Sterilization When the Dentist is Out of the Office: What Does Washington State Law Allow?

By Hollie H. Reese, RDH

Let’s start by reviewing some definitions, of close supervision” versus general supervision.”

• General supervision means a supervising dentist has examined and diagnosed the patient, and provided subsequent instructions to be performed by the assistive personnel but does not require that the dentist be physically present in the treatment facility.
• Close supervision means the supervising dentist whose patient is being treated has personally diagnosed the patient, authorized the procedures, and is onsite and physically present in the treatment facility while assistive personnel perform the tasks. The dentist must be able to and capable of responding immediately in the event of an emergency. However, close supervision does not require a supervising dentist to be physically present in the operatory. (WAC 246-817-510)

According to WAC 246-817-520, a supervising dentist may delegate supportive services, including sterilizing equipment and disinfecting operatories, in subsection (4) of this section under the dentist's close supervision, provided the registered dental assistant. However, these tasks must be performed under the dentist’s close supervision, and the dental assistant must have demonstrated the skills needed to perform them competently.

Conclusion

In Washington state, a dentist must be present in the treatment facility for a registered dental assistant to sterilize equipment. If you’re curious about other options:

• Expanded Function Dental Auxiliaries (EFDAs) fall under the same rules as registered dental assistants - the dentist must be present in the facility to sterilize equipment.
• A licensed dental hygienist, however, can sterilize equipment under general supervision, meaning the dentist does not need to be in the facility. (WAC 246-817-550)