Virginia does two things differently from most states, and both change how a practice owner should plan. Dental x-ray inspections are performed by private inspectors who set their own fees, not by state employees on a schedule you cannot influence. And Virginia's non-compete statute draws a line that lands in an awkward place for dental offices: it protects low-wage employees and a defined list of health care professionals, and dentists are not on that list.
Key takeaways
- Dentists need a minimum of 15 hours of continuing education annually, with exceptions for the first renewal after initial licensure and for restricted volunteer licenses. Up to 15 hours may carry over to the next renewal year.
- Dental x-ray machines are registered with the Virginia Department of Health at $100 per machine, billed every three years, and the dental inspection frequency is three years.
- Inspections are conducted by private inspectors who set their own fees, so it pays to compare. Initial inspections must be started within 30 days and completed within 60 days after installation.
- Virginia's non-compete statute bars covenants with low-wage employees and with a defined group of health care professionals. That definition lists the Boards of Medicine, Nursing, Counseling, Optometry, Psychology and Social Work. Dentists are not among them, though many dental staff will qualify as low-wage employees.
Rules change. Everything below was checked against an official Virginia or federal source in September 2026. The non-compete statute in particular was amended in 2025 and 2026, so read the current text rather than relying on a summary. Confirm with the agency and with counsel before acting.
Who regulates what
| Topic | Agency | Official link |
|---|---|---|
| Dentist and hygienist licensure and renewal | Virginia Department of Health Professions, Board of Dentistry | Virginia Board of Dentistry |
| Dentist continuing education | Virginia Board of Dentistry | CE requirements for dentists |
| Dental hygienist continuing education | Virginia Board of Dentistry | CE requirements for dental hygiene |
| Laws and regulations governing dentistry | Virginia Board of Dentistry | Laws and regulations |
| Dental x-ray machine registration and inspection | Virginia Department of Health, Radiological Health | Dental x-ray machines |
| X-ray program rules and fees | VDH, 12VAC5-490 | X-ray regulations |
| Non-competes | Virginia Code 40.1-28.7:8 | Covenants not to compete, low-wage employees |
| Amalgam separators and dental wastewater | US EPA rule, enforced through your pretreatment control authority | EPA Dental Effluent Guidelines |
| Sales and use tax on equipment | Virginia Department of Taxation | Virginia Tax |
License renewal and continuing education
Virginia runs dentist CE annually rather than biennially: a minimum of 15 hours of continuing education for each renewal, with two exceptions the board names, the first renewal following initial licensure and restricted volunteer licenses.
What counts is narrower than many people assume, and the board writes the boundary explicitly. Acceptable subjects are clinical dentistry plus nonclinical topics that support the delivery of dental services, such as patient management, legal and ethical responsibilities, and stress management. Estate planning, financial planning, investments, business management, marketing and personal health are specifically not acceptable. If you are buying discounted CE at a trade show, read the topic against that list before you pay, because "practice growth" sessions are exactly the kind of thing that does not count.
Two mechanics are worth knowing:
- Carryover. Up to 15 hours may be carried into the next renewal year. That effectively lets a productive CE year cover a lean one, but only one year forward.
- CPR is a standing requirement. Dentists must maintain current certification in basic CPR with hands-on airway training for health care providers, or basic life support, unless they are required to hold advanced life support certification.
Dentists who administer sedation or anesthesia add 4 hours every two years of approved CE directly related to the administration and monitoring of that sedation or anesthesia, on top of the general requirement.
X-ray equipment: registration and inspection
Virginia's model is unusual and worth understanding before you buy imaging equipment.
- Registration and fee. Dental x-ray machines must be registered with VDH. The registration fee is $100 per machine, billed every three years. Machines under exclusive federal jurisdiction, and out-of-state machines used in Virginia for fewer than 180 days, are excepted.
- Three year inspection cycle for dental. Medical, osteopathic and chiropractic machines are inspected annually. Dental, podiatry, bone densitometry and veterinary units run on a three year cycle.
- Private inspectors, private pricing. Inspections are performed by private inspectors rather than state employees, and those inspectors set their own fees. VDH either issues the certificate afterward or refers serious noncompliance to a state inspector for follow-up. The fees for state inspections themselves are set in 12VAC5-490.
- New installations. An initial inspection must be started within 30 days and completed within 60 days after installation.
- Certificates and postings. Virginia expects the facility to post a notice to employees, radiation safety practices documentation, an operator's list, and the certificate near each x-ray unit. A facility receives a notice roughly 90 days before its certification expires.
Because inspectors compete on price, get more than one quote, especially if you have several tubes. Ask what the quote includes (report, certificate submission, any retest) rather than comparing headline numbers. This is one of the few compliance costs in dentistry you can actually shop.
On shielding, VDH advises consulting a medical physicist before you buy equipment, and lists what the physicist will need: distances to surrounding rooms, how the spaces on the other side of each wall are used, patient workload, technique factors and the operator booth location. That is a pre-purchase conversation, not a post-installation one. See our equipment pages on intraoral x-ray units, panoramic units and CBCT units, plus the general guide to x-ray registration and inspections.
Buying and selling used equipment in Virginia
Both parties file, in writing, within 30 days
Virginia's FAQ is specific about transitions: when a practice relocates or is sold, both doctors must report the change in writing within 30 days, with new certificates completed for each machine and submitted to the address shown on the certificate. Establishing a new practice or changing locations also means completing a new registration form documenting the address, phone number and machine inventory.
"Both doctors" is the operative phrase. In a sale, the seller's filing does not substitute for the buyer's, and the buyer's does not close out the seller. Assign both sides at closing.
Time the inspection cycle in due diligence
Because dental machines are inspected every three years and registration is billed on the same cadence, ask any seller for the current certificate and the date of the last inspection. If the cycle expires two months after your closing date, that is a cost and a scheduling problem you just inherited. It is also a negotiating point, and a small one that sellers rarely argue about.
Amalgam separators and wastewater
The federal EPA dental rule at 40 CFR Part 441 applies. If you place or remove amalgam and discharge to a publicly owned treatment works, you need a compliant amalgam separator, you follow the best management practices (no discharging scrap amalgam, and restrictions on certain line cleaners), and you file a one-time compliance report with your pretreatment control authority. EPA routes reports to a state agency in only a handful of states, and Virginia is not one of them, so your control authority is almost certainly your local water or sewer utility. Ask them what they expect from an incoming owner at closing. See amalgam separators.
Lead, chemicals and processor rooms
Lead foil, lead aprons, spent fixer and developer and lead-lined cabinetry need a licensed waste vendor and manifests. See dental waste disposal and disconnecting dental equipment safely. Before committing to a used imaging purchase, run the pre-purchase equipment checklist and read the hidden costs of buying used equipment.
Non-competes and employment
Virginia Code section 40.1-28.7:8 is the operative statute, and it has been amended repeatedly, most recently in 2025 and 2026. It prohibits an employer from entering into, enforcing or threatening to enforce a covenant not to compete with a low-wage employee or with a health care professional.
The two defined terms are where a dental office lives or dies.
Low-wage employee
The definition covers employees whose average weekly earnings are less than the Commonwealth's average weekly wage, and employees who are entitled to overtime under federal law. It also reaches interns, students, apprentices and trainees employed to gain work or educational experience, and independent contractors compensated below the state median hourly wage.
That second prong is the one owners underestimate. Dental assistants, sterilization technicians and most front office staff are non-exempt under the Fair Labor Standards Act, which means they are entitled to overtime, which appears to place them inside the definition regardless of what they earn. If your employee handbook or offer letters contain restrictive covenants for those roles, they deserve a look from counsel.
Health care professional
The statute defines a health care professional as a person licensed, registered or certified by the Board of Medicine, Nursing, Counseling, Optometry, Psychology or Social Work. The Board of Dentistry is not on that list, and neither is Title 54.1 Chapter 27, which governs dentistry. So a Virginia dentist does not get the health care professional protection, and a dentist earning above the state average weekly wage will usually fall outside the low-wage definition too.
Read those two definitions side by side and you get the odd Virginia result: your hygienist, your assistants and your front desk are likely protected, and you as an associate dentist likely are not. Your covenant gets judged on general Virginia reasonableness principles instead, while theirs may be barred outright.
The statute also provides that covenants are unenforceable where the employer terminates the employee without severance or payment, unless the termination is for cause, and it carries real penalties: a civil penalty of $10,000 per violation, plus escalating penalties up to $1,000 for a third or subsequent failure to post the required notice.
Because the section has been amended in consecutive years, read the current text rather than a summary, and have a Virginia employment attorney apply it to the specific agreements you use.
At the federal level, the FTC's non-compete rule is not in effect. The Commission announced on September 5, 2025 that it would dismiss its appeals and accede to the vacatur of the rule, so state law controls. See our national overview of non-compete agreements for dentists and the associate contract review checklist.
What we could not confirm
- The Virginia dental license renewal deadline. The board publishes an annual CE requirement but we did not confirm the expiration date pattern from its pages.
- Dental hygienist CE hours in Virginia. Confirm from the board's dental hygiene CE page.
- What training Virginia requires before a dental assistant may expose radiographs. The dental x-ray page addresses postings and operator lists but does not state a credential requirement.
- Typical private inspector pricing. Virginia sets fees only for state inspections, in 12VAC5-490, and private inspectors price independently.
- Whether the 2025 and 2026 amendments to 40.1-28.7:8 apply to agreements signed before their effective dates.
- Sales and use tax treatment of dental equipment, including private party purchases. Confirm with Virginia Tax and your CPA.
- Virginia limits on non-dentist ownership of a dental practice. Confirm with a dental-specific attorney.
Where to verify
- Virginia Board of Dentistry: board home, dentist CE, dental hygiene CE, and laws and regulations
- Virginia Department of Health, Radiological Health: dental x-ray machines, the x-ray FAQ, and the x-ray regulations
- Virginia Law Library: Va. Code 40.1-28.7:8, covenants not to compete
- US Environmental Protection Agency: dental effluent guidelines, 40 CFR Part 441
- Federal Trade Commission: September 2025 statement on the non-compete rule
- Virginia Department of Taxation: tax.virginia.gov
Putting it to work
If you own a Virginia practice, the highest value hour you can spend this quarter is having counsel read your non-dentist employment agreements against the low-wage employee definition, because a covenant you cannot enforce is worse than no covenant: it carries a penalty. On the equipment side, calendar your three year registration and inspection cycle, get competing quotes from private inspectors, and file the written change within 30 days whenever a machine or an address moves.
Related reading: non-compete agreements for dentists, x-ray registration and inspections, the pre-purchase equipment checklist, and the rest of the state resources directory.
This guide is educational content and does not constitute legal, financial, tax, or clinical advice. Laws and regulations vary by state and change over time. Consult your own dental-specific attorney, CPA, and state dental board before acting.