wa-law.org > bill > 2025-26 > SB 6146 > Original Bill
It is the intent of the legislature to advance oral health equity, expand care availability, and ensure that children and families in Washington have meaningful access to basic preventive dental services. Washington families, especially children, continue to face barriers to timely oral health care, even though preventive care is essential to healthy development and long-term well-being.
The legislature finds that as federal policies continue to restrict pathways for internationally trained health professionals, Washington is embracing a more welcoming and pragmatic approach, recognizing that qualified providers strengthen our communities, and that Washington should not be held back by federal barriers that limit access to care.
The legislature recognizes that Washington faces a significant shortage of preventive care dental professionals, which limits access to basic preventive services in many communities. Oral preventive assistants and dentists trained internationally can play a crucial role in addressing these gaps. Creating clear pathways for these practitioners will help stabilize the workforce, expand service capacity across the state, and offer meaningful relief to families who currently struggle to secure timely oral health care.
The commission shall issue a license to practice as an oral preventive assistant to any applicant who:
Pays any applicable fees as established by the secretary in accordance with RCW 43.70.110 and 43.70.250;
Submits, on forms provided by the secretary, the applicant's name, address, and other applicable information as determined by the secretary; and
Demonstrates successful completion of oral preventive assistant training approved by the commission with consultation from the dental hygiene examining committee as defined in RCW 18.29.110.
The commission shall adopt rules relating to the scope of oral preventive assistant services that may be performed by oral preventive assistants under the supervision of a licensed dentist.
The scope of oral preventive assistant services that the commission identifies in subsection (1) of this section must include:
Dental assisting services that a dental assistant may perform under the supervision of a licensed dentist;
Periodontal probing after initial probing by a dentist or dental hygienist and diagnosis by a dentist; and
Dental prophylaxis for patients in a healthy oral state as defined by the commission with consultation from the dental hygiene examining committee as defined in RCW 18.29.110.
A dentist may not assign an oral preventive assistant to perform services until the oral preventive assistant has demonstrated skills necessary to competently perform all assigned duties and responsibilities.
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The commission shall adopt rules relating to the scope of dental assisting services related to patient care and laboratory duties that may be performed by dental assistants.
In addition to the services and duties authorized by the rules adopted under (a) of this subsection, a dental assistant may apply topical anesthetic agents.
All dental services performed by dental assistants under (a) or (b) of this subsection must be performed under the close supervision of a supervising dentist or supervising dental therapist as the dentist or dental therapist may allow, except for the procedures involving sterilization of dental instruments or equipment, which may be performed under general supervision.
In addition to any other limitations established by the commission, dental assistants may not perform the following procedures:
Any scaling procedure;
Any oral prophylaxis, except coronal polishing;
Administration of any general or local anesthetic, including intravenous sedation;
Any removal of or addition to the hard or soft tissue of the oral cavity;
Any diagnosis of or prescription for treatment of disease, pain, deformity, deficiency, injury, or physical condition of the human teeth, jaw, or adjacent structures; and
The taking of any impressions of the teeth or jaw or the relationships of the teeth or jaws, for the purpose of fabricating any intra-oral restoration, appliance, or prosthesis, other than impressions allowed as a delegated duty for dental assistants pursuant to rules adopted by the commission.
A dentist or dental therapist may not assign a dental assistant to perform duties until the dental assistant has demonstrated skills necessary to perform competently all assigned duties and responsibilities.
The commission shall issue an initial credential or renewal credential to an applicant who has met the requirements for a credential or deny an initial credential or renewal credential based upon failure to meet the requirements for a credential or unprofessional conduct or impairment governed by chapter 18.130 RCW.
The commission may adopt rules for renewal requirements for a credential, including continuing education requirements, for oral preventive assistants and expanded function dental auxiliary licenses.
The department shall issue a license to any applicant who, as determined by the secretary:
Has successfully completed an educational program approved by the secretary. This educational program shall include coursework encompassing the subject areas within the scope of the license to practice dental hygiene in the state of Washington;
Has successfully completed an examination administered or approved by the dental hygiene examining committee; and
Has not engaged in unprofessional conduct or is not unable to practice with reasonable skill and safety as a result of a physical or mental impairment.
A person who is a dentist and who has been lawfully engaged in the practice of dentistry for not less than five years in another country or foreign province may apply for examination and licensure as a dental hygienist. The applicant must present to the secretary satisfactory documentation of registration or licensure in that jurisdiction and proof of the duration of such practice issued by the dental regulatory authority of that country or province. The foreign jurisdiction must require a level of competency that, as determined by the secretary in consultation with the dental commission and dental hygiene examining committee, is equal to the competency required of applicants for dental hygiene licensure in Washington.
Applications for licensure must comply with administrative procedures, administrative requirements, and fees established according to RCW 43.70.250 and 43.70.280.