- Are there infection control guidelines for dental hygienists?
The department is beginning to work on developing infection control rules for dental hygienists. At this time the department recommends that dental hygienists refer to WAC 246-817-601 and the CDC guidelines for direction.
- What can a dental hygienist do in the state of Washington?
A licensed dental hygienist in Washington may remove deposits and stains from the surfaces of the teeth, may apply topical preventive or prophylactic agents, may polish and smooth restorations, may perform root planing and soft-tissue curettage and may perform other dental operations and services delegated by a licensed dentist. Refer to RCW 18.29.050, WAC 246-817-550, WAC 246-817-560 and WAC 246-817-570.
- May I practice if my doctor (dentist) is out of the office, e.g., on vacation?
If your doctor (dentist) is out of the office, you may perform tasks that are allowed under "general supervision." The allowable task can be found in WAC 246-817-550.
- What procedures fall under close supervision, and what procedures fall under general supervision?
The acts that may be performed under general supervision are in WAC 246-817-550.
The acts that may be performed under close supervision are in WAC 246-817-560.
- Do I need to be licensed to place restorations or give anesthetic even if I won't be doing these procedures?
Under appropriate supervision, the placing of restorations and administration of anesthesia and nitrous oxide are included in the full dental hygiene license even if a dental hygienist will not be doing these procedures. Refer to WAC 246-817-560.
A dental hygienist with an initial limited license may obtain a temporary endorsement to place restorations and administer local anesthesia upon meeting the licensing requirements per RCW 18.29.190.
A dental hygienist with a renewed limited license is given endorsements that allow them to administer local anesthesia and nitrous oxide. See RCW 18.29.190 for more information.
- What are the allowed procedures that a dental hygienist may perform outside of a clinical setting?
Licensed dental hygienists providing services in healthcare facilities and senior centers are limited to the following procedures: removal of deposits and stains from the surfaces of the teeth; application of topical preventive or prophylactic agents; application of topical anesthetic agents; polishing and smoothing restorations, and performing root planing and soft-tissue curettage. Refer to RCW 18.29.056.
Licensed dental hygienists providing services to homebound patients under the general supervision of a licensed dentist are limited to the following procedures: oral inspection and measuring of periodontal pockets, with no diagnosis; patient education in oral hygiene; take intra-oral and extra-oral radiographs; apply topcal preventive or prophylactic agents; polish and smooth restorations; oral prophylaxis, and removal of deposits and stains from the surfaces of the teeth; record health histories; take and record blood pressure and vital signs; perform sub-gingival and supra-gingival scaling; perform root planing; apply sealants; and application of topical anesthetic agents. Refer to RCW 18.29.058.
Licensed dental hygienists providing services in community-based sealant programs in schools are limited to the following procedures: assess for and apply sealants and fluoride varnishes and may remove deposits and stains from the surfaces of the teeth. Refer to RCW 18.29.220.
- May hygienists working in healthcare facilities or senior centers use silver diamine fluoride?
Yes. Silver diamine fluoride is a topical preventative agent, which is allowed under RCW 18.29.056(1)(c).
- Where do I learn more about non-clinical opportunities for dental hygienists?
Licensed dental hygienists with two years' practical clinical experience with a licensed dentist within the preceding five years may be employed, retained, or contracted by healthcare facilities and senior centers. Refer to RCW 18.29.056.
The licensed dental hygienist may also perform delegated tasks on a homebound patient under the general supervision of a dentist licensed under chapter 18.32 RCW if the patient has first been examined by the supervising dentist within a time frame deemed appropriate by the supervising dentist. Refer to RCW 18.29.058.
For low-income, rural, and other at-risk populations, and in coordination with local public health agencies and local oral health coalitions, a licensed dental hygienist may perform certain procedures. Refer to RCW 18.29.220 and WAC 246-814.
- May dental hygienists have clinics of their own and refer to a dentist to increase access to care?
Licensed dental hygienists may perform dental operations and services only under the supervision of a licensed dentist, and under such supervision may be employed by hospitals, boards of education of public or private schools, county boards, boards of health, or public or charitable institutions, or in dental offices. They may also be employed, retained or contracted by healthcare facilities and senior centers; provide services in community-based sealant programs carried out in schools; and perform delegated acts on homebound patients. Refer to RCW 18.29.050, RCW 18.29.056, RCW 18.29.058 and RCW 18.29.220.
- May I start my own business of providing dental hygiene care to homebound people or those in healthcare facilities? Is there any literature that could guide me through the process?
See the question above titled "Where do I learn more about non-clinical opportunities for dental hygienists?"
- What does expanded function imply for dental hygienists?
Expanded function for dental hygienists refers to the placement, carving, contouring and adjusting of restorations and the administration of local anesthesia and nitrous oxide. See RCW 18.29.050 and WAC 246-817-560.
- Are there other requirements aside from a Washington state license needed in order to practice outside of a clinical setting?
- For employment by healthcare facilities and senior centers, refer to RCW 18.29.056.
- For school settings, refer to RCW 18.29.220.
- For homebound patients, refer to RCW 18.29.058.
- May a dental hygienist do in-office bleaching or take impressions for bleaching trays?
A dental hygienist under the general supervision of a dentist may take impressions, fabricate and deliver bleaching trays and fluoride trays. Refer to WAC 246-817-560 and WAC 246-817-520.
- May a dental hygienist apply antimicrobials?
Dental hygienists may place antimicrobials under the close supervision of a dentist. This means the dentist has diagnosed the condition(s) being treated, authorized the placement and is present in the treatment facility. The dentist doesn't have to be physically present in the operatory. Refer to RCW 18.29.050 and WAC 246-817-560.
- What dental tasks can a dentist delegate to licensed dental hygienists?
State law lists allowable and prohibited tasks (WAC 246-817-550, 246-817-560, and 246-817-570). See dentist delegation chart (PDF).
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