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.
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Provider Type
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Years and Type of Education Required
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Credential Required to Practice in Washington
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Dentists
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DDS or DMD via 4 years of dental school post-bachelor’s degree; specialists receive additional education; 63 hours CE every 3 years
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License; residents can obtain a limited license for practice within approved educational settings
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Dental Hygienists
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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
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License
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Expanded Function Dental Auxiliaries (EFDAs)
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EFDA certificate following completion of nationally accredited dental assistant program
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License
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Dental Therapists
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Associates degree from a dental therapy program accredited through the American Dental Association (ADA) Commission on Dental Accreditation (CODA).
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License
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Dental Assistants
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Range: from on-the-job training to associate’s degree; No CE required for state but 12 hours annually for national certification
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Registration – annual renewal
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Denturists
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1-2 years, associate degree, or completion of an approved technical program; 15 hours CE annually
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License
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Dental Laboratory Assistants/Technician
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High school, 4 years’ experience or 2 years’ experience and completion of a dental lab tech education program
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Certification
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Dental Anesthesia Assistant
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Approved dental anesthesia assistant training course that includes IV access or phlebotomy; 12 hours CE every 3 years to maintain certification
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Certification and valid anesthesia permit of oral and maxillofacial surgeon or a dental anesthesiologist.
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Primary Care Medical Providers
(Physicians, Physician Assistants [PAs], Advanced Practice Nurse Practitioners [APRNs])
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No specific oral health education required beyond medical degree; to be reimbursed by Medicaid, must have training through Washington Dental Service Foundation
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Professional medical license
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Supporting Caregivers
(i.e., in-home caregivers for people with disabilities and older adults)
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Oral health is a component of initial short-term training for in-home caregivers; 10 hours CE in oral health available
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None
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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.
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Procedures
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Dentists
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Dental Therapists×
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Dental Hygienist
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Expanded Function Dental Auxiliaries
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Dental Assistants
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Denturists
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Primary Care Medical Providers†
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In-Home Care Givers
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Diagnostic
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Taking medical and dental history
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Dental screening and assessment
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Dental charting and oral inspection
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Vital signs
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Dental diagnosis and treatment planning
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Referral to dentists, other providers, specialists
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Assess for sealants
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Clinical support
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X-rays
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Primary prevention
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Oral hygiene instruction
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Dietary counseling
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Topical fluorides
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Dental sealants
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Removal of deposits from teeth
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Coronal polishing
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Dental prophylaxis (scaling)
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Nonsurgical therapeutic periodontal procedures
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Preventive anti-microbial therapy
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Apply antimicrobials
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Anesthesia
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Topical anesthetics
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Local anesthetics
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Nitrous oxide
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General anesthesia for surgery
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Cavity treatment
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Atraumatic Restorative Technique (ART)
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Placement of temporary restorations
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Pack and carve restorations (amalgam or resin)
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Extractions
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Prefabricated crowns
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Pulpotomy
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Pulp capping
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Root canal therapy
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Other services
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Denture fabrication
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Denture repair and adjustment
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Impressions for models and guards
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Impressions for crowns
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Other oral surgery
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Placement of orthodontic appliances
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Orthodontic adjustment
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Check for loose bands, wires
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Periodontal dressings
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Other periodontal surgery
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Prescriptive authority
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Prescribe antimicrobials, infection control
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Prescribe controlled substances (pain medication)
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Dispense medications by doctor’s order
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*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.
