New laws aim to bolster Washington’s dental workforce, particularly among hygienists


Shane Ersland


New laws passed during the 2023 legislative session will provide more support for Washington’s dental workforce, particularly among hygienists.


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Lawmakers passed several new dental reform laws during the session, including House Bill 1466, which allows dental hygienists moving to Washington more time to get licensed while working in the field. Washington State Dental Association (WSDA) Executive Director Bracken Killpack discussed the bill with State of Reform.

“Washington dentists face significant and persistent shortages in the dental workforce, especially among hygienists,” Killpack said. “For example, for every one hygienist looking for a position, there are more than four openings. As a result, hygienist position openings take months to fill, which negatively impacts patient access to preventive care. One strategy to address this shortage is to make it more seamless for hygienists moving into the state to begin practicing here.”

Washington’s scope of practice and educational requirements for hygienists are more extensive than some other states, Killpack said.

“HB 1466 extends the initial limited license period for hygienists moving into the state to complete these additional educational requirements from 18 months to five years. This will allow hygienists to begin providing much-needed preventive care to patients while they work to obtain additional education in restorative procedures, along with administration of nitrous oxide and local anesthesia that Washington requires of fully-licensed hygienists.”


Before this extension, some hygienists moving to Washington were overwhelmed by the limited time frame in which they were allowed to complete the additional education requirements while working, Killpack said. 

“The new law’s longer time frame provides a practical strategy to help bring more hygienists into the dental workforce,” he said.

WSDA supported two other bills that were passed during the session, Killpack said. HB 1287 removes the requirement for a hygienist in another state or Canadian province to be in active practice in order to qualify for the initial limited license referred to in HB 1466 when moving to Washington.

“The law previously required a hygienist to have worked for a minimum of 560 hours over the previous 24 months in order to be eligible,” Killpack said. “This law allows newly-trained hygienists from states like Idaho to practice in Washington more easily.”

HB 1576 authorizes Washington’s membership in the Dentist and Dental Hygienist Licensing Compact, which will allow dentists and dental hygienists who are licensed in one compact member state to practice in other participating states once it is established.

“Under this bill, licensed dentists and licensed dental hygienists in good standing will be allowed to practice in all states participating in the compact, rather than having to secure individual licenses in each state. The compact is still in the formative stage, and a minimum of seven states are required for it to become operational.”


Washington, Iowa, and Tennessee were the first states to enact legislation committing to their participation in the compact, and similar bills have been introduced or are under consideration in several other states. 

“Given the fact almost every state is facing a dental workforce shortage, the hope is that the seven-state threshold will be reached quickly, and the benefits of the compact will begin to be seen,” Killpack said.

HB 1466, HB 1287, and HB 1576 represent pragmatic strategies for addressing the dental workforce shortage, while long-term responses (such as creating more hygiene education program capacity) are pursued, Killpack said.

“For a state with a growing population fueled in part by significant numbers of new people moving into the state, especially in areas with large military populations, these new laws will begin paying real dividends for dentists and their patients almost immediately.”


Lawmakers also passed HB 1678 during the session, which establishes and authorizes the profession of dental therapy, and allows dental therapy to be used in limited settings. WSDA was not as supportive of HB 1678 as the other bills, however.

“WSDA and the vast majority of dentists that WSDA has talked with do not see dental therapy as a solution to reducing barriers to care,” Killpack said.

WSDA will advocate for a new licensed position in order to support the dental workforce during the 2024 session, Killpack said.

“WSDA will continue to address the dental workforce shortage by proposing a new licensed profession that will expand preventive care,” he said. “This new profession would fit in between a dental assistant and a dental hygienist. We are also exploring several policies to improve the quality of dental benefits available in our state.”