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Washington Dental Occupation Titles, Descriptions and Clinical Capacity

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Occupations Comprising Washington’s Oral Health Workforce

Several occupations comprise Washington’s oral health workforce. Not all occupations require formal licensing in the state, although most require at least a certification or registration. Click the links for more specific state requirements by provider type from the Washington State Department of Health.

Provider Type

Years and Type of Education Required

Credential Required to Practice in Washington

Dentists

DDS or DMD via 4 years of dental school post-bachelor’s degree; specialists receive additional education; 63 hours CE every 3 years

License; residents can obtain a limited license for practice within approved educational settings

Dental Hygienists

Associate degree (2 years following prerequisites) or bachelor’s (4 years) or master’s in dental hygiene from an accredited program; pass the Dental Hygiene National Board Exam; 15 hours CE annually

License

Expanded Function Dental Auxiliaries (EFDAs)

EFDA certificate following completion of nationally accredited dental assistant program

License

Dental Therapists

Associates degree from a dental therapy program accredited through the American Dental Association (ADA) Commission on Dental Accreditation (CODA). 

License

Dental Assistants

Range: from on-the-job training to associate’s degree; No CE required for state but 12 hours annually for national certification

Registration – annual renewal

Denturists

1-2 years, associate degree, or completion of an approved technical program; 15 hours CE annually

License

Dental Laboratory Assistants/Technician

High school, 4 years’ experience or 2 years’ experience and completion of a dental lab tech education program

Certification

Dental Anesthesia Assistant

Approved dental anesthesia assistant training course that includes IV access or phlebotomy; 12 hours CE every 3 years to maintain certification

Certification and valid anesthesia permit of oral and maxillofacial surgeon or a dental anesthesiologist.

Primary Care Medical Providers
(Physicians, Physician Assistants [PAs],  Advanced Practice Nurse Practitioners [APRNs])

No specific oral health education required beyond medical degree; to be reimbursed by Medicaid, must have training through Washington Dental Service Foundation

Professional medical license

Supporting Caregivers
(i.e., in-home caregivers for people with disabilities and older adults)

Oral health is a component of initial short-term training for in-home caregivers; 10 hours CE in oral health available

None

 

Clinical Capacity of Oral Health Providers

This table displays the scope of practice by provider type, showing how the roles and responsibilities of the different oral health occupations compare in the state of Washington. Updated from the UW CHWS 2009 Washington State Oral Health Workforce Report.

  Procedures Dentists Dental Therapists× Dental Hygienist Expanded Function Dental Auxiliaries Dental Assistants Denturists Primary Care Medical Providers† In-Home Care Givers
Diagnostic Taking medical and dental history    
Dental screening and assessment ●*    
Dental charting and oral inspection ●*    
Vital signs    
Dental diagnosis and treatment planning          
Referral to dentists, other providers, specialists        
Assess for sealants          
Clinical support X-rays      
Primary prevention Oral hygiene instruction  
Dietary counseling  
Topical fluorides    
Dental sealants      
Removal of deposits from teeth Coronal polishing      
Dental prophylaxis (scaling)          
Nonsurgical therapeutic periodontal procedures          
Preventive anti-microbial therapy Apply antimicrobials          
Anesthesia Topical anesthetics      
Local anesthetics          
Nitrous oxide          
General anesthesia for surgery              
Cavity treatment Atraumatic Restorative Technique (ART)            
Placement of temporary restorations      
Pack and carve restorations (amalgam or resin)        
Extractions            
Prefabricated crowns            
Pulpotomy              
Pulp capping            
Root canal therapy              
Other services Denture fabrication            
Denture repair and adjustment          
Impressions for models and guards      
Impressions for crowns            
Other oral surgery              
Placement of orthodontic appliances              
Orthodontic adjustment              
Check for loose bands, wires        
Periodontal dressings      
Other periodontal surgery              
Prescriptive authority Prescribe antimicrobials, infection control            
Prescribe controlled substances (pain medication)            
Dispense medications by doctor’s order            

*Limited application of practice.
× To the extent the supervising dentist authorizes the service or procedure to be provided by the dental therapist as authorized by RCW 18.265.050
† Increasingly, primary care medical providers are delivering the identified preventive oral health services during well-child exams. Physicians may perform all listed procedures under the scope of practice of their license, but rarely perform more than the functions shown. Physician assistants and advanced practice nurses have more limited scopes of practice than physicians, but when delivering oral health services, they perform the same procedures as physicians.