DEPARTMENT OF HEALTH

(Dental Quality Assurance Commission)

[Filed December 1, 2025, 3:17 p.m.]

Preproposal statement of inquiry was filed as WSR 24-21-038.

Title of Rule and Other Identifying Information: Continuing education (CE) and training requirements for dentists administering sedation. The dental quality assurance commission (commission) is proposing amending WAC 246-817-773 to ensure clear CE and training requirements.

Hearing Location(s): On January 16, 2026, at 10:00 a.m., at the Washington State Department of Health, TC2 Room 164, 111 Israel Road S.E., Tumwater, WA 98501; or via Zoom at https://us02web.zoom.us/webinar/register/WN_e0L0e3c-Rnu_shHLkBojmg. Please follow this link to register for the virtual hearing, which will give you instructions to either join the meeting on a device, or to call in to the meeting on the phone. After registering, you will receive a confirmation email containing information about joining the webinar.

Date of Intended Adoption: January 16, 2026.

Submit Written Comments to: Debbie Gardner, Program Manager, P.O. Box 47852, Olympia, WA 98504-7852, email dental@doh.wa.gov, web https://fortress.wa.gov/doh/policyreview, beginning the date of and time of this filing, by January 6, 2026, at 11:59 p.m.

Assistance for Persons with Disabilities: Contact Debbie Gardner, program manager, phone 360-236-4893, TTY 711, email dental@doh.wa.gov, by January 6, 2026.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The commission is proposing amending WAC 246-817-773 Continuing education for dentists administering sedation, to ensure clear CE and training requirements. The commission updated rules for the administration of anesthetic agents for dental procedures, effective January 11, 2024, and added new WAC 246-817-773. The new section was adopted to combine sedation and endorsement CE requirements into one rule for simplicity. Upon implementation, it was noticed that some information on the table did not transfer correctly, and one category was unintentionally omitted. Further work with interested parties also identified other updates that are needed to provide further clarification.

The commission is proposing the following amendments:

Reasons Supporting Proposal: The proposed amendments are necessary to correct errors and provide explanation, which will set clear expectations regarding CE and training requirements for dentists administering sedation. The proposed rule amendments meet the intent of the underlying statutes by establishing clear and consistent sedation CE and training requirements for dentists who administer sedation in WAC 246-817-773.

The existing rule under the administration of anesthetic agents for dental procedures, WAC 246-817-720 Basic life support requirements, requires both didactic and hands-on components for initial and renewal BLS certification. Amending WAC 246-817-773 will clarify that ACLS and PALS certifications require both didactic and hands-on components for initial and renewal certification. Hands-on training helps the practitioner develop the competence and practical skills essential for actual emergency scenarios and increases patient safety. Additionally, the commission would like consistency across permit and endorsement requirements, ensuring that sedation CE hours contribute to the professional knowledge and development of the licensed dentist to enhance sedation services provided to patients.


•	Amending the requirements for advanced cardiac life support (ACLS) and pediatric advanced life support (PALS) certifications to require both didactic and hands-on components for initial and renewal certification, and to align with the basic life support (BLS) training requirements.
•	Removing ACLS and PALS from the table and explaining that BLS, ACLS, and PALS certification hours may not count towards sedation CE requirements.
•	Adding venipuncture to the table that identifies CE subject categories, as it was unintentionally omitted from the table when the rules were last adopted.
•	Changing the formatting and order of the columns on the table for clarity, increasing CE category options for sedation permit holders, correcting CE subject category titles for accuracy, and adding two additional categories to clarify the requirements for the three- and five-year CE reporting periods.

Statutory Authority for Adoption: RCW 18.32.0365 and 18.32.640.

Statute Being Implemented: RCW 18.32.640.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Dental quality assurance commission, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Debbie Gardner, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-4893.

A school district fiscal impact statement is not required under RCW 28A.305.135.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Debbie Gardner, Program Manager, P.O. Box 47852, Olympia, WA 98504-7852, phone 360-236-4893, TTY 711, email dental@doh.wa.gov.

This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:

Is exempt under RCW 19.85.025(4).

Explanation of exemptions: The entire proposed rule is exempt under RCW 19.85.025(4) as it only affects the dentist license, which does not meet the definition of "small business" in RCW 19.85.020.

Scope of exemption for rule proposal:

Bryan Swanson, DDS, Chair

AMENDATORY SECTION(Amending WSR 24-01-033, filed 12/11/23, effective 1/11/24)

WAC 246-817-773Continuing education for dentists administering sedation.

Continuing education must contribute to the professional knowledge and development of the licensed dentist to enhance sedation services provided to patients.

(1) The continuing education reporting period for a licensed dentist that administers sedation in Washington before December 31, 2023, begins January 1, 2024.

(2) The five-year continuing education reporting period for a licensed dentist that administers minimal sedation with nitrous oxide or minimal sedation in Washington on January 1, 2024, or later begins the date of first administration of sedation.

(3) The three-year continuing education reporting period for a licensed dentist initially issued a moderate sedation with enteral agents, moderate sedation with parenteral agents, pediatric sedation endorsement, or general anesthesia permit in Washington on January 1, 2024, or later begins the date of permit issuance.

(4) A licensed dentist who holds a valid permit ((or)), endorsement, or administers minimal sedation with or without nitrous oxide shall complete required hours of continuing education in one or more of the subject categories as required in ((below))Table 1. A licensed dentist who holds a valid permit and pediatric sedation endorsement shall complete required hours of continuing education in the pediatric sedation endorsement column, which may count toward moderate sedation continuing education requirements.

	((WAC 246-817-740 Minimal sedation with nitrous oxide – 7 hours	WAC 246-817-745 Minimal sedation – 7 hours	WAC 246-817-755 Moderate sedation with enteral agents – 7 hours	WAC 246-817-760 Moderate sedation with parenteral agents – 14 hours	WAC 246-817-765 Pediatric sedation endorsement – 14 hours	WAC 246-817-770 General anesthesia and deep sedation – 18 hours
Appropriate use of immobilization devices					X
ACLS	X	X	X
Behavioral management						X
General anesthesia						X
Inhalation analgesia						X
Medical emergencies	X	X	X	X	X	X
Nitrous oxide analgesia	X	X	X	X	X
Oral or intravenous sedation				X
Oral sedation	X	X	X
PALS	X	X	X	X		X
Patient evaluation	X	X	X	X	X	X
Patient monitoring	X	X	X	X	X	X
Pediatric behavioral management					X
Pediatric pharmacology					X
Pediatric physiological					X
Pediatric sedation					X
Pharmacology				X		X
Physiology	X	X	X	X		X))

Table 1

	WAC 246-817-740 Minimal sedation with nitrous oxide – 7 hours	WAC 246-817-745 Minimal sedation – 7 hours	WAC 246-817-755 Moderate sedation with enteral agents – 7 hours	WAC 246-817-760 Moderate sedation with parenteral agents – 14 hours	WAC 246-817-770 General anesthesia and deep sedation – 18 hours	WAC 246-817-765 Pediatric sedation endorsement – 14 hours
Appropriate use of immobilization devices					X	X
Behavioral management	X	X	X	X	X	X
General anesthesia					X
Inhalation anesthetic					X
Medical emergencies	X	X	X	X	X	X
Nitrous oxide sedation	X	X	X	X	X	X
Intravenous sedation				X	X
Oral sedation		X	X	X	X
Patient evaluation	X	X	X	X	X	X
Patient monitoring	X	X	X	X	X	X
Pediatric behavioral management					X	X
Pediatric pharmacology					X	X
Pediatric physiology					X	X
Pediatric sedation					X	X
Pharmacology	X	X	X	X	X
Physiology	X	X	X	X	X
Venipuncture				X	X
Three-year CE reporting period			X	X	X	X
Five-year CE reporting period	X	X

(5) ((Verification))A licensed dentist shall submit a written declaration of completion of continuing education hours ((will be due)) on the dentist's sedation permit or endorsement renewal date beginning in 2027.

(6) Continuing education in subject categories identified in Table 1 in subsection (4) of this section may be completed using any of the activities or methods authorized in WAC 246-817-440(((4)))(5).

(7) Proof of continuing education requirements are listed in WAC 246-817-440(((5)))(6).

(8) Hourly credits earned from certification in basic life support (BLS), advanced cardiac life support (ACLS), and pediatric advanced life support (PALS) may not be used to meet the educational requirements in subsection (4) of this section. However, the hourly credits earned in BLS, ACLS, or PALS certification may be used to meet the requirements of WAC 246-817-440 to renew the dentist license.

(9) Initial and renewal BLS, ACLS, and PALS certification must include both didactic and hands-on components.

(10) Hourly credits earned from sedation continuing education requirements for licensed dentists who hold a moderate sedation with enteral agents permit, moderate sedation with parenteral agents permit, general anesthesia and deep sedation permit, or pediatric sedation endorsement are in addition to the educational requirements of WAC 246-817-440 to renew the dentist license.