Licensing of Dental Hygienists.
In order to be licensed, dental hygienists must complete an educational program and pass an examination approved by the Dental Hygiene Examining Committee.  Under state law, a dental hygienist may remove deposits and stains from the surfaces of teeth; apply topical, preventive, or prophylactic agents; polish and smooth restorations; and perform root planing, soft tissue curettage, and other operations and services delegated to him or her by a dentist.  Generally, dental hygienists must be supervised by a licensed dentist.  Dental Quality Assurance Committee rules authorize a dental hygienist working under supervision of a dentist to perform a number or services and tasks including:

• record patient history and health status;
• take and record blood pressure and vital signs;
• perform a comprehensive clinical evaluation including an inspection of the head, neck, and oral cavity;
• take intraoral and extraoral radiographs;
• patient education in oral hygiene;
• give pre and post operative instructions;
• give fluoride treatments;
• apply topical anesthetic agents;
• deliver oral antibiotic prophylaxis as prescribed by a dentist;
• administer local anesthetic agents, if the patient is an adult and has been examined by the delegating dentist in the last year;
• perform subgingival and supragingival scaling;
• polish and smooth restorations;
• place restorations into the cavity prepared by the dentist, and thereafter could carve, contour, and adjust contacts and occlusion of the restoration;
• administer nitrous oxide analgesia;
• place antimicrobials, retraction cord, and periodontal packs;
• take impressions, bite registration, or digital scans of the teeth and jaws;
• remove periodontal packs or sutures; and
• other authorized procedures.

 
Initial Limited Licenses.
A dental hygienist licensed in another state or a Canadian province may be temporarily licensed without examination if the applicant provides the Department of Health with certain documentation and information, demonstrates a knowledge of Washington law pertaining to the practice of dental hygiene, is currently engaged in active practice in their home state or province, which means at least 560 hours of practice in the preceding 24 months, pays required fees, and meets requirements for AIDS education.  The procedures a dental hygienist with an initial limited license may perform are limited, although the holder of an initial limited license may obtain endorsements for local anesthesia, restorative procedures, or nitrous oxide analgesia.  The term for initial limited license is 18 months and it may be renewed upon demonstration of:

• successful passage of:
• a substantively equivalent dental hygiene patient evaluation or prophylaxis examination;
• a substantially equivalent local anesthesia examination;
• an educational program on the administration of local anesthesia and nitrous oxide analgesia; and
• didactic and clinical competency in the administration of nitrous oxide analgesia.

 
In addition to the other procedures a limited license holder may provide, a person practicing with a renewed limited license may also give injections of local anesthetic, perform soft tissue curettage, and administer nitrous oxide or oxygen analgesia.

The following procedures a dental hygienist is authorized to perform by rule are codified in statute:

• performing oral inspections and measuring of periodontal pockets;
• educating patients in oral hygiene;
• taking intra-oral and extra-oral radiographs;
• applying topical preventive or prophylactic agents;
• polishing and smoothing restorations;
• performing oral prophylaxis and removing of deposits and stains;
• recording health histories;
• taking and recording blood pressure and vital signs;
• performing subgingival and supragingival scaling;
• performing root planing;
• performing soft tissue curettage; and
• performing other dental operations and services delegated to them by a licensed dentist.

 
The Department of Health (DOH) must adopt requirements that qualify a licensed dental hygienist to be issued the following endorsements:

• a restorative expanded function endorsement authorizing the placement of restorations into the cavity prepared by a dentist and afterwards carve, contour, and adjust contacts and occlusion of the restoration;
• a local anesthesia expanded function endorsement authorizing the administration of nitrous oxide or oxygen analgesia; and
• a nitrous sedation expanded function endorsement authorizing giving injections of local anesthetic.

 
Beginning January 1, 2024, the DOH must issue an expanded function endorsement to any applicant who:

• holds a hygiene license or temporary hygiene license in Washington;
• completes clinical training approved by the Secretary of Health, including coursework encompassing the subject areas within the scope of the expanded function endorsement;
• performs satisfactorily on an examination, if required by the Dental Hygiene Examining Committee; and
• completes an application and pays any required application fees.

 
A person who holds an active full dental hygienist license on January 1, 2024, must automatically be issued all of the endorsements.
 
Limited or Temporary License.
The DOH must issue a temporary, rather than initial limited license without examination to any applicant.  The requirements that an applicant for an initial limited license, now a temporary license, is currently engaged in active practice in another state or Canadian province and meets requirements for AIDS education are removed.  The limitations on when a temporary license can be renewed and the additional authorities for a renewed limited license are removed, and the expiration is extended to 36 months.   A person practicing with a temporary license is authorized to perform soft tissue curettage.