WSDA Advocates for Reducing Barriers to Hygiene Licensure

This legislative session, WSDA is focusing on several efforts to help address the severe workforce shortages faced by the dental industry. One of those important efforts is advocating for the passage of House Bill 1466, which seeks to reduce barriers to hygiene licensure in our state. Unfortunately, it has come to our attention that there is misinformation circulating regarding this bill. We would like to take this opportunity to clarify the intention behind this proposed legislation as well as its intended effect.

HB 1466 Brings Washington’s Hygiene Licensure Process Into Alignment with the Majority of States

Several decades ago, Washington made it easy for dentists licensed in another state to obtain a dental license in our state. This act, called licensure reciprocity, was a boon for dental access, especially since three of four dentists practicing here were trained outside Washington.

We need to do the same thing for our state’s dental hygiene reciprocity law. Washington’s current hygiene law is an outlier when compared to the rest of country and a barrier for too many dental hygienists that want to work in our state.

Washington is the only state in the nation that requires applicants to have completed education programs and exams in local anesthesia and restorative procedures, along with an education program in administering nitrous oxide, in order to receive a full hygiene license.

In 2023, WSDA is advocating for HB 1466, legislation that simplifies licensure reciprocity for dental hygienists.

WSDA and the Department of Health have heard from employer dentists as well as hygienists about the difficulties of obtaining a permanent dental hygiene license here when a hygienist was trained in a state with a different scope of practice. These hygienists have very limited options for taking the training courses and exams needed to obtain a permanent license.

These barriers result in some out-of-state trained hygienists only working in Washington temporarily or not practicing at all. Keeping qualified dental hygienists out of the workforce makes a dire dental hygiene shortage even worse. Inefficient or overly burdensome licensure reciprocity is both a barrier to care and a strike against retaining hygienists that are already trained to provide necessary, preventive care.

There are only two ways to create seamless licensure reciprocity: make the scope of practice for dental hygiene across the country identical OR make the portions of the dental hygiene scope that are the same across the country into a core license and make the other portions an optional endorsement. Unfortunately, the first option is out of our control (16 states do not include local anesthesia and/or administration of nitrous oxide in their dental hygiene scope of practice according to data from the American Dental Hygienists' Association). This leaves the second option as the only alternative to seamless licensure reciprocity.

The Washington State Dental Hygienists’ Association (WDHA) has been busy promulgating disinformation about HB 1466, claiming that the bill “creates a narrow ‘basic’ dental hygiene scope of practice, eliminating key treatments that dentists and patients rely on every day.” This claim is completely false.

If enacted, HB 1466 does not change the scope of practice of dental hygienists that currently have a dental hygiene license, nor does it alter the list of procedures that can be performed by dental hygienists in statute or rule. Furthermore, the bill does not require our state’s dental hygiene programs to change what is taught in their training. Dental hygiene programs can continue to train dental hygienists to perform restorative care and administration of local anesthetic and nitrous oxide that is, and remains, in Washington’s dental hygiene scope of practice.

Washington dentists broadly support the current dental hygiene scope of practice in our state, and HB 1466 does not change or diminish that support. What HB 1466 does is make it easier for a dental hygienist that is not trained to the full scope of a Washington hygienist to get a permanent Washington licensure to practice the hygiene scope that is consistent across 49 of the 50 states.

Finally, some may ask whether the newly proposed Dentist & Dental Hygienist Compact is an alternative to HB 1466. Unfortunately, the Compact is only as effective as the number of states that opt into participating. While both WSDA and WDHA support Washington joining the Compact, it is unlikely that a significant number of states will join for several years. Once enacted, HB 1466 can help address our workforce shortage promptly without requiring action from other states.

HB 1466 is a necessary part of addressing our dental hygiene workforce shortage and brings dental hygiene reciprocity law in line with the spirit of Washington’s long standing reciprocity law for dentists.

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