Rule Changes

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for many reasons including: legislative law changes, request to change a rule, national standards change, and updating outdated rule language.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

Dental provider health equity continuing education requirements

The Dental Quality Assurance Commission adopted rule amendments for WAC 246-817-440 (Dental continuing education requirements) and WAC 246-817-445 (Dental anesthesia assistant continuing education requirements) to adopt the health equity continuing education (CE) model rules, WAC 246-12-800 through 246-12-830, to comply with RCW 43.70.613.

The rule is effective January 18, 2024.

Administration of anesthetic agents for dental procedures

The Dental Quality Assurance Commission adopted rule amendments for WAC 246-817-701 through 790 to update general requirements.

Dental health profession monitoring programs updates

The Dental Quality Assurance Commission has adopted amendments to WAC 246-817-801, 236-817-810, 246-817- 820, and 246-817-830 making technical amendments to align with changes required from Substitute Senate Bill (SSB) 5496 without changing the effect. SSB 5496 updated terminology, definitions, and references for dentists in RCW 18.32.534 and clarified confidentiality protections in RCW 18.131.070 for health professional monitoring programs.

The rule is effective August 19, 2023.

Faculty at school of dentistry

The Dental Quality Assurance Commission adopted rule amendments regarding out-of-state licensure in line with Senate Bill (SB) 5113 (chapter 89, Laws of 2023). SB 5113 amended RCW 18.32.195 to include any institution of higher education in Washington state accredited by the Commission on Dental Accreditation (CODA) for faculty licensure.

The rule is effective April 29, 2024.

Past Completed Rule Changes

Dentist Continuing Education

The Dental Quality Assurance Commission adopted rule amendments for the number of hours allowed under self-study methods, WAC 246-817-440.

The rule is effective January 28, 2022.

Dental retired active status

The Dental Quality Assurance Commission completed 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.

The rule is effective January 28, 2022.

COVID-19 Vaccinations

The Dental Quality Assurance Commission completed 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.

The emergency rule was withdrawn January 22, 2022, when the permanent rule became effective.

The rule is effective January 22, 2022.

Specialty Representation

WAC 246-817-420 (PDF)

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.

The rule is effective July 3, 2021.

Examination Content

WAC 246-817-120 (PDF)

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.

The rule is effective on May 9, 2021.

COVID-19 Screenings

WAC 246-817-580 (PDF)

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.

The emergency rule expires through August 28, 2021, when the permanent rule is effective.

The rule is effective August 28, 2021.

Infection Control

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.

Rule repeals are effective January 23, 2021 (PDF).

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


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