By Natalie Kaweckyj, LDA, RF, CDA, CDPMA, COA, COMSA, CPFDA, CRFDA, MADAA, BA
One of the greatest challenges for current dental assistants is the portability of their profession across state lines. With more than 50 designations of dental assistants nationwide, no two designations are alike, nor are the requirements for becoming a dental assistant.
Allowable duties, education and continuing education requirements as well as state specific credentials are all over the spectrum. This series explores the requirements to become a dental assistant in each of the states, comparing and contrasting prerequisites and providing some useful sources for additional information.
Information was obtained from each individual state dental practice act, individual state boards of dentistry or boards of dental examiners, and the Dental Assisting National Board (DANB).
District of Columbia – two levels of dental assistants
To legally operate dental x-ray equipment and perform dental radiographic procedures in the District of Columbia, a dental assistant must:
- Pass DANB’s Radiation Health and Safety (RHS) exam or DANB’s Certified Dental Assistant (CDA) exam, OR
- Successfully complete a dental radiography training program approved by the D.C. Board of Dentistry, AND
- Register as a dental assistant with the D.C. Board of Dentistry (see additional requirements below)
- Complete in-office training and demonstrate competency to perform the task to the supervising dentist’s satisfaction, AND
- Register as a dental assistant with the D.C. Board of Dentistry no later than 9/17/12 (see additional requirements below) DC Municipal Regulations for DAs
Level I Dental Assistant
To be registered as a Level I Dental Assistant in the District of Columbia, one must:
- Have graduated from high school or hold a general equivalency diploma, AND
- Complete a course in dental radiography training that the D.C. Board of Dentistry deems satisfactory (see “Radiography Requirements” above), AND
- Apply to the D.C. Board of Dentistry for registration
Level II Dental Assistant
To be registered as a Level II Dental Assistant in the District of Columbia, one must:
- Have graduated from high school or hold a general equivalency diploma, AND
- Successfully complete a dental assisting education program approved by the D.C. Board of Dentistry or accredited by the Commission on Dental Accreditation (CODA), OR
- Hold current DANB Certified Dental Assistant (CDA) certification, AND
- Complete a course in dental radiography training that the D.C. Board of Dentistry deems satisfactory (see above), AND
- Apply for a registration as a Level II Dental Assistant to the D.C. Board of Dentistry
An applicant who has been performing the duties of an assistant on July 15, 2011 may be granted a registration if he or she fulfills the following requirements:
- Demonstrate competency to perform the duties of a dental assistant to the satisfaction of the supervising dentist, AND
- Apply for a registration as a dental assistant to the D.C. Board of Dentistry no later than 9/17/12. Licensing page
Florida – three levels of dental assistants
To legally operate dental x-ray equipment and perform dental radiographic procedures in Florida, a dental assistant must either:
- Graduate from a Florida Board of Dentistry-approved dental assisting school or program, OR
- Be state-certified as a dental radiographer by the Florida Department of Health (FDOH).
To obtain the dental radiography certification, one must:
- Successfully complete at least three months of continuous on-the-job training through assisting in the positioning of digital radiographic sensors and positioning and exposing of dental radiographic images under the direct supervision of a Florida-licensed dentist, AND
- Successfully complete a Florida Board-approved radiology course within 12 months of completing on-the-job training, AND
- Apply to the FDOH for certification.
On the Job Trained Dental Assistant
A dental assistant in the state of Florida may perform basic supportive dental procedures specified by the state dental practice act under the supervision of a licensed dentist. On-the-job trained assistants in Florida must be trained in the dental office under the supervision of a licensed dentist who assumes full responsibility for assuring that the assistant so trained is competent to perform the tasks.
Dental Assistant Formally Trained in Expanded Functions
Dental assistants in Florida must have formal training to perform the expanded functions listed in the Practice Act. To qualify to perform expanded functions, one must:
- Complete a course or program administered by or developed as part of the regular curriculum at a dental, dental hygiene, or dental assisting educational program accredited by CODA that provided training in the expanded function;
- Successfully complete a Florida Board-approved expanded duties formal training program.
Note: The DANB Certified Dental Assistant (CDA) certification was removed as a pathway to qualify to perform expanded functions in Florida effective May 2009. Dental Assistants who were employed in Florida and had earned the CDA certification prior to the effective date of this rule change are “grandfathered in” and are permitted to perform expanded functions in Florida. Contact the Florida Board of Dentistry for specific information about this rule change.
To monitor nitrous oxide inhalation analgesia, a dental assistant must:
- Complete a course of training of no less than two days as described in the American Dental Association’s “Guidelines for Teaching and Comprehensive Control of Pain and Anxiety in Dentistry” or equivalent, AND
- Be certified in an American Heart Association, American Red Cross, or equivalent agency sponsored CPR course at the basic life support level, to include one man CPR, two-man CPR, infant resuscitation, obstructed airway, and use of either an Automated External Defibrillator or a defibrillator and electrocardiograph, with a periodic update not to exceed two years.
Dental Assistant Formally Trained in Restorative Functions
A dentist may delegate remediable intraoral restorative functions to be performed under direct supervision to a Dental assistant who has met the following requirements:
- Be at least 18 years of age, AND
- Be a high school graduate or equivalent, AND
- Hold current BLS for Healthcare Provider certificate, AND
- Graduate from a dental assisting program accredited by a dental accrediting entity recognized by the U.S. Department of Education, OR
- Successfully complete a Florida Board-approved expanded duties formal training program, AND
- Document proof of 2,400 hours of clinical work experience in either a dental office or as a dental assisting educator, AND
- Complete a mandatory restorative functions training course offered by a dental or dental hygiene school or program that is accredited by a dental accrediting entity recognized by the United States Department of Education meeting the requirements of Florida Board of Dentistry rules and receive a course completion certificate.
Georgia – two levels of dental assistants
In order to legally operate dental x-ray equipment and perform dental radiographic procedures under the direct supervision of a licensed dentist in Georgia, a dental assistant must complete a minimum of six (6) hours of instruction, in the content areas defined in the Georgia Department of Human Services’ x-ray requirements*.
- Instruction should begin within 30 days of initial employment and be completed no more than 90 days after employment begins. A record of training must be maintained by the employer.
- A dental assistant who shows written proof of completed x-ray training is considered to have satisfied the requirements of the Department of Human Services.
*Note: The DALE Foundation’s DANB RHS Review course meets the requirements of the Georgia Department of Human Services regulation 290-5-22-.04, X-Rays in the Healing Arts.
A dental assistant in Georgia may perform basic supportive dental procedures specified by the state dental practice act and by rule of the Board under the direct supervision of a licensed dentist.
- A dental assistant must acquire appropriate training before performing phlebotomy and venipuncture procedures.
- To use rubber cup prophy on primary dentition, an assistant must complete a curriculum approved by the Georgia Board of Dentistry or a minimum of eight hours of on-the-job training in the provision of rubber cup prophies by a dentist licensed to practice in Georgia. (Note: The Board has outlined course curriculum and eligibility requirements in an addendum to its policy manual – see page 12.) Georgia Dental Policy Manual
Expanded Duty Dental Assistant
To perform expanded functions under the direct supervision of a licensed dentist in the state of Georgia, a dental assistant must earn status as an Expanded Duty Dental Assistant (EDDA). To qualify as an EDDA, one must:
- Hold a high school diploma or its equivalent, AND
- Hold a current Cardiopulmonary Resuscitation (CPR) certification, AND
- Provide a certificate documenting successful completion of a Georgia Board-approved course pertaining to the specific expanded duties outlined in that certificate. (A national DANB Certified Dental Assistant [CDA] certification is one of the ways by which an assistant may qualify to enroll in a Georgia Board-approved course.)
Only those expanded duties listed on the certificate(s) may be performed by an EDDA. Georgia Board of Dentistry
Hawaii – one level of dental assistant
There are no radiography requirements for assistants in the state of Hawaii. All assistants may legally operate dental x-ray equipment and perform dental radiographic procedures under the direct supervision of a licensed dentist.
A dental assistant in the state of Hawaii may perform basic supportive dental procedures specified by the state dental practice act under the direct supervision of a licensed dentist. The supervising dentist must appropriately train or provide training to dental assistants, including but not limited to training in the following:
- Proper sterilization and disinfection procedures
- Proper record keeping and patient confidentiality
- Cardiopulmonary Resuscitation (CPR)
Training must meet the OSHA and the Hawaii Occupational Safety and Health (OSHA/HIOSH) bloodborne pathogen standards and CDC and ADA prevention guidelines and recommendations, and must be provided by a Hawaii Board of Dentistry-approved continuing education sponsoring organization. Approved sponsoring organizations include but are not limited to providers approved by the American Dental Association Continuing Education Recognition Program (ADA CERP) and the Academy of General Dentistry Program Approval for Continuing Education (AGD PACE). Hawaii Board of Dentistry
Idaho – one level of dental assistant
There are no radiography requirements for dental assistants in the state of Idaho. All dental assistants may legally operate dental x-ray equipment and perform dental radiographic procedures.
Rules for dental assistant practice were modified in 2019. The supervising dentist is responsible to ensure the dental assistant is adequately trained to perform assigned duties, including duties previously identified as expanded functions. The current rule reads:
- IDAPA 24.31.01.037. DENTAL ASSISTANTS – PRACTICE. Pursuant to Section 54-903(4), Idaho Code, and these rules, dental assistants are authorized to perform dental services for which they are trained unless prohibited by these rules. Dental assistants must be directly supervised by a dentist when performing intraoral procedures except when providing palliative care as directed by the supervising dentist. (3-20-20). To administer nitrous oxide/oxygen to patients, a dental assistant must be trained in accordance with Idaho Board of Dentistry rules. Idaho Board of Dentistry
As you can see with the first thirteen states explored, requirements do vary greatly from one state to the next. Being credentialed in one state or being DANB certified as a CDA does assist in some cases. For the most up to date information (because it is forever changing), please visit the individual state regulating body.
Tune in next time for further exploration into more state requirements for dental assistants!
Note on photo: “U.S. Capitol building” by Gage Skidmore is licensed with CC BY-SA 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by-sa/2.0/