Next Steps for Virginia Dental Workforce Bills
The 2026 Virginia General Assembly passed two measures to expand patient access to preventive dental care in Virginia, which went into effect on July 1. Both measures passed with overwhelming bipartisan support in the General Assembly and were signed by Governor Abigail Spanberger. It is important for VDA member dentists and their team members interested in the pathways established by the legislation to understand the specific processes established by each bill.
Pathways for Dental Assistants to Become Credentialed to Supragingivally Scale Teeth
Senate Bill 178/House Bill 970 updates Virginia law to allow trained and certified dental assistants with 1,800 hours of clinical experience to perform supragingival scaling and coronal polishing under indirect supervision, adding duties permitted to be delegated to credentialed team members in Dental Assistant I and II positions.
The law states that:
A dental assistant I or dental assistant II with a minimum of 1,800 hours of clinical experience may obtain certification to provide additional treatments pursuant to subsection D, provided that:
1. The dental assistant I or dental assistant II has undergone training and obtained certification (i) from a licensed dentist or licensed dental hygienist employed or engaged by a licensed dentist and implementing an education curriculum provided by a statewide association that is exempt under 26 U.S.C. § 501(c)(6) of the Internal Revenue Code and primarily represents dentists licensed in the Commonwealth, (ii) from a federal program approved by or associated with the Indian Health Service or while serving on active military duty, or (iii) from an existing dental assistant education program; and
2. The licensed dentist who provides, supervises, or confirms the training of the dental assistant I or dental assistant II certifies under oath that the dental assistant I or dental assistant II has completed the training described in subdivision 1, as well as at least 20 supervised full mouth supragingival scaling procedures with consent of the patients. Documentation of such certification shall be maintained in writing or electronically by the licensed dentist and produced to the Board upon request. Such certifications and documentation thereof may be relied upon and maintained by subsequent employers of a dental assistant I or dental assistant II. A licensed dentist may certify any dental assistant I or dental assistant II who presents evidence of such training completed pursuant to clause (ii) of subdivision 1.
D. A dental assistant I or dental assistant II, upon obtaining certification and under indirect supervision of a licensed dentist, may perform (i) supragingival scaling with hand and ultrasonic scalers and (ii) coronal polishing.
E. A licensed dentist shall not indirectly supervise more than two dental assistants at any given time while such dental assistants are performing supragingival scaling or coronal polishing.
The law creates three pathways to training and certification from:
- A licensed dentist or dental hygienist implementing a curriculum provided by a statewide association that is exempt under 26 U.S.C. § 501(c)(6) of the Internal Revenue Code and primarily represents dentists licensed in the Commonwealth
- A federal program approved by or associated with the Indian Health Service or while serving on active military duty
- An existing dental assistant education program
The Virginia Dental Association is developing a curriculum to fulfill the first pathway, drawing on models from other states and collaborating with the American Dental Association. That development process will continue through the summer and fall of 2026.
The VDA is also working with the Virginia Department of Veterans Services to develop guidance documents for transitioning veterans interested in the second pathway and for dental assistants who have successfully completed a federal education program.
At its June 12, 2026, business meeting, the Board of Dentistry adopted a motion to add “supragingival scaling with hand and ultrasonic sealers certified by a dentist under Va. Code” as a hygiene duty that may be delegated to Dental Assistants I and II under indirect supervision of a dentist to its Guidance Document 60-7.
This certification allows one additional duty to be delegated to a credentialed dental assistant, practicing under a dentist’s license. The law requires documentation of such certification to be maintained in writing or electronically by the licensed dentist and produced to the Board upon request.
Pathway for Internationally Educated Dentists to Become Licensed to Practice Hygiene
Senate Bill 282/House Bill 1036 allows Virginia’s Board of Dentistry to license certain internationally educated dentists as dental hygienists if they graduated from an overseas dental program the Board deems acceptable. This effectively expands the pool of eligible applicants for dental hygiene licensure by recognizing qualified international dental credentials.
Specifically, the legislation states, “The Board may grant a license to practice dental hygiene to an applicant if he (i) provides proof of graduation from a dental school outside the United States, (ii) was or is eligible to practice dentistry in a country or jurisdiction outside the United States, and (iii) meets the requirements of subsection B.”
Those requirements of subsection B are, “An application for such license shall be made to the Board in writing and shall be accompanied by satisfactory proof that the applicant (i) is of good moral character, (ii) is a graduate of a dental school outside the United States as approved by the Board pursuant to subsection D or a dental hygiene program accredited by the Commission on Dental Accreditation and offered by an accredited institution of higher education, (iii) has passed the dental hygiene examination given by the Joint Commission on National Dental Examinations, and (iv) has successfully completed a clinical examination acceptable to the Board.”
This pathway requires an expedited regulatory process from the Board of Dentistry to implement the new law. The Board of Dentistry has stated they intend to outline criteria such as foreign-education assessments, supervision levels, and minimum training requirements as part of that expedited regulatory process. The next Board business meeting will take place on September 4, 2026, and we expect to have additional clarification on the next steps for that process following that meeting.
Until the regulations are promulgated, the duties delegable to an internationally educated dentist in Virginia are unchanged from before the legislation was passed. The VDA will be an active part of the regulatory process to help ensure it is a fair, clear process consistent with the intent of the legislators who passed the bill with broad bipartisan support.
Note: The masculine generics used by Virginia lawmakers in Senate Bill 282/House Bill 1036 do not limit which individuals can serve in these roles.
Stay Tuned
The VDA will share additional guidance and FAQs on these workforce pathways at vadental.org/workforce in the coming days.
Glossary of Terms
"Direct supervision" means that the dentist examines the patient and records diagnostic findings prior to delegating restorative or prosthetic treatment and related services to a dental assistant II for completion the same day or at a later date. The dentist prepares the tooth to be restored and remains immediately available in the office to the dental assistant II for guidance or assistance during the delivery of treatment and related services. The dentist examines the patient to evaluate the treatment and services before the patient is dismissed.
"Direction" means the level of supervision (i.e., immediate, direct, indirect, or general) that a dentist is required to exercise with a dental hygienist, a dental assistant I, a dental assistant II, or a certified registered nurse anesthetist or the level of supervision that a dental hygienist is required to exercise with a dental assistant to direct and oversee the delivery of treatment and related services. For the purpose of a digital scan technician, "direction" means the written or electronic instructions provided by a dentist to a digital scan technician in the form of a work order for a digital scan of a patient and the dentist's specified availability to consult with a digital scan technician while the scan is being taken.
"General supervision" means that a dentist completes a periodic comprehensive examination of the patient and issues a written order for hygiene treatment that states the specific services to be provided by a dental hygienist during one or more subsequent appointments when the dentist may or may not be present. Issuance of the order authorizes the dental hygienist to supervise a dental assistant performing duties delegable to dental assistants I.
"Immediate supervision" means the dentist is in the operatory to supervise the administration of sedation or provision of treatment.
"Indirect supervision" means the dentist examines the patient at some point during the appointment and is continuously present in the office to advise and assist a dental hygienist, a dental assistant, or a certified registered nurse anesthetist who is (i) delivering hygiene treatment, (ii) preparing the patient for examination or treatment by the dentist, (iii) preparing the patient for dismissal following treatment, or (iv) administering topical local anesthetic, sedation, or anesthesia as authorized by law or regulation.
"Remote supervision" means that a supervising dentist is accessible and available for communication and consultation with a dental hygienist during the delivery of dental hygiene services, but such dentist may not have conducted an initial examination of the patients who are to be seen and treated by the dental hygienist and may not be present with the dental hygienist when dental hygiene services are being provided. For the purpose of practice by a public health dental hygienist, "remote supervision" means that a public health dentist has regular, periodic communications with a public health dental hygienist regarding patient treatment, but such dentist may not have conducted an initial examination of the patients who are to be seen and treated by the dental hygienist and may not be present with the dental hygienist when dental hygiene services are being provided. For the purpose of supervision of a digital scan technician, remote supervision means that a directing dentist is accessible and available for communication and consultation in the practice of teledentistry.
