FAQ Dental Hygiene

Link To DOH site for information on Dental Hygiene Licenses

Dental Hygienist - General

Who do I contact if I need additional information?
You may contact the Customer Service Office by phone at 360-236-4700 or by email at hsqa.csc@doh.wa.gov.

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?
WAC 246-817-720 requires dental staff members who provide direct patient care in an in-office or out-patient setting to hold current and valid healthcare provider basic life support (BLS) certification. Dental staff members providing direct patient care include: licensed dentists, licensed dental hygienists, licensed expanded function dental auxiliaries, certified dental anesthesia assistants and registered dental assistants. Newly hired dental hygienists providing direct patient care are required to obtain the BLS certification within 45 days from the hiring date.

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 do restorative. Restorative isn’t allowed with the limited dental hygiene license per RCW 18.29.190.

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 (WAC 246-817-301).

Frequently Asked Questions - Scope of Practice

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 can be found here: WAC 246-817-550.
The acts that may be performed under close supervision can be found here: 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. Refer to 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. Refer to RCW 18.29.190.

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 topical 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.

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. Refer to 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 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

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 18 months. At the end of the 18 months, 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:
• Received education and training for anesthesia and nitrous oxide;
• Passed the Western Regional Examining Board (WREB) anesthesia exam; and
• Passed an approved clinical dental hygiene exam.
Once renewed, the renewed limited dental hygiene license will expire yearly on the licensee’s birth date.

Frequently Asked Questions - Licensing

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 may be found 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 that I may not have learned in my previous state?
Listed below are the expanded function education courses that have been approved by the Department of Health if restorative, anesthesia and nitrous oxide weren’t a part of your ADA CODA accredited dental hygiene curriculum.

Pierce College: Tacoma, WA Continuing education questions: 253-840-8452
www.pierce.ctc.edu/Go/PNDHI
Spring Course (March – Anesthetic and Nitrous Oxide)
Summer Course (August – Anesthetic, Nitrous Oxide and 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
Winter (Anesthetic and Nitrous Oxide)
Summer (Anesthetic and Nitrous Oxide)

Phoenix College: Phoenix, AZ Contact Nan Reif, director, Center for Health Professions at 602-285-7331
Classes available in May and in the Fall (Anesthetic and Nitrous Oxide)

Oregon Health & Science University: Portland, OR Contact Debbie Reaume, Continuing Education Program at 503-494-8857 - Contact school for class date and times (Nitrous Oxide)

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 does an out-of-state dental hygienist have to do 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 the Western Regional Examining Board (WREB) examinations in: clinical dental hygiene, restorative and 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 Western Regional Examining Board (WREB) 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-approved expanded function anesthesia course. The initial limited dental hygiene license application packet (PDF) is online

Do I need CPR/BLS certification? 

Yes. Dentists and dental staff members providing direct patient care in an in-office or outpatient setting must hold a current and valid healthcare provider basic life support (BLS) certification. Dental staff   members providing direct patient care include: licensed dentists, licensed dental hygienists, licensed expanded function dental auxiliaries, certified dental anesthesia assistants and registered dental assistants. Newly hired staff members providing direct patient care are required to get the certification within 45 days from the date hired (WAC 246-817-720)

 Infection Control Rules

Effective January 23, 2021