Frequently Asked Questions

Continuing Education | General | Licensing | Renewals | Scope of Practice

Continuing Education

What is acceptable continuing education?

Continuing education must be dental-related education for professional development as a dental hygienist per WAC 246-815-140.

What is the required number of continuing education credits per year?

Licensed dental hygienists must complete 15 clock hours of continuing education a year. A current basic life support (BLS) card for health care providers must be maintained as part of this requirement per WAC 246-815-140.

Are certain continuing education courses required each year?

No specific continuing education courses are required yearly (WAC 246-815-140).

How long do I have to keep my documentation of continuing education?

WAC 246-12-200 requires licensees to keep continuing education records for four years.

Is basic life support required every year even though the card says it's good for two years?

Basic life support (BLS) for healthcare providers isn't required to be taken yearly. The rule just says that a current BLS card must be maintained per WAC 246-815-140.

Are there stipulations on the type of continuing education I can get, e.g., online versus lecture?

See WAC 246-815-140 for more information.

If I volunteer in a school setting in a teaching role, does that count as continuing education?

Yes. See WAC 246-815-140 for information on continuing education.

What is the difference between Distance Learning and Self-Study?

There is a limit of 5 hours per year for self-study courses. There is no limit to the number of distance learning hours that may be taken per year. If the course includes an assessment tool upon completion, then the course would be considered distance learning. If there is no assessment tool, then it would be considered self-study. An example of an assessment tool would be a quiz or exam that must be successfully completed in order to receive credit for the course. Please see WAC 246-815-140(2)(c) and (d) for further details.

General

Whom do I contact if I need additional information?

You may contact the Customer Service Office by phone at 360-236-4700 or by email.

If I have a concern about a dentist or other licensed person's conduct or quality of work, is there a certain protocol to address the issue?

Refer to Health Professions Complaint Process and frequently asked questions.

Does a dental hygienist need to have basic life support (BLS) certification?

Yes. The continuing education rule was amended to require dental hygienists to maintain a current basic life support (BLS) card for healthcare providers.

What is the difference between a full dental hygiene license and a limited dental hygiene license?

A full dental hygiene license allows a dental hygienist to perform restorative work, administer local anesthetic or nitrous oxide analgesia. Restorative, local anesthesia and nitrous oxide are not allowed with an initial limited license per RCW 18.29.190. If the hygienist completes appropriate education and passes approved examinations, a temporary endorsement can be added to the limited license to allow restorative and local anesthetic and nitrous oxide.

I won't be practicing dental hygiene for a while, can I put my license in retired or inactive status?

No, at this time there is no retired or inactive status for dental hygienists. If your credential is active, you must complete renewal requirements even if you are not actively practicing.

Does a patient of record have to have been seen by a dentist within the past year to fall within the general supervision for the purposes of providing services with the dentist out of the office?

There is no time limit in the rules. He or she must only be a patient of record. In a dental office, a dental hygienist may not see or treat a new patient who has never been seen by the dentist.

Do I have to post my license?

Yes. The rules require all dental staff members to post their credentials, whether they have licenses, certifications or registration per WAC 246-817-301.

Licensing

I'm licensed in a Canadian province. Do I qualify for an initial limited dental hygiene license?

Senate Bill (SB) 5606, passed during the 2015 legislative session, amended the law relating to dental hygienists and is effective July 24, 2015. The law now allows for the issuance of an initial limited dental hygiene license to an applicant who holds a valid license in a Canadian province that has a substantively equivalent scope of practice.

Canadian provinces will be reviewed for acceptance as applications are received. Currently we have reviewed and accepted British Columbia and Ontario.

The Canadian National Dental Hygiene Certification Exam (NDHCE) is not accepted for licensure in Washington state. All applicants will need to complete the ADA - National Board Dental Hygiene Examination (NBDHE).

I'm licensed in another state. Is there reciprocity?

We don't have reciprocity with any other state. There is licensure by endorsement. Refer to RCW 18.29.045 and WAC 246-815-100.

Where do I find accredited dental hygiene schools in the state of Washington?

Accredited dental hygiene schools in the state of Washington are on the American Dental Association (ADA) Commission on Dental Accreditation (CODA) website.

Where may I get the training I need to pass the required parts of the regional exams for which I may not have prepared for in my previous state?

Listed below are the expanded function education courses the Department of Health has approved if restorative, anesthesia and nitrous oxide weren't a part of your ADA CODA accredited dental hygiene curriculum.

Eastern Washington University
Cheney, WA		 Contact 509-828-1300
awetmore@ewu.edu www.ewu.edu
(Restorative)
Lake Washington Institute of Technology
Kirkland, WA		 Contact the Dental Hygiene Department: Beth Davis at 425-739-8386 or Monta Frost, director, at 425-739-8404
(Anesthetic and Nitrous Oxide)
Oregon Health & Science University
Portland, OR		 Contact Debbie Reaume, Continuing Education Program at 503-494-8857
(Nitrous Oxide)
Phoenix College
Phoenix, AZ		 Contact Nan Reif, director, Center for Health Professions at 602-285-7331
(Anesthetic and Nitrous Oxide)
Pierce College at Fort Steilacoom
Lakewood, WA		 Contact phone: 253-840-8452
Contact email vm-dentalinstitute@pierce.ctc.edu
www.pierce.ctc.edu
(Anesthetic, Nitrous Oxide and Restorative)
Portland Community College
Portland, OR		 Contact Stacy Bone at 971-722-6627
stacy.bone@pcc.edu www.pcc.edu/climb/health
(Restorative)
How do I get an endorsement for sealant and fluoride varnish programs?

The authorized practices and training requirements are listed in Chapter 246-814 WAC. The Dental Hygiene Sealant/Fluoride Varnish Endorsement Application Packet (PDF) for sealant and fluoride varnish is on our website.

What education and training requirements does an out-of-state dental hygienist have to meet regarding anesthesia?

Out-of-state dental hygienists may apply for either a full dental hygiene license or a limited dental hygiene license.

The full dental hygiene license requires that the out-of-state hygienists must have received education and training in restorative, anesthesia and nitrous oxide in their American Dental Association (ADA) Commission on Dental Accreditation (CODA)-accredited dental hygiene program curriculum. They must also have passed either the Western Regional Examining Board (WREB) or Central Regional Dental Testing Service (CRDTS) examinations in: clinical dental hygiene, restorative and local anesthesia. A copy of the full dental hygiene license application packet (PDF) is online.

Out-of-state hygienists who apply for and are issued an Initial limited license may practice for 18 months. During this time, they must obtain the required anesthesia and nitrous oxide education and training, and pass the WREB or CRDTS local anesthesia exam. This hygienist must also have passed an approved clinical dental hygiene exam. If anesthesia education and training were part of the applicant's ADA CODA-accredited dental hygiene curriculum, the applicant won't be required to take additional training. If anesthesia wasn't a part of the applicant's ADA CODA-accredited curriculum, the applicant will be required to take and complete a secretary of health-approved expanded function anesthesia course. The initial limited dental hygiene license application packet (PDF) is online.

Which examinations are approved in the state of Washington?

Dental Hygiene Practical Examinations

The patient based clinical examinations from the following exam companies have been approved for licensure.

  • Western Regional Examining Board (WREB) Dental Hygiene Examination if passed after May 8, 1992.
  • Central Regional Dental Testing Services (CRDTS) Dental Hygiene Examination if passed after November 1, 2001.
  • Commission on Dental Competency Assessments (CDCA) [Formerly NERB] Dental Hygiene Examination if passed between January 1, 2000 and August 21, 2009, or if passed after March 16, 2018.
  • Council of Interstate Testing Agencies, Inc. if passed after July 23, 2021.

The manikin/simulated clinical examinations from the following exam companies have been approved for licensure.

  • Western Regional Examining Board (WREB) Dental Hygiene Manikin-Based Clinical Examination if passed after October 8, 2021.
  • Central Regional Dental Testing Services (CRDTS) Dental Hygiene Simulated Patient Examination if passed after October 8, 2021.
  • Commission on Dental Competency Assessments (CDCA) Simulated Dental Hygiene Examination if passed after October 8, 2021. Must include both the CSCE/OSCE exam and the simulated patient exam.
  • Must include both the CSCE/OSCE exam and the simulated patient exam.

Dental Hygiene Expanded Functions Examinations

  • WREB Anesthesia Exam if passed after May 8, 1992
  • WREB Restorative Exam if passed after May 8, 1992
  • CRDTS Anesthesia Exam if passed after October 13, 2017
  • CRDTS Restorative Exam if passed after March 7, 2016

Renewals

Basic Life Support for the Health Care Provider

Dental Hygienists are required to keep a current BLS for the health care provider card in order to renew their credential. See WAC 246-815-140(2)(b) for further information.

If my license expired, how do I get it reinstated?

Refer to WAC 246-12-040 - How to return to active status when a credential has expired.

How do I renew my limited dental hygiene license?

The initial limited dental hygiene license is valid for five years. At the end of the five years, the licensee must complete and return the limited license first-time renewal application packet (PDF). The licensees must provide documentation that they have completed the following:

  • Passed an approved Dental Hygiene Patient Eval/Prophy clinical exam
  • Passed an approved local anesthesia course
  • Passed an approved local anesthesia exam
  • Passed an approved nitrous oxide course (no exam for nitrous)

Once renewed, the renewed limited dental hygiene license will expire yearly on the licensee's birth date. Dental hygienists are required to complete 15 clock hours of continuing education (CE) annually. WAC 246-815-140 discusses the requirements and acceptable continuing education.

Scope of Practice

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?
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).