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Radiography Requirements

To legally operate dental x-ray equipment and perform dental radiographic procedures in Washington, a dental assistant must meet the requirements shown below.

Radiography Requirements

All dental assistants (registered dental assistants or EFDAs) operating x-ray equipment in the state of Washington shall be adequately instructed in safe operating procedures and shall be able to demonstrate competence, upon request from the Washington State Dental Quality Assurance Commission (DQAC), in the correct use of the equipment.

The following are areas in which the DQAC considers it important that an individual have expertise for the competent operation of x-ray equipment:

(1) Familiarization with equipment 
    (a) Identification of controls 
    (b) Function of each control 
    (c) The use of a technique chart

(2) Radiation protection 
    (a) Collimation 
    (b) Filtration 
    (c) Gonad shielding and other patient protection devices 
    (d) Restriction of x-ray tube radiation to the image receptor 
    (e) Personnel protection 
    (f) Grids

(3) Film processing 
    (a) Film speed as relates to patient exposure 
    (b) Film processing parameters 
    (c) Quality assurance and quality control

A registered dental assistant requires close supervision and an EFDA requires general supervision by a licensed dentist to perform dental radiography procedures.

Dental Assisting Job Titles and Requirements for Each Level

Registered Dental Assistant

Every dental assistant in the state of Washington must be registered. To be eligible for registration as a dental assistant, one must:

1. Provide a completed application on forms provided by the Washington State Dental Quality Assurance Commission, AND

2. Pay applicable fees, AND

3. Provide evidence of completion of seven clock hours of AIDS education and training as required by chapter 246-12 WAC, Part 8, AND

4. Provide any other information determined by the Washington State Dental Quality Assurance Commission.

The dental assistant registration must be renewed annually on or before the dental assistant’s birthday.

A registered dental assistant must hold a current and valid health care provider basic life support (BLS) certification.

A registered dental assistant in the state of Washington may earn an endorsement in sealant/fluoride varnish solely for the purpose of treating children in school-based programs. Applicants must:

1. Have had 200 hours of employment by a Washington State licensed dentist that has included theoretical and clinical training in the application of dental sealants and fluoride varnish treatments, verified by a declaration provided by the licensed dentist who provided the training, AND

2. Meet one of the following requirements (which must have incorporated the Washington State Department of Health program guidelines):
a. Graduation from a CODA-accredited dental assisting, dental hygiene, or dental educational program, or
b. Continuing education courses, or
c. Individual training provided by a Washington-licensed dentist, AND

3. Apply to the Washington State Dental Quality Assurance Commission for endorsement.

Note: Registered dental assistants monitoring patients receiving deep sedation or general anesthesia must receive a minimum of 14 hours of documented training in a course specifically designed to include instruction and practical experience in the use of equipment.

Note: A volunteer dental assistant is an individual who, without compensation, provides supportive services in a charitable dental clinic.

Washington State Dental Assistant Registration Packet

Expanded Function Dental Auxiliary (EFDA)

To become an Expanded Function Dental Auxiliary (EFDA) in Washington, a registered dental assistant must:

1a. Graduate from a CODA-accredited dental assisting program, or

1b. Be DANB CDA certified (after meeting DANB CDA/GC pathway II eligibility requirements, and completing an additional dental assisting review course), AND

2. Complete an EFDA course approved by the Dental Quality Assurance Commission (DQAC), AND

3. Pass the Washington State Restorative Exam (WARE) administered by DANB, AND

4. Pass the clinical exam administered by the Western Regional Examining Board, AND

5. Provide evidence of completion of seven clock hours of AIDS education and training as required by Chapter 246-12 WAC, Part 8, AND

6. Provide any other information determined by DQAC, AND

7. Apply to DQAC for an EFDA license.

An EFDA must hold current and valid health care provider basic life support (BLS) certification.

Note: DANB administers the Washington State Dental Hygiene Drug and Law Examination under agreement with the Washington State Department of Health. To obtain an application or for additional information, contact the Washington State Dental Hygiene Program at 360-236-4837 (dental hygiene department).

Washington State Restorative Exam (WARE) Application (PDF)

Dental Anesthesia Assistant

Each applicant for certification as a dental anesthesia assistant must submit to the Washington State Dental Quality Assurance Commission (DQAC):

1. An application, on a form provided by the department, AND

2. An application fee, AND

3. Evidence of completion of one of the following:

a. The "Dental Anesthesia Assistant National Certification Examination (DAANCE)" or predecessor program, provided by the American Association of Oral and Maxillofacial Surgeons (AAOMS), or

b. The "Oral and Maxillofacial Surgery Assistants Course" course provided by the California Association of Oral and Maxillofacial Surgeons (CALAOMS), or

c. Substantially equivalent education and training approved by DQAC, AND

4a. Evidence of completion of training in intravenous access or phlebotomy that includes 8 hours of didactic training and hands on experience starting and maintaining intravenous lines with at least ten successful intravenous starts on a human or simulator/manikin, or

4b. Evidence of completion of substantially equivalent education and training approved by DQAC, AND

5. A current and valid certification for health care provider basic life support (BLS), advanced cardiac life support (ACLS), or pediatric advanced life support (PALS), AND

6. A valid Washington state general anesthesia permit of the oral and maxillofacial surgeon or dental anesthesiologist where the dental anesthesia assistant will be performing his or her services, AND

7. Completion of seven clock hours of AIDS education and training, AND

8. Any other information determined by DQAC

Note: A certified dental anesthesia assistant shall notify DQAC in writing on a form provided by DQAC of any changes in his or her supervisor. DQAC must be notified of the change prior to the certified dental anesthesia assistant accepting delegation from another supervisor.

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