Grandparent Dental Consent in Washington State: What You Need for the Dentist

One Declaration Covers Dental, Too

If you're raising a grandchild in Washington and need to get them to the dentist, you don't need a separate dental consent form. The same RCW 7.70.065 caregiver health declaration that covers medical care covers dental care — cleanings, fillings, X-rays, fluoride treatments, and extractions included.

This surprises many kinship caregivers who assume they need one form for the doctor and another for the dentist. You don't. But dental offices sometimes push back because they're unfamiliar with the declaration, and there are limits to what it covers.

What Your Declaration Authorizes

Under RCW 7.70.065, a relative caregiver's signed declaration covers routine outpatient medical, dental, and mental health care. For dental specifically, that includes:

• Preventive visits — cleanings, exams, fluoride, sealants
• Diagnostic imaging — X-rays and panoramic films
• Restorative work — fillings, crowns on baby teeth
• Simple extractions
• Emergency dental treatment for pain, infection, or injury

The statutory protection that applies to medical providers also applies to dentists: a dental provider who renders care in good-faith reliance on a properly executed declaration is protected from civil liability for failure to secure parental consent.

What It Doesn't Cover

The declaration authorizes routine outpatient care. Procedures that go beyond that threshold — orthodontic treatment plans, oral surgery requiring general anesthesia, or elective procedures — may require either explicit parental consent through a power of attorney under RCW 11.130.145 or a court order.

In practice, most pediatric dental offices treat everything short of oral surgery under the caregiver declaration without issue. If the dentist wants to refer your grandchild for orthodontics or wisdom tooth extraction under sedation, ask whether they need a POA or whether the referral provider will accept the declaration. The answer varies by provider.

Presenting the Declaration at the Dental Office

Bring the signed declaration to the first appointment. Many dental offices have their own "responsible party" or "guardian information" forms that they ask you to fill out at intake. Fill in your information as the responsible adult, attach a copy of the declaration, and let the front desk know you're a relative caregiver authorized under Washington law.

If the office hasn't seen the form before — and many haven't — the key information to convey is:

1. You are a relative (grandparent, aunt, uncle, sibling) of the child
2. You've signed under penalty of perjury that you are responsible for the child's healthcare
3. The statutory authority is RCW 7.70.065
4. The declaration is valid for six months from the date of signature

Keep a copy of the declaration in the child's dental file. Some offices will scan it into their records system; others will keep a paper copy. Either way, it should be on file before the hygienist touches the child's teeth.

Insurance and Billing

Dental consent and dental insurance are separate issues. Your declaration gives you the legal authority to say yes to treatment. It doesn't automatically put the child on your dental insurance plan.

If the child has Apple Health (Medicaid), dental coverage is included. Apple Health for Kids covers comprehensive dental services for children, and the child's eligibility is based on their own income status. Present the child's ProviderOne number or Apple Health ID at check-in.

If you have private dental insurance and want to add the child as a dependent, contact your insurer. Some plans cover dependents who live in the policyholder's household regardless of legal custody status. Others require legal guardianship. Check your specific plan's dependent eligibility rules.

If the child has no dental coverage, community health centers and Federally Qualified Health Centers (FQHCs) across Washington offer sliding-scale dental care. The child's eligibility for these programs depends on household income, not custody status.

The Six-Month Renewal

Your declaration expires six months after you sign it. Dental offices typically schedule cleanings every six months, which means your declaration could expire right around the time the next cleaning is due. Renew the declaration before the six-month mark and deliver an updated copy to the dental office, just as you would for the pediatrician.

The Washington Consent Guide for Kinship Caregivers covers dental consent alongside medical and school authority, including what to do when a dental office requests additional documentation beyond the declaration.

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