We, the undersigned Licensed Expanded Function Dental Auxiliaries (EFDAs), dental healthcare professionals and concerned citizens of Washington State, call upon the Legislature to update RCW 18.260 to allow certified EFDAs to administer local anesthesia and local anesthetic reversal agents under the supervision of a licensed dentist.

Licensed EFDAs perform advanced restorative procedures—placing, carving, and finishing composite and amalgam fillings, placing matrix bands, and taking final crown impressions. Yet, when a restoration requires localized pain relief or a top-up injection during treatment, the workflow stops dead in its tracks. EFDAs must pause patient care, pull the supervising dentist or dental hygienist away from another patient, and wait for an injection that EFDAs are fully capable of safely administering with targeted training.

It is time to modernize Washington’s scope of practice.

Why Washington Must Update RCW 18.260

1. Following the Proven Regional Benchmark in Oregon

In Oregon, state regulators recognized that EFDAs are uniquely positioned to safely deliver local pain management. Under OAR 818-042-0096, Oregon established the Local Anesthesia Functions Certificate (LAFC), authorizing certified EFDAs to administer local anesthesia and reversal agents under dentist supervision. Oregon proved that when EFDAs receive standardized, accredited instruction (combining didactic science, lab simulation, and supervised clinical injections), scope expansion improves practice safety without increasing adverse events. Washington patients deserve the same modern, efficient standard of care enjoyed by our neighbors. 

2. Elevating Patient Care, Comfort, and Recovery

Reduced Chair Time: Patients spend less time sitting numb in the dental chair waiting between the initial injection and restorative placement.

Fewer Complications with Reversal Agents: Extending EFDAs' scope to include local anesthetic reversal agents (such as phentolamine mesylate) allows soft-tissue sensation to return twice as fast. This significantly reduces accidental post-treatment lip, cheek, and tongue biting—a major benefit for pediatric, geriatric, and special-needs patients.

3. Economic Efficiency and Reduced Healthcare Costs
Operating a dental practice at peak efficiency requires optimizing every credentialed professional on the team:

Eliminating Practice Bottlenecks: When a dentist does not have to interrupt a complex surgical or crown procedure in Operatory A just to deliver a routine block in Operatory B, total practice throughput increases.
Increasing Community Access to Care: Allowing EFDAs to administer local numbing enables community health clinics and dental offices to treat more patients per day, shortening waiting lists for dental care across Washington State.

Addressing Safety: Rigorous Training and Strict Guardrails
Patient safety is our absolute priority. Expanding our scope does not mean skipping rigorous education or safety protocols. We propose an endorsement framework that guarantees maximum public protection:

Comprehensive Certification: Authorization requires a 60+ hour accredited program covering head and neck neuroanatomy, local anesthetic pharmacology, dosage calculations (Maximum Recommended Dose), Local Anesthetic Systemic Toxicity (LAST) identification, and emergency management.

Supervised Clinical Injections: Candidates must complete supervised clinical injection requirements on live patients under direct faculty observation.

Strict Supervision: Administration occurs under the Close Supervision of a licensed dentist who remains physically present on-site. 

Pediatric Safety Guardrails: Clear statutory boundaries prohibiting the administration of reversal agents on children under 6 years of age or weighing under 33 pounds. 

Sign this petition to tell Washington lawmakers: Empower EFDAs, improve practice efficiency, and put patient care first!