be obtained any time during the required three-year reporting period.
- When does my three-year reporting period start?
The three-year continuing education reporting period for a dentist licensed in Washington before 2019 begins January 1, 2019. Verification of completion of continuing education hours will be due on the dentist's annual license renewal date in 2022, and every three years thereafter.
The three-year continuing education reporting period for a dentist initially licensed in Washington in 2019 or later begins upon date of licensure and every three years thereafter.
The commission has determined it will accept appropriate continuing education completed during the old reporting period of 2018-2019. To clarify, appropriate continuing education completed after a dentist's birthdate in 2018 through December 31, 2018, may be counted for the new three year reporting period that ends in 2022.
- Why was the continuing education reporting period changed to three years?
The commission determined a three-year reporting period provides more flexibility for dentists to complete continuing education. Some dentists earn more than 21 hours in one year and will now be able to claim all hours within their specific three-year reporting period. Better quality continuing education can be sought, rather than dentists taking any course to meet the one-year deadline. Additionally, many other states have two- or three-year reporting periods. This change creates consistency with other states.
- Why is my license renewal every year if continuing education is required every three years?
WAC 246-817-990 requires annual license renewal. Although continuing education is required at time of renewal, the continuing education rule, WAC 246-817-440, is separate from the license renewal rule.
- When will I be audited for continuing education?
Continuing education audits are random and fall in the month you renew your license. If you receive an audit letter, respond with appropriate copies of your continuing education documentation.
- How do I prove I took the dental jurisprudence examination?
After you complete the dental jurisprudence examination, print the results page. Keep your printed copy with your completed continuing education documentation. Be sure to print before submitting the examination at the end.
- Why do I have to complete the dental jurisprudence examination every three years?
The commission considered a request to require the dental jurisprudence examination as part of continuing education. The commission determined that dentistry laws change and knowledge of the laws is necessary to help dentists comply with requirements in Washington State. The dental jurisprudence examination is a free, open-book examination online. You receive one hour of continuing education for this activity.
- Does the dental jurisprudence examination fall into the self-study or online category?
No. This is a separate requirement and available only online.
- I supervise dental students or residents in a dental clinic, how do I document continuing education hours?
A letter from the clinic director detailing your responsibility and hours related to supervision is acceptable.
- How many hours of continuing education can I do online?
There is no limit, but only 30 minutes for every one hour completed counts toward continuing education. Example: You complete 30 hours of continuing education online; you may use 15 hours toward your required 63 hours of continuing education.
- What is education in evidence-based dentistry or medicine that includes journal article evaluation?
It is education that practices critical thinking and builds a knowledge base of logical fallacies and biases to filter out literature that is poorly done or misleading. It will also teach the learner how to measure the level of reliability of the conclusions of any particular paper even if it is well done. Readers will be more effective if they are familiar with that literature. The learners will develop a series of questions that will lead them to methodically dissect the information in a verifiable and reproducible way.
- Where do I obtain a critical evaluation of journal article education?
Courses are available by multiple organizations in person or online; i.e. universities, Johns Hopkins, and Cochrane courses. Education should contain literature analysis. Verification of any Commission on Dental Accreditation residency meets the critical evaluation of a journal article education.
- May I count specialty board certification as continuing education?
Yes. Certification and recertification must have been obtained during your continuing education reporting period to count 62 hours. The dental jurisprudence examination is required for one hour, to reach the total 63-hour requirement.
- How do I document teaching hours for continuing education?
A letter from the institution detailing the subject and hours you taught is acceptable.
- Are live webinars considered self-study or online education?
No. Live interactive webinars are specifically indicated as allowable in WAC 246-817-440 (4)(a) of the rule.
- Is there a limit on the number of hours for live webinars?
No. No limit is indicated in WAC 246-817-440 (4)(a).
- If I take the jurisprudence examination in December of 2018, may I count that as part of the required 63 hours?
Yes. Changes to WAC 246-817-440 become effective January 1, 2019. However, the commission has determined it will accept appropriate continuing education completed during the old reporting period of 2018-2019.
- When can I begin taking CE to meet the new 63 hour CE requirement?
On or after January 1, 2019. However, the commission has determined it will accept appropriate continuing education completed during the old reporting period of 2018-2019. To clarify, appropriate continuing education completed after a dentist's birthdate in 2018 through December 31, 2018, may be counted for the new three year reporting period that ends in 2022.
- May I count a course taken in year one of the CE reporting period and count the same course again in year three of the CE reporting period?
No. You may not count the same course twice in one CE reporting period. (WAC 246-12-230), except for basic life support which may be taken once each year. You may count three hours every three years (WAC 246-817-440).
- Where do I obtain the critical evaluation of a journal article questionnaire?
On our webpage. WAC 246-817-440 (4)(f)(ii).
Past Completed Rule Changes
WAC 246-817-420 Specialty representation. The Dental Quality Assurance Commission adopted rule amendments to clarify dental specialty areas of practice and requirements for those who want to represent themselves as a specialist.
- CR-101 filed on November 17, 2017, as WSR #17-23-124 (PDF)
- CR-102 filed March 3, 2021, as WSR #21-06-105 (PDF)
- CR-103 filed June 2, 2021, as WSR #21-12-107 (PDF)
The rule is effective July 3, 2021.
The Dental Quality Assurance Commission is considering permanent rulemaking to add the Joint Commission on National Dental Examination's (JCNDE) Dental Licensure Objective Structured Clinical Examination (DLOSCE), a non-patient based examination, to allowable practical/clinical examinations in WAC 246-817-120. The commission is also included an amendment to allow an applicant to pass components of the practical examination using two testing agencies, rather than only one agency.
- CR101 filed on August 27, 2020 as WSR #20-18-040 (PDF)
- CR102 filed on January 25, 2021 as WSR #21-04-024 (PDF)
- CR103 filed on April 8, 2021 as WSR #21-09-011 (PDF)
The rule is effective on May 9, 2021.
The Dental Quality Assurance Commission is considering rule making allowing dentists to delegate administration of novel coronavirus disease 2019 (COVID-19) screening tests to registered dental assistants, licensed expanded function dental auxiliaries, and licensed dental hygienists with appropriate supervision and demonstration of competency.
- CR103 Emergency rule filed on December 30, 2020 as WSR #21-02-040 (PDF)
- CR103 Extended emergency rule filed on April 30, 2021 as WSR #21-10-058 (PDF)
The emergency rule expires through August 28, 2021, when the permanent rule is effective.
- CR101 filed on January 27, 2021, as WSR #21-04-050 (PDF)
- CR102 filed on April 13, 2021, as WSR#21-09-040 (PDF)
- CR103 filed on July 21, 2021, as WSR #21-15-114 (PDF)
The rule is effective August 28, 2021.
The Dental Quality Assurance Commission evaluated the CDC Guidelines for Infection Control in Dental Health-Care Settings -2003 and the 2016 Summary of Infection Prevention Practices in Dental Setting –Basic Expectation for Safe Care guidelines as the basis for the adopted amendments and new sections.
The adopted rule amendments and new sections incorporate many of the Centers for Disease Control and Prevention (CDC) recommendations including:
- Written policies and procedures with annual staff training;
- Sterilization of low-speed hand piece motors;
- Sterilization of single use items when appropriate;
- Storage and wrapped packages, container, or cassette requirements;
- Identification of appropriate disinfectants;
- High volume evacuation; and
- Water line testing.
The rules are effective January 23, 2021.
Repeal of AIDS education and training requirements
Engrossed Substitute House Bill (ESHB) 1551, chapter 76, Laws of 2020 repealed AIDS education and training requirements for health professionals obtaining registration, certification, and licensure.
Opioid Prescribing – Patient Notification
Substitute Senate Bill (SSB) 5380 required the Dental Quality Assurance Commission, along with the Podiatric Medical Board, Board of Osteopathic Medicine and Surgery, Washington Medical Commission, and Nursing Care Quality Assurance Commission to adopt or amend rules establishing patient notification requirements for those prescribing opioids.
Section 4 of SSB 5380 directed the commission to adopt or amend the opioid prescribing rules by January 1, 2020, to establish the requirement for dentists to notify patients of their right to refuse an opioid prescription or order and to document any refusal.
Section 17 of SSB 5380 added a new section to chapter 69.50 RCW requiring the prescribing practitioner prior to the first opioid prescription to discuss with the patient risks of opioids, pain management alternatives to opioids, and provide the patient a written copy of the warning.
The commission also considered exempting patient notification, documentation, and counseling requirements for opioid prescribing which may be required for certain providers in certain settings where prior notification is not possible.
The adopted rule includes an alternative in the patient notification. In addition, the adopted rule clarifies situations where the notification requirements would not apply.
The amended rule, WAC 246-817-907, is effective March 5, 2020.
Delegation to dental hygienist under general supervision
WAC 246-817-550 Acts that may be performed by licensed dental hygienists under general supervision.
The Dental Quality Assurance Commission adopted rule amendments updating the listing of allowable duties a dentist may delegate to a licensed dental hygienist under general supervision. The commission considered a petition for rulemaking in July 2017 to allow dental hygienists to perform certain tasks under general supervision that are typically completed by dental assistants under close supervision. Close supervision requires the dentist to be physically present in the treatment facility during the performance of a delegated task while general supervision does not.
A licensed dental hygienist has appropriate education and training to competently perform the tasks in the rule amendments after a dentist has examined and diagnosed the patient and provided subsequent instructions to be performed without the dentist physically present in the office.
The amended rule is effective October 5, 2019.
Dental Examination Name Change
WAC 246-817-110 Dental licensure and application requirements and WAC 246-817-120 Examination content. (PDF)
The commission adopted amendments to the existing rules to change the name of the acceptable national written examination for dentist licensure. The Joint Commission on National Dental Examination has developed an updated national written dental examination that will replace the current national written dental examination, the National Board Dental Examination, Parts I and II beginning in August 2020 with complete change in August 2022.
The amended rules took effect August 22, 2019.
Opioid Prescribing - Substitute House Bill 1427
The dental commission adopted new and amended rule sections to implement section 3 of Engrossed Substitute House Bill (ESHB) 1427, (chapter 297, Laws of 2017), codified as RCW 18.32.800. The adopted rules provide a framework, structure, and guidance for safe, consistent opioid prescribing practice for dentists that align with the directives of ESHB 1427, and reduce the risks associated with opioid use in the management of pain, while increasing public health and safety.
The adopted rules took effect January 26, 2019. Education and outreach information is on our website.
Dentist Suicide Prevention Education
The dental commission adopted a rule to establish a one-time continuing education and training requirement for dentists on suicide prevention due to 2017 legislation, Engrossed Second Substitute House Bill 1612. Training must be obtained from an approved organization on the Department of Health's model list.
Training is required as of August 1, 2020 - WSR 18-12-112
Dentist continuing education requirements
Dentist continuing education requirements - WAC 246-817-440
- The dental commission adopted rule amendments to clarify existing continuing education requirements. Amendments clarify appropriate continuing education subject matter, minimum and maximum number of hours in specified subject matter, methods to obtain continuing education including web-based options, and required dental jurisprudence examination.
- Rule effective January 1, 2019 - WSR 18-12-116
- Continuing education frequently asked questions are on available on our webpage.
- Jurisprudence examination is available on our webpage.
Dental assistant and expanded function dental auxiliary delegation rules - WAC 246-817-510, 246-817-520, 246-817-525, 246-817-540, and 246-817-545
- The dental commission adopted rule amendments to update the scope of practice (listing of allowable and prohibited tasks that may and may not be performed) for registered dental assistants and licensed expanded function dental auxiliaries (EFDAs). Adopted rule amendments clarify tasks dentists are currently delegating to registered dental assistants in dental facilities.
- Rule effective March 13, 2017 - WSR 17-05-056
Examination content - WAC 246-817-120
- The adopted rule will clarify that a single testing agency must process a complete clinical examination. Each testing agency creates its examination as a whole examination, identifying each content section. The successful completion of a whole examination demonstrates the minimum competency necessary for licensure. Completing portions of examinations from multiple examination organizations may not provide a true assessment of minimum dentist competency. Additionally, the adopted rule changes "consider acceptance of" to "accept" the Canada clinical examination.
- Rule effective November 24, 2017 - WSR 17-22-035
Moderate sedation with parenteral agents - WAC 246-817-760
- The dental commission adopted amendments to include specific requirements and exceptions for dentists when sedating pediatric patients. The adopted rule amendments specifically add monitoring and equipment requirements with three exceptions for dentists when sedating children related to intravenous infusions, monitoring expired carbon dioxide (CO2), and monitoring end-tidal CO2. Requiring all dentists administering moderate sedation with parenteral agents to monitor appropriate patient vital signs follows consistent practice standards. Providing specific exemptions for dentists when sedating children is consistent with the American Academy of Pediatric Dentistry Guidelines on Behavior Guidance for the Pediatric Dental Patient.
- Rule effective April 8, 2017 - WSR 17-07-037
License by residency in lieu of examination - WAC 246-817-110, 246-817-160, 246-817-155, and 246-817-220
- The adopted rule amendments implement changes made to RCW 18.32.040. Substitute House Bill 1411, (Chapter 100, Laws of 2017) modifies RCW 18.32.040 (3)(c) by changing the dentist licensure eligibility. The law allows dental residency in lieu of practical examination from approved community-based residencies to all Commission on Dental Accreditation general practice residency, advanced education in general dentistry residency, and pediatric residency programs. The residency must be at least one year in length and must be in a setting that serves predominantly low-income patients in Washington State.
- Rule effective January 19, 2018 - WSR 18-01-106