Preventive dental care

AN ACT Relating to expanding oral health equity and increasing 1
access to preventive dental care; amending RCW 18.260.040, 2
18.260.090, and 18.29.021; adding new sections to chapter 18.260 RCW; 3
and creating a new section. 4
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:5
NEW SECTION. Sec. 1. (1) It is the intent of the legislature to 6
advance oral health equity, expand care availability, and ensure that 7
children and families in Washington have meaningful access to basic 8
preventive dental services. Washington families, especially children, 9
continue to face barriers to timely oral health care, even though 10
preventive care is essential to healthy development and long-term 11
well-being.12
(2) The legislature finds that as federal policies continue to 13
restrict pathways for internationally trained health professionals, 14
Washington is embracing a more welcoming and pragmatic approach, 15
recognizing that qualified providers strengthen our communities, and 16
that Washington should not be held back by federal barriers that 17
limit access to care. 18
(3) The legislature recognizes that Washington faces a 19
significant shortage of preventive care dental professionals, which 20
limits access to basic preventive services in many communities. Oral 21
S-3895.1
SENATE BILL 6146
State of Washington 69th Legislature 2026 Regular Session
By Senators Chapman, Hasegawa, Lovick, Orwall, Saldaña, and Trudeau
Read first time 01/14/26. Referred to Committee on Health & Long-
Term Care.
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preventive assistants and dentists trained internationally can play a 1
crucial role in addressing these gaps. Creating clear pathways for 2
these practitioners will help stabilize the workforce, expand service 3
capacity across the state, and offer meaningful relief to families 4
who currently struggle to secure timely oral health care.5
NEW SECTION. Sec. 2. A new section is added to chapter 18.260 6
RCW to read as follows: 7
The commission shall issue a license to practice as an oral 8
preventive assistant to any applicant who: 9
(1) Pays any applicable fees as established by the secretary in 10
accordance with RCW 43.70.110 and 43.70.250; 11
(2) Submits, on forms provided by the secretary, the applicant's 12
name, address, and other applicable information as determined by the 13
secretary; and 14
(3) Demonstrates successful completion of oral preventive 15
assistant training approved by the commission with consultation from 16
the dental hygiene examining committee as defined in RCW 18.29.110.17
NEW SECTION. Sec. 3. A new section is added to chapter 18.260 18
RCW to read as follows: 19
(1) The commission shall adopt rules relating to the scope of 20
oral preventive assistant services that may be performed by oral 21
preventive assistants under the supervision of a licensed dentist.22
(2) The scope of oral preventive assistant services that the 23
commission identifies in subsection (1) of this section must include:24
(a) Dental assisting services that a dental assistant may perform 25
under the supervision of a licensed dentist; 26
(b) Periodontal probing after initial probing by a dentist or 27
dental hygienist and diagnosis by a dentist; and 28
(c) Dental prophylaxis for patients in a healthy oral state as 29
defined by the commission with consultation from the dental hygiene 30
examining committee as defined in RCW 18.29.110. 31
(3) A dentist may not assign an oral preventive assistant to 32
perform services until the oral preventive assistant has demonstrated 33
skills necessary to competently perform all assigned duties and 34
responsibilities. 35
Sec. 4. RCW 18.260.040 and 2023 c 460 s 17 are each amended to 36
read as follows: 37
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(1)(a) The commission shall adopt rules relating to the scope of 1
dental assisting services related to patient care and laboratory 2
duties that may be performed by dental assistants. 3
(b) In addition to the services and duties authorized by the 4
rules adopted under (a) of this subsection, a dental assistant may 5
apply topical anesthetic agents. 6
(c) All dental services performed by dental assistants under (a) 7
or (b) of this subsection must be performed under the close 8
supervision of a supervising dentist or supervising dental therapist 9
as the dentist or dental therapist may allow , except for the 10
procedures involving sterilization of dental instruments or 11
equipment, which may be performed under general supervision.12
(2) In addition to any other limitations established by the 13
commission, dental assistants may not perform the following 14
procedures: 15
(a) Any scaling procedure; 16
(b) Any oral prophylaxis, except coronal polishing;17
(c) Administration of any general or local anesthetic, including 18
intravenous sedation; 19
(d) Any removal of or addition to the hard or soft tissue of the 20
oral cavity; 21
(e) Any diagnosis of or prescription for treatment of disease, 22
pain, deformity, deficiency, injury, or physical condition of the 23
human teeth, jaw, or adjacent structures; and 24
(f) The taking of any impressions of the teeth or jaw or the 25
relationships of the teeth or jaws, for the purpose of fabricating 26
any intra-oral restoration, appliance, or prosthesis, other than 27
impressions allowed as a delegated duty for dental assistants 28
pursuant to rules adopted by the commission. 29
(3) A dentist or dental therapist may not assign a dental 30
assistant to perform duties until the dental assistant has 31
demonstrated skills necessary to perform competently all assigned 32
duties and responsibilities. 33
Sec. 5. RCW 18.260.090 and 2007 c 269 s 8 are each amended to 34
read as follows: 35
(1) The commission shall issue an initial credential or renewal 36
credential to an applicant who has met the requirements for a 37
credential or deny an initial credential or renewal credential based 38
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upon failure to meet the requirements for a credential or 1
unprofessional conduct or impairment governed by chapter 18.130 RCW.2
(2) The commission may adopt rules for renewal requirements for a 3
credential, including continuing education requirements, for oral 4
preventive assistants and expanded function dental auxiliary 5
licenses.6
Sec. 6. RCW 18.29.021 and 1996 c 191 s 10 are each amended to 7
read as follows: 8
(1) The department shall issue a license to any applicant who, as 9
determined by the secretary: 10
(a) Has successfully completed an educational program approved by 11
the secretary. This educational program shall include coursework 12
encompassing the subject areas within the scope of the license to 13
practice dental hygiene in the state of Washington;14
(b) Has successfully completed an examination administered or 15
approved by the dental hygiene examining committee; and16
(c) Has not engaged in unprofessional conduct or is not unable to 17
practice with reasonable skill and safety as a result of a physical 18
or mental impairment. 19
(2) A person who is a dentist and who has been lawfully engaged 20
in the practice of dentistry for not less than five years in another 21
country or foreign province may apply for examination and licensure 22
as a dental hygienist. The applicant must present to the secretary 23
satisfactory documentation of registration or licensure in that 24
jurisdiction and proof of the duration of such practice issued by the 25
dental regulatory authority of that country or province. The foreign 26
jurisdiction must require a level of competency that, as determined 27
by the secretary in consultation with the dental commission and 28
dental hygiene examining committee, is equal to the competency 29
required of applicants for dental hygiene licensure in Washington.30
(3) Applications for licensure must comply with administrative 31
procedures, administrative requirements, and fees established 32
according to RCW 43.70.250 and 43.70.280. 33
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