Wash. Admin. Code § 246-817-550 : Health, Department of —PROFESSIONAL STANDARDS AND LICENSING —817 - Dental quality assurance commission —DELEGATIONS OF DUTIES TO PERSONS NOT LICENSED AS DENTISTS —817-550 - Acts that may be performed by licensed dental hygienists under general supervision

A dentist may allow a dental hygienist licensed under chapter 18.29 RCW to perform the following acts under the dentist's general supervision:

(1) Head and neck examination.
(2) Oral inspection and measuring of periodontal pockets, with no diagnosis.
(3) Record health histories.
(4) Take and record blood pressure and vital signs.
(5) Take intraoral and extraoral radiographs.
(6) Take intraoral and extraoral photographs.
(7) Patient education in oral hygiene.
(8) Give preoperative and postoperative instructions.
(9) Oral prophylaxis and removal of deposits and stains from the surfaces of the teeth.
(10) Give fluoride treatments.
(11) Apply topical anesthetic agents.
(12) Deliver oral antibiotic prophylaxis as prescribed by a dentist.
(13) Place and remove the rubber dam.
(14) Apply topical preventive or prophylactic agents.
(15) Administer local anesthetic agents and adjunctive procedures if all conditions in (a) through (d) of this subsection are met. Adjunctive procedures include local anesthetic reversal agents and buffered anesthetic.
(a) The patient is at least eighteen years of age;
(b) The patient has been examined by the delegating dentist within the previous twelve months;
(c) There has been no change in the patient's medical history since the last examination. If there has been a change in the patient's medical history within that time, the dental hygienist must consult with the dentist before administering local anesthetics;
(d) The delegating dentist who performed the examination has approved the patient for the administration of local anesthetics by a dental hygienist under general supervision and documented this approval in the patient's record;
(e) If any of the conditions in (a) through (d) of this subsection are not met, then close supervision is required.
(16) Perform subgingival and supragingival scaling.
(17) Perform root planing.
(18) Apply sealants.
(19) Polish and smooth restorations.
(20) Sterilize equipment and disinfect operatories.
(21) Place retraction cord.
(22) Take impressions, bite registration, or digital scans of the teeth and jaws for:
(a) Diagnostic and opposing models;
(b) Fixed and removable orthodontic appliances, occlusal guards, bleaching trays, and fluoride trays; and
(c) Temporary indirect restorations such as temporary crowns.
(23) Take a facebow transfer for mounting study casts.
(24) Fabricate and deliver bleaching and fluoride trays.
(25) Fabricate, cement, and remove temporary crowns or temporary bridges.
(26) Place a temporary filling such as zinc oxide-eugenol or ZOE after diagnosis and examination by the dentist.
(27) Remove excess cement after the dentist has placed a permanent or temporary inlay, crown, bridge or appliance, or around orthodontic bands.
(28) Pack and medicate extraction areas.
(29) Place periodontal packs.
(30) Remove periodontal packs or sutures.
(31) Select denture shade and mold.
(32) Place and remove orthodontic separators.
(33) Select and fit orthodontic bands, try in fixed or removable orthodontic appliances prior to the dentist cementing or checking the appliance.

Wash. Admin. Code § 246-817-550

Amended by WSR 14-12-057, Filed 5/30/2014, effective 6/30/2014
Amended by WSR 17-01-045, Filed 12/13/2016, effective 1/13/2017
Amended by WSR 19-18-095, Filed 9/4/2019, effective 10/5/2019

Statutory Authority: RCW 18.32.035. 95-21-041, § 246-817-550, filed 10/10/95, effective 11/10/95.