Subject of Possible Rule Making: Dental hygienist and dental assistant usage of silver diamine fluoride (SDF) and participation in regional health coalition meetings. The department of health (department) in consultation with the dental quality assurance commission (commission) and dental hygiene examining committee (committee) are considering making amendments to WAC 246-814-020 Practices authorized and 246-814-030 Application process and documentation of training required for endorsement, for the following reasons:

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: On July 3, 2024, the department received a rule-making petition to clarify, revise, or add language around the use of SDF in school settings for both dental hygienists and dental assistants. On July 19, 2024, the department approved the rule-making petition. SDF is a low-cost fluoride that can arrest carious lesions and strengthen tooth enamel. Allowing dental hygienists and dental assistants to apply SDF in school-settings and school-linked programs increases access to care for vulnerable populations of children.

On October 2, 2024, the secretary received a request from health care authority (HCA) requesting the removal of WAC 246-814-030(6), the requirement for dental assistants and their supervising dentists, as well as dental hygienists to coordinate with established local oral health coalitions by participating in oral health coalition meetings that may be held in the geographical region. We are not enforcing this rule because there are only a few oral health coalitions in all of the state. Oral health coalitions cover specific geographic regions and do not monitor actions in other areas. Having this requirement is causing barriers because dental hygienists and dental assistants may avoid providing services because they do not want to be disciplined for not following the requirements which are impossible to adhere to.


•	WAC 246-814-020, to include silver diamine fluoride (SDF) to practices authorized in school-based and school-linked program settings for dental hygienists and dental assistants.
•	WAC 246-814-030, to amend the requirement that dental assistants and their supervising dentists, as well as dental hygienists coordinate with established local oral health coalitions by participating in oral health coalition meetings that may be held in the geographical region.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Kitty Einert, Program Manager, P.O. Box 47852, Olympia, WA 98504-7852, phone 360-236-4843, TTY 771 [711], email kitty.einert@doh.wa.gov, website www.doh.wa.gov.

Additional comments: Interested parties can participate in the drafting of the proposed rules. The department will be conducting rules workshops with interested parties and subject matter experts. The department will use existing GovDelivery lists and other known contact information to inform interested parties of opportunities to provide input on proposed rule language. To find out more information about our rule making, visit doh.wa.gov. To subscribe to GovDelivery, please visit doh.wa.gov and select the button titled "Sign up for Updates From DOH" button at the bottom of the page. After signing in, select "Health Systems Quality Assurance" and "Health Professions" and "Dental List" and "Dental Hygiene Examining Committee." You may also check the box next to one or more of the other professions listed to receive information related to that specific profession.