Dental Assistant Requirements for New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, and Oklahoma

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 over fifty 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).

Table of Contents:

New Hampshire

Three Levels of Dental Assistants

To legally operate dental x-ray equipment and perform dental radiographic procedures under the direct supervision of a licensed dentist in New Hampshire, a dental assistant must meet the following requirements shown:

  • Be 18 years of age or older, AND
  • Be a Graduate Dental Assistant or hold DANB Certified Dental Assistant (CDA) certification, OR
  • Complete 200 hours of experience in clinical dental assisting and pass an Introduction to Dental Assisting course and qualify in infection control (see requirements below), AND
  • Successfully complete an expanded duty course in dental radiology meeting the requirements established by rule of the New Hampshire Board of Dental Examiners (NHBDE), AND
  • Pass the national DANB Radiation Health and Safety (RHS) or Certified Dental Assistant (CDA) exam.

1. Traditional Dental Assistant

A traditional dental assistant in New Hampshire may perform basic supportive dental procedures specified by the state dental practice act under the direct or general supervision of a licensed dentist.

There are no education or training requirements for this level of dental assisting. A traditional dental assistant is a dental assistant who is neither a Certified Dental Assistant nor a Graduate Dental Assistant.

2. DNAB Certified Dental Assistant (CDA)

Dental assistants who hold the national DANB CDA certification are qualified in the state of New Hampshire to perform the functions listed in section Den 401.02 of the rules of the New Hampshire Board of Dental Examiners. For some functions, CDA certificants must also have 400 hours of clinical dental assisting experience before performing the function.

3. Graduate Dental Assistant

Graduate Dental Assistants are authorized to perform the functions listed in section Den 401.02 of the rules of the New Hampshire Board of Dental Examiners. Dental assistants in New Hampshire can earn status as a Graduate Dental Assistant by graduating from a dental assisting program accredited by the Commission on Dental Accreditation (CODA).

Dental Assistant Qualified to Perform Expanded Functions

To perform any expanded duty in New Hampshire, with the exception of restorative duties restricted to EFDAs, a dental assistant must:

  • Be at least 18 years of age; AND
  • Meet the specific prerequisites, course, certification, or experience requirements for each function as listed below:
  • Introduction to Dental Assisting
    • Be a Graduate Dental Assistant OR hold DANB’s CDA certification, OR
    • Have at least 200 hours of clinical dental assisting experience prior to course, AND
    • Successfully complete a course or exam in Introduction to Dental Assisting meeting requirements established by rule of the NHBDE.
  • Function: Infection control in the dental office
    • Be a Graduate Dental Assistant OR hold DANB’s CDA certification, OR
    • Successfully complete a course or exam in infection control meeting requirements established by rule of the NHBDE.

Note: The DALE Foundation’s DANB ICE Review course meets this requirement. Successful performance on DANB’s Infection Control exam [ICE] also meets this requirement.

  • Function: Provisional crown and bridge restorations
    • Be a Graduate Dental Assistant OR hold DANB’s CDA certification, AND
    • Successfully complete a course or exam in provisional crown and bridge restorations meeting requirements established by rule of the NHBDE; OR
    • Have at least 200 hours of clinical dental assisting experience prior to course, AND
    • Meet Introduction to Dental Assisting course requirements (see requirements above), AND
    • Qualify in infection control (see requirements above), AND
    • Successfully complete a course or exam in provisional crown and bridge restorations meeting requirements established by rule of the NHBDE.
  • Function: Orthodontic duties
    • Be a Graduate Dental Assistant OR hold DANB’s CDA certification, AND
    • Successfully complete a course or exam in orthodontic duties meeting requirements established by rule of the NHBDE; OR
    • Hold DANB’s CDA certification or have at least 400 hours of clinical dental assisting experience prior to course, AND
    • Meet Introduction to Dental Assisting course requirements (see requirements above), AND
    • Qualify in infection control (see requirements above), AND
    • Successfully complete a course or exam in orthodontic duties meeting requirements established by rule of the NHBDE.
  • Function: Dental sealants
    • Be a Graduate Dental Assistant OR hold DANB’s CDA certification, AND
    • Successfully complete a course or exam in dental sealants meeting requirements established by rule of the NHBDE; OR
    • Have at least 400 hours of clinical dental assisting experience prior to course, AND
    • Meet Introduction to Dental Assisting course requirements above, AND
    • Qualify in infection control (see requirements on prior page), AND
    • Successfully complete a course or exam in dental sealants meeting requirements established by rule of the NHBDE.
  • Function: Coronal polishing
    • Be a Graduate Dental Assistant OR hold DANB’s CDA certification, AND
    • Have at least 400 hours of clinical dental assisting experience, AND
    • Successfully complete a course and exam in coronal polishing meeting requirements established by rule of the NHBDE; OR
    • Have at least 400 hours of clinical dental assisting experience, AND
    • Meet Introduction to Dental Assisting course requirements (see requirements above), AND
    • Qualify in infection control (see requirements on prior page), AND
    • Successfully complete a course and exam in coronal polishing meeting requirements established by rule of the NHBDE
  • Function: Monitoring nitrous oxide administration
    • Be a Graduate Dental Assistant OR hold DANB’s CDA certification, AND
    • Successfully complete a course and exam in nitrous oxide meeting requirements established by rule of the NHBDE, AND
    • Be currently certified in CPR; OR
    • Hold DANB’s CDA certification or have at least 400 hours of clinical dental assisting experience prior to course, AND
    • Meet Introduction to Dental Assisting course requirements (see requirements above), AND
    • Qualify in infection control (see requirements on prior page), AND
    • Successfully complete a course and exam in monitoring the administration of nitrous oxide anesthesia meeting requirements established by rule of the NHBDE, AND
  • Function: In-office tooth whitening
    • Be a Graduate Dental Assistant OR hold DANB’s CDA certification, AND
    • Successfully complete a course or exam in in-office tooth whitening meeting requirements established by rule of the NHBDE; OR
    • Hold DANB’s CDA certification or have at least 400 hours of clinical dental assisting experience prior to course, AND
    • Meet Introduction to Dental Assisting course requirements (see requirements above), AND
    • Qualify in infection control (see requirements above), AND
    • Successfully complete a course and exam in in-office tooth whitening meeting requirements established by rule of the NHBDE

State Requirements for Public Health Supervision

To perform specified duties under public health supervision to assist a Certified Public Health Dental Hygienist (CPHDH), a dental assistant must meet Introduction to Dental Assisting course requirements and infection control in the dental office (see requirements above).

Expanded Function Dental Auxiliary

To qualify to place, contour, and adjust direct restorative materials within the oral cavity, one must register as an Expanded Function Dental Auxiliary (EFDA) with the New Hampshire Board of Dental Examiners (NHBDE).

To register, one must:

  • Be at least 18 years of age; AND
  • Be a registered dental hygienist or a Graduate Dental Assistant or hold current DANB CDA certification, AND
  • Have a minimum of 4,500 hours of dental clinical experience; AND
  • Obtain a recommendation for the EFDA course from a NH-licensed dentist; AND
  • Complete an EFDA course in dental restorations meeting requirements established by rule of the NHBDE; AND
  • Be currently certified in BLS-HCP; AND
  • Apply to the NHBDE for an EFDA permit.

Note: A dental auxiliary qualified in these restorative functions in another jurisdiction may qualify for endorsement by the Board by presenting written documentation of equivalent training and a letter from a supervising dentist attesting to experience with direct restorations within the previous two years.

New Hampshire Board of Dental Examiners


New Jersey

Three Levels of Dental Assistants

To legally operate dental x-ray equipment and perform dental radiographic procedures in New Jersey, a dental assistant must be licensed as a Dental Radiologic Technologist (DRT) by the New Jersey Radiologic Technology Board of Examiners.

To obtain this license, one must:

  • Successfully complete high school or its equivalent, AND
  • Be at least 18 years of age, AND
  • Be of good moral character, AND
  • Successfully complete a New Jersey State-approved dental radiography course or its equivalent within the 5 years prior to application and pass the national DANB Radiation Health and Safety (RHS) exam within the five years prior to application, OR
  • Successfully complete a NJ state-approved dental radiography course or its equivalent more than 5 years prior to application and pass the national DANB Radiation Health and Safety (RHS) exam within the five years prior to application, and document competent work experience in performing dental radiography procedures within 5 years prior to application (Note: it is illegal to obtain this work experience in New Jersey without the permission of the NJ Bureau of X-Ray Compliance.), OR
  • Successfully complete a NJ state-approved dental radiography course or its equivalent and hold current national DANB Certified Dental Assistant (CDA) certification, AND
  • Apply for licensure to the State of New Jersey Bureau of X-Ray Compliance.

Note: A licensed DRT is not permitted to perform cone-beam CT procedures unless he or she has met the requirements in the 12/31/13 exemption. Please contact the Bureau of X-Ray Compliance at 609-984-5890 for details.

1. Unregistered Dental Assistant

An unregistered dental assistant in the state of New Jersey may perform basic supportive dental procedures specified by the state dental practice act under the direct supervision of a NJ licensed dentist. There are no education or training requirements for this level of dental assisting.

2. Registered Dental Assistant (RDA)

To perform expanded functions under the direct supervision of a licensed dentist in the state of New Jersey, dental assistants must be licensed by the New Jersey State Board of Dentistry as a Registered Dental Assistant (RDA). To register as an RDA, one must:

  • Obtain at least two years’ work experience as a dental assistant (within five years prior to application), successfully complete a New Jersey Board-approved program in expanded functions, and pass the New Jersey Expanded Duties-General Exam (administered by DANB), OR

3. Limited Registered Dental Assistant in Orthodontics (LRDA-O)

To perform specified orthodontic functions under the direct supervision of a licensed dentist in the state of New Jersey, a dental assistant must be licensed by the New Jersey State Board of Dentistry as a Limited Registered Dental Assistant in Orthodontics (LRDA-O). To register as an LRDA-O, one must:

  • Be a high school graduate (or its equivalent), AND
  • Have at least two years’ work experience as a dental assistant under the supervision of a licensed dentist holding a specialty permit in orthodontics during the five-year period prior to application, AND
  • Have passed, within the past 10 years, DANB’s Certified Orthodontic Assistant (COA) Exam, Topical Fluoride (TF) Exam, and the Coronal Polish (CP) Exam, AND
  • Apply to the New Jersey State Board of Dentistry for registration as an LRDA-O.

Note: To satisfy the work experience requirement for the second pathway, a dental assistant must complete the work experience requirements needed to sit for the COA examination.


New Mexico

Three Levels of Dental Assistants

To legally operate dental x-ray equipment and perform dental radiographic procedures in New Mexico, a dental assistant must be New Mexico state-certified.

To obtain certification, one must:

  • Study by independent preparation or in a training course on radiation health and safety within the past 36 months, AND
  • Have assisted with or observed five cases of full mouth series intraoral radiographs (or five extraoral radiographs, if applying for limited certificate), AND
  • Pass the national DANB Radiation Health and Safety (RHS) exam, AND
  • Apply to the NM Board of Dental Health Care for a training permit, valid for six months, AND
  • Pass a state radiography clinical exam, within six months of passing the DANB RHS exam, AND
  • Pass the New Mexico state jurisprudence exam (take-home), AND
  • Apply to the New Mexico Board of Dental Health Care for certification to perform radiography.

1. Dental Assistant

A dental assistant in New Mexico is an individual who may perform basic supportive dental procedures specified by the state dental practice act under the supervision of a licensed dentist. There are no education or training requirements for this level of dental assisting.

2. Dental Assistant with State Certification in Expanded Funcaitons

To perform expanded functions under the general supervision of a licensed dentist in New Mexico, a dental assistant must earn state certification in each of the desired expanded functions. To qualify, one must do the following for each of the expanded functions:

  • Rubber cup coronal polishing and application of topical fluoride
    • Study by independent preparation or in a training course in the functions and assist with/observe five cases of rubber cup coronal polishing on children and adults and five applications of topical fluoride on children, AND  
    • Pass DANB’s Coronal Polish (CP) exam and DANB’s Topical Fluoride (TF) exam, AND
    • Apply to the New Mexico Board of Dental Health Care for advanced certification in coronal polishing and application of topical fluoride, AND
    • Pass the New Mexico Jurisprudence (take-home) exam, AND
    • Perform rubber cup coronal polishing on five adults and children and application of topical fluoride on five children while being personally observed by a licensed dentist, dental hygienist, or dental assistant certified in rubber cup coronal polishing and application of topical fluoride.
  • Pit and Fissure Sealants
    • Have 2,080 hours of dental assisting chairside experience in the two years prior to application, AND
    • Study by independent preparation or in a training course in the function, AND
    • Assist with/observe 12 cases of application of pit and fissure sealants, AND
    • Pass DANB’s Sealants (SE) exam, AND
    • Apply to the New Mexico Board of Dental Health Care for advanced certification in pit and fissure sealants, AND
    • Pass the New Mexico Jurisprudence (take-home) exam, AND
    • Apply pit and fissure sealants on five patients while being personally observed by a licensed dentist or dental hygienist.

Holders of state certification in dental assisting expanded functions and EFDAs must have formal training in infection control from a course approved in accordance with New Mexico Board of Dental Health Care rules and regulations.

Note: Holding a current DANB Certified Dental Assistant (CDA) certification automatically qualifies a dental assistant to apply for state certification for each of these expanded functions.

A dental assistant who is certified to perform dental radiography, coronal polishing, pit and fissure sealants, and/or topical fluoride procedures in another state with requirements not less stringent than those in New Mexico may apply for state certification based on credentials (see New Mexico Rules and Regulations, section 16.5.33.13 for details).

Learn more about DANB’s Certified Dental Assistant (CDA) certification

Expanded Funcion Dental Auxillary

To earn New Mexico certification as an expanded function dental auxiliary (EFDA), one must:

  • Complete an accepted EFDA course in a program approved by the New Mexico Board of Dental Health Care or accredited by CODA OR
  • Complete a minimum of five years, 1000 hours per year, continuous employment as a dental assistant or dental hygienist, AND
  • Complete a course of study in subject areas prescribed by the board, including a post-test approved by the board, AND
  • Obtain a recommendation for EFDA certification from a supervising dentist, AND
  • Earn state certification in radiography, rubber cup coronal polishing and application of topical fluoride and pit and fissure sealant expanded functions*, AND
  • Pass a clinical exam accepted by the New Mexico Board of Dental Health Care for EFDA certification, AND
  • Complete the New Mexico jurisprudence exam with a score of at least 75%, AND
  • Apply for an apprenticeship permit from the NM Board of Dental Health Care, AND
  • Complete an apprenticeship within 180 days, AND
  • Return permit and a signed affidavit to New Mexico Board of Dental Health Care, which will then issue EFDA certificate.

Note: Holders of state certification in dental assisting expanded functions and EFDAs must have formal training in infection control from a course approved in accordance with New Mexico Board of Dental Health Care rules and regulations.

Note: A new rule effective 3/13/18 specifies that all current EFDA permit holders must earn the four-state certificates in expanded functions no later than 7/1/19. EFDA permits will suspend automatically if the expanded functions certifications are not current, and once they are earned, the EFDA permit will become valid until its regular expiration date.

3. Community Dental Health Coordinator (CDHC)

New Mexico CDHCs may perform specified preventive, restorative, and palliative procedures under general supervision of a dentist. To qualify, one must:

  • Have a high school diploma or equivalent, or a college degree, AND
  • Have New Mexico certification in radiography, rubber cup coronal polishing and application of topical fluoride and pit and fissure sealant expanded functions (see above for requirements), AND
  • Complete the New Mexico jurisprudence exam with a score of at least 75%, AND
  • Successfully complete a CDHC program approved by the New Mexico Board of Dental Health Care.

CDHCs must have formal training in infection control from a course approved in accordance with New Mexico Board of Dental Health Care rules and regulations.

New Mexico Dental Health Care Board


New York

Two Levels of Dental Assistants

There are no radiography requirements for dental assistants in the state of New York. All dental assistants may legally operate routine oral radiography and panoramic radiographic dental equipment under the supervision of a NY licensed dentist. A dental assistant may operate conebeam computed tomography (CBCT) equipment under the direct supervision of a dentist after demonstrating satisfactory completion of a training program approved by the Department of Health or provided by the manufacturer.

1. Dental Assistant with a Limited Permit

A person who has completed a dental assisting program or an alternative course of study in dental assisting acceptable to the New York State Education Department may apply for a limited (one-year) permit prior to taking and passing the required exams. A limited permittee may perform all tasks designated to Registered Dental Assistants, under the direct personal supervision of a licensed dentist. The permit expires after one year and may be renewed for an additional year.

2. Registered Dental Assistant

A dental assistant in the state of New York must be licensed in order to perform supportive services under the direct supervision of a licensed dentist. To be licensed as a Registered Dental Assistant in the state of New York, one must:

  • Be at least 18 years of age, AND
  • Be a high school graduate or its equivalent, AND
  • Be of good moral character, as determined by the New York State Education Department, AND
  • Successfully complete one of these two education options:
    • A New York-approved one-year course of study in dental assisting, consisting of 24 semester hours, in a degree-granting institution or a Board of Cooperative Educational Services (BOCES) program that includes at least 200 hours of clinical experience or an equivalent approved course of study in dental assisting in a non-degree granting institution which shall not be a professional association or professional organization, OR
    • An alternate course of study in dental assisting acceptable to the New York State Education Department that includes at least 1,000 hours of relevant work experience in accordance with the Commissioner’s regulations, AND
  • Successfully complete one of the following two exam pathways:
  • Apply for licensure from the New York State Education Department after completing all of the above requirements.

Note: Dental assistants who have been granted a license in New York may identify themselves as “Registered Dental Assistant” or “RDA.”

Please note: Candidates not eligible for CDA certification may now take the three exams required for New York RDA licensure in one exam administration. To apply for the combined exam administration, select “RHS/ICE/NYPDA” on the exam application in the New York exam application packet.


North Carolina

Three Levels of Dental Assistants

To legally operate dental x-ray equipment and perform dental radiographic procedures in North Carolina, a dental assistant must meet the requirements:

1. Dental Assistant I (DA I)

A Dental Assistant I (DA I) in North Carolina is an individual who may perform basic supportive dental procedures under the direct control and supervision of a licensed dentist. To qualify to monitor patients under nitrous oxide, a DA I must:

  • Successfully complete a North Carolina Board-approved seven-hour course in nitrous oxide-oxygen conscious sedation.

2. Dental Assistant II in Training (DA II in Training)

A Dental Assistant II in Training (DA II in Training) is an individual who is participating in on-the-job training to become a DA II. Training consists of at least two years (3,000 hours) of chairside assisting, during which period the assistant may be trained and allowed to perform most of the functions of a DA II under the direct control and supervision of a North Carolina licensed dentist. A DA II in Training may not monitor patients under nitrous oxide, take radiographs, or perform coronal polishing until he or she successfully completes the required courses in these topics.

3. Dental Assistant II (DA II)

To perform expanded functions under the direct supervision of a licensed dentist in North Carolina, one must be classified as a DA II.

To qualify as a DA II, one must:

  • Hold a current Cardiopulmonary Resuscitation (CPR) certification, AND
  • Successfully complete a CODA-accredited dental assisting program or one academic year or longer in a CODA-accredited dental hygiene program, OR 
  • Pass the national DANB Certified Dental Assistant (CDA) exam, OR
  • Complete a 3-hour course in sterilization and infection control and complete a 3-hour course in dental office emergencies and, after completing these courses and Item (1) above, receive training in any dental delivery setting and perform the functions of a Dental Assistant II under the direct control and supervision of a licensed dentist.
  • To qualify to perform coronal polishing, a DA II must:
    • Complete a course in coronal polishing identical to that taught in a CODA-accredited dental assisting program, or by a licensed North Carolina hygienist or dentist lasting at least seven clock hours and meeting content requirements established by the North Carolina Board, before using a slow speed handpiece with rubber cup or bristle brush attachment.

North Dakota

Three Levels of Dental Assistants

To legally operate dental x-ray equipment and perform dental radiographic procedures in North Dakota, a dental assistant must be a Registered Dental Assistant (RDA) or Qualified Dental Assistant (QDA).

1. Dental Assistant

A dental assistant in North Dakota may perform basic supportive dental procedures specified by the state dental practice act under the direct supervision of a licensed dentist. Every dental assistant in North Dakota must have a current certificate of proficiency in cardiopulmonary resuscitation.

2. Qualified Dental Assistant (QDA)

To earn status as a QDA in the state of North Dakota, one must:

  • Have passed the national DANB RHS and ICE exams and completed, within two years of application, 16 hours of continuing education, AND
  • Complete 650 hours of dental assistance instruction including on-the-job training, AND
  • Pass a written examination of the laws and rules governing the practice of dentistry in North Dakota within one year of application, AND
  • Maintain current CPR certification, AND
  • Provide verification of completing an infection control course within two years prior to application (if passing DANB’s ICE exam occurred more than two years prior to application), AND
  • Apply to the North Dakota State Board of Dental Examiners.

3. Registered Dental Assistant (RDA)

To earn status as an RDA in North Dakota, one must:

  • Within one year prior to application, have passed DANB’s national Certified Dental Assistant (CDA) exam or have completed a CODA-accredited or North Dakota board-approved dental assisting program, OR
  • Have passed DANB’s national CDA exam or have completed a CODA-accredited or North Dakota board-approved dental assisting program (more than one year prior to application), and have completed 16 hours of continuing education within two years prior to application, AND
  • Pass a written examination of the laws and rules governing the practice of dentistry in North Dakota within one year of application, AND
  • Maintain current CPR certification, AND
  • Provide verification of completing an infection control course within two years prior to application (if graduation from approved program or passing DANB’s CDA exam occurred more than two years prior to application), AND
  • Apply for registration to the North Dakota State Board of Dental Examiners (NDSBDE)

Registered Dental Assistant (RDA) qualified to apply pit and fissure sealants

To apply pit and fissure sealants in the state of North Dakota under the direct supervision of a licensed dentist, a dental assistant must:

  • Be a Registered Dental Assistant (see requirements above), AND
  • Provide documentation of successfully completing a North Dakota Board-approved sealant class or course.

Registered Dental Assistant (RDA) with Anesthesia Assisting Permits (Class I and II)

To earn a permit to perform specified anesthesia assisting functions under the supervision of a dentist authorized by permit to administer parenteral sedation, a Registered Dental Assistant may earn a Class I or a Class II anesthesia assistant permit. To earn a Class I anesthesia assistant permit, a Registered Dental Assistant must:

  • Complete a board-approved dental anesthesia assistant education and training course, AND
  • Submit proof of current certification status from the American Association of Oral and Maxillofacial Surgeons dental anesthesia assistant national certification, or a board-approved competency examination, AND
  • Hold current and valid certification for health care provider basic life support, or advanced cardiac life support or pediatric advanced life support, AND
  • Provide a copy of a valid North Dakota general anesthesia or parenteral permit of the dentist where the registered dental assistant will be performing anesthesia assistant services, AND
  • Apply to the North Dakota Board of Dental Examiners for a Class I anesthesia assisting permit.

To earn a Class II anesthesia assistant permit, a Registered Dental Assistant must:

  • Complete all requirements for a Class I anesthesia assistant permit AND
  • Complete training in intravenous access or phlebotomy that includes live experience starting and maintaining intravenous lines, AND
  • Apply to the North Dakota Board of Dental Examiners for a Class II anesthesia assisting permit.

Registered Dental Assistant (RDA) with Restorative Functions Permit

To earn a permit to perform specified restorative functions under the direct supervision of a dentist, a Registered Dental Assistant must:

  • Complete a board-approved curriculum from a program accredited by the Commission on Dental Accreditation or another board-approved course, AND
  •  Pass the Western Regional Examining Board (WREB) Restorative Examination or other equivalent examinations approved by the board within the last five years

The Board may require completion of the Restorative Function (RF) component of DANB’s Certified Restorative Functions Dental Assistant (CRFDA) certification exam.

OR

  • Pass the WREB Restorative Examination or other board-approved examination more than five years from the date of application, AND
  • Complete the RF component of DANB’s CRFDA certification examination, AND
  • Provide evidence from another state or jurisdiction where the applicant legally is or was authorized to perform restorative functions and certification from the supervising dentist of successful completion of at least 25 restorative procedures within the immediate five years prior to the date of application

North Dakota Board of Dental Examiners


Ohio

Three levels of Dental Assistants

To legally operate dental x-ray equipment and perform dental radiographic procedures in Ohio under the direct supervision of a dentist, a dental assistant must be state certified as a Dental X-Ray Machine Operator. To obtain this certification, one must:

  • Be a Certified Assistant (see requirements below), OR
  • Complete an Ohio Board-approved training course in dental radiography, including a clinical section (Note: The DALE Foundation’s DANB RHS Review Course meets this requirement. See instructions below.*), OR
  • Hold a license, certificate, or other credential issued by another state that the Ohio State Dental Board deems equivalent to Ohio’s standards for Dental X-ray Machine Operator certification, AND
  • Apply to the Ohio State Dental Board for certification as a Dental X-Ray Machine Operator.

A Dental X-Ray Machine Operator may perform radiologic procedures when the supervising dentist is not physically present at the location where the radiologic procedures are performed if the supervising dentist examined the patient not more than one year prior to the date the Dental X-Ray Machine Operator performs the radiologic procedures and the supervising dentist has ordered the radiologic procedures.

    *Instructions for completing Ohio Board-approved training course in dental radiography, using the DALE Foundation’s DANB RHS Review Course:

  • Purchase and complete the DALE Foundation’s online DANB RHS Review course. The Ohio State Dental Board requires a minimum of 75% on the post-course assessment.
  • Within 60 days of successfully completing the DANB RHS Review course, submit the completed Affidavit of Ohio Clinical Radiography Training form and a $40 processing fee to the DALE Foundation. Forms may be submitted via email, mail or fax as noted at the bottom of the form. The DALE Foundation accepts credit card, check or money order.
  • Approximately 3-4 weeks after submitting the completed form and payment, the DALE Foundation will send an email notification to the candidate informing him or her that the Ohio Clinical Radiography Training form has been processed and the Ohio State Dental Board has been notified that the education and clinical components of Ohio’s dental radiography requirements have been met.
  • Contact the Ohio State Dental Board to complete the Ohio dental assistant radiographer certificate application process. It is the candidate’s responsibility to read and comply with the current laws and guidelines provided by the Ohio State Dental Board. Candidates should retain a copy of the DALE Foundation email and submit it to the Ohio State Dental Board along with the application. Click here to apply online.

    Learn more about DANB’s Certified Dental Assistant (CDA) certification

1. Basic Qualified Personnel (BQP)

Basic Qualified Personnel must be trained directly via an employer/dentist, via a planned sequence of instruction in an educational institution, or via in-office training. To monitor nitrous oxide-oxygen minimal sedation, Basic Qualified Personnel must:

  • Be at least 18 years of age, AND
  • Have completed an accepted basic life-support training course and remains current at all times when monitoring nitrous oxide/oxygen, AND
  • Have successfully completed a six-hour course in nitrous oxide/oxygen monitoring from an Ohio State Dental Board-approved permanent sponsor, OR
  • Hold a current credential issued by another state for the monitoring of nitrous oxide/oxygen and received training that was substantially equivalent to the Ohio training requirements, AND
  • Have at least two years of active practice and at least 3,000 hours of experience in the practice of dental assisting.

NOTE: All dental health care workers in Ohio must show evidence of immunity to or immunization against the hepatitis B virus, unless a waiver has been granted.

2. Certified Assistant

The Ohio State Dental Board recognizes the following two dental assisting certifications:

Current holders of either of these certifications are considered Certified Assistants. Current Certified Assistants may qualify to perform placement of pit and fissure sealants and to earn a state certificate in coronal polishing by meeting additional requirements. In order to receive a certificate from the Ohio State Dental Board permitting the dental assistant to perform coronal polishing procedures, a current Certified Assistant** must:

  • Successfully complete an Ohio Board-approved training program in coronal polishing, AND
  • Successfully pass standardized testing immediately following successful completion of a skills assessment component of an approved training program, OR

**Please note: Holders of the Ohio coronal polishing certificate must maintain DANB CDA certification or Certified Ohio Dental Assistant certification through OCDAC to perform coronal polishing.

Pit and Fissure Sealants:

  • Successfully complete a course containing a minimum of two hours of didactic instruction and six hours of clinical instruction, AND
  • The supervising dentist must observe the assistant successfully apply at least six sealants.

NOTE: Certified Assistants may perform specified functions when the supervising dentist is not physically present (for not more than 15 consecutive business days), subject to the conditions listed below.

NOTE: All dental health care workers in Ohio must show evidence of immunity to or immunization against the hepatitis B virus unless a waiver has been granted.

Learn more about DANB’s Coronal Polishing (CP) exam

3. Expanded Function Dental Auxiliary (EFDA)

To perform expanded functions under the direct supervision of a licensed dentist in Ohio, a dental assistant must qualify as an Expanded Function Dental Auxiliary (EFDA). To qualify as an EFDA, one must:

  • Be an unlicensed dentist who has graduated from an accredited dental college and does not have a dental license under suspension or revocation by the OSDB, OR
  • Be a dental student who is enrolled in an accredited dental college and is in good standing as a dental student, OR
  • Be a graduate of an unaccredited dental college located outside the United States, OR
  • Be a Certified Assistant (see definition and requirements above), OR
  • Be a dental hygienist licensed by the OSBD in good standing, OR
  • Be a dental hygienist who has graduated from an accredited dental hygiene program and does not have a dental hygiene license under suspension or revocation by the OSBD, AND
  • Complete an Ohio Board-approved EFDA training course that is accredited by either the Commission on Dental Accreditation (CODA) or the Higher Learning Commission (course may require proof of DANB CDA certification for entry), AND
  • Pass the EFDA exam administered by the Commission on Dental Testing in Ohio (CODT) or the Commission on Dental Competency Assessments (CDCA), AND
  • Complete a basic life support (BLS) training course certified by the American Red Cross, American Heart Association or American Safety and Health Institute, AND
  • Apply to the Ohio State Dental Board for registration as an EFDA.

Note: An EFDA may not perform coronal polishing unless he or she has met the requirements described above Certified Assistants and received a state certificate in coronal polishing from the Ohio State Board of Dentistry. An EFDA may apply pit and fissure sealants prior to a dentist examining the patient and rendering a diagnosis, if all of the conditions below have been met.

CODA-Accredited Dental Assisting Programs

Conditions for Performing Functions When Dentist Is Not Present

A Certified Assistant or an Expanded Function Dental Auxiliary (EFDA) may perform specified functions when the supervising dentist is not physically present, for not more than 15 consecutive business days, under the following conditions:

  • The Certified Assistant or EFDA has at least 1 year/1,500 hours experience as a dental assistant or EFDA;
  • The Certified Assistant or EFDA successfully completes a board-approved course in identification and prevention of potential medical emergencies;
  • The supervising dentist has evaluated the skills of the Certified Assistant or EFDA, and made a determination that the Certified Assistant or EFDA is competent to treat patients without the dentist being physically present;
  • The supervising dentist has established written protocols or written standing orders for the Certified Assistant or EFDA to follow during and in the absence of an emergency;
  • The supervising dentist completed and evaluated a medical and dental history of the patient not more than one year prior to the date that the Certified Assistant or EFDA provides services to the patient, and the supervising dentist determines that the patient is in a medically stable condition;
  • The patient is notified, in advance of the appointment for services, that the supervising dentist will be absent from the location and that the Certified Assistant or EFDA cannot diagnose the patient’s dental health care status;
  • The Certified Assistant or EFDA is employed by, or under contract with, the supervising dentist, a government entity that employs the dental assistant to provide services in a public school or in connection with other programs the government entity administers, or a dentist licensed under this chapter who is one of the following:
  • The employer of the supervising dentist;
  • A shareholder in a professional association formed under Chapter 1785. of the Revised Code of which the supervising dentist is a shareholder;
  • A member or manager of a limited liability company formed under Chapter 1705. of the Revised Code of which the supervising dentist is a member or manager;
  • A shareholder in a corporation formed under division (B) of section 1701.03 of the Revised Code of which the supervising dentist is a shareholder;
  • A partner or employee of a partnership or a limited liability partnership formed under Chapter 1775. or 1776. of the Revised Code of which the supervising dentist is a partner or employee.

A Certified Assistant or an Expanded Function Dental Auxiliary (EFDA), may perform application of pit and fissure sealants prior to the dentist examining the patient and rendering a diagnosis under the following conditions:

  • All of the conditions listed above;
  • The Certified Assistant or EFDA is providing the service as part of a program operated through any of the following: a school district board of education or the governing board of an educational service center; the board of health of a city or general health district or the authority having the duties of a board of health; a national, state, district, or local dental association; or any other public or private entity recognized by the state dental board;
  • The supervising dentist for the program is employed by or a volunteer for, and the patients are referred by, the entity through which the program is operated and is available for consultation by telephone, videoconferencing, or other means of electronic communication;
  • The application of sealants is limited to erupted permanent posterior teeth without suspicion of dentinal cavitation;
  • For minor patients, a parent or other person responsible for the patient is notified that a dentist will not be present and that the dental assistant is not trained to diagnose or treat other serious dental concerns that could exist.

Ohio State Dental Board


Oklahoma

Three levels of Dental Assistants

To legally operate dental x-ray equipment and perform dental radiographic procedures in Oklahoma, a dental assistant must obtain a permit from the Oklahoma Board of Dentistry (OBD). To qualify, one must:

  • Complete a course of study in radiation safety and protection, consisting of a minimum of seven hours, approved by the OBD, AND
  • Submit written verification to the OBD from the applicant’s current employing dentist attesting to competent clinical experience, AND
  • Apply for a Radiation Safety permit from the OBD and pass a background check with criteria established by the OBD.

1. Dental Assistant

Every dental assistant in Oklahoma must obtain a Dental Assistant permit from the Board of Dentistry within 30 days of beginning employment. To obtain a permit, one must:

Prior to receiving a permit, the dental assistant must work under the dentist’s direct visual supervision at all times. Beginning January 1, 2020, every dental assistant receiving a permit shall complete an infection control course approved by the OBD within one year of the date of receipt of the permit. Dental assistants holding permits prior to January 1, 2020, must complete an infection control course approved by the OBD before December 31, 2020.

A dental assistant in Oklahoma may perform basic supportive dental procedures specified by the state dental practice act under the direct supervision of a licensed dentist. A dental assistant must receive adequate office-based training by the supervisory dentist to ensure that the dental assistant is aware of all requirements and responsibilities of each duty to be performed.

2. Dental Assistant with expanded function permit

To perform expanded functions in Oklahoma under the direct supervision of a licensed dentist, a dental assistant must obtain a permit from the Oklahoma Board of Dentistry (OBD) for each expanded duty that he or she desires to perform.

Permit applicants must complete expanded duty training in each of the desired functions at a CODA-accredited dental assisting program, or a course approved by the OBD. Available permits are:

Radiation Safety: See “Radiography Requirements” above

Coronal Polishing/Topical Fluoride: A dental assistant must successfully complete an OBD-approved course of study, including a clinical component, consisting of a minimum of 14 hours.

Sealants: A dental assistant must successfully earn the coronal polishing/topical fluoride permit and complete an OBD-approved course of study, consisting of a minimum of 12 hours.

Assisting in the Administration of Nitrous Oxide: A dental assistant must successfully complete an OBD-approved course of study, consisting of a minimum of 12 hours.

Assisting a dentist who holds a parenteral or pediatric anesthesia permit: The Oklahoma Board of Dentistry will be developing rules to establish requirements for this permit. (Note: Only a dentist may administer anesthesia and assess the patient’s level of sedation.)

A dental assistant who holds an out-of-state dental assistant permit with expanded duties may apply for credentialing and reciprocity for a dental assistant permit including any expanded duty by demonstrating that he or she has:

  • Held a valid dental assistant permit in another state for a minimum of two years and is in good standing, AND
  • Held a valid expanded duty in another state for a minimum of one year, AND
  • Completed an educational class for the expanded duty and that the dental assistant been providing this treatment to dental patients while working as a dental assistant in a dental office for a minimum of one year.

Any person having served in the military as a dental assistant shall receive credentialing and reciprocity for expanded functions by providing:

  • Proof of military service in excess of two years with any certifications or training in the expanded function areas, AND
  • Verification from the commanding officer of the medical program or the appropriate supervisor stating that the dental assistant provided the expanded functions on patients in the military dental facility for a minimum of one year within the past five years.

3. Oral Maxillofacial Surgery Assistant

To perform specified oral maxillofacial surgical assisting functions in Oklahoma, one must hold an Oral Maxillofacial Surgery Assistant permit. To qualify, one must:

  • Pass a background check with criteria established by the Oklahoma Board of Dentistry, AND
  • Be supervised by an oral maxillofacial surgeon with a current Oklahoma license, AND
  • Be employed and complete a minimum of six months of training under the direct supervision of a licensed oral maxillofacial surgeon prior to starting the DAANCE program (see below), AND
  • Complete the Dental Anesthesia Assistant National Certification Examination (DAANCE) program provided by the American Association of Oral Maxillofacial Surgeons (AAOMS), AND
  • Hold valid BLS certification, AND
  • Complete a standardized course approved by the OBD including a minimum of four hours of didactic training that includes the required content, AND
  • Complete an infection control course approved by the Board, AND
  • Meet any other requirements established by the OBD, AND
  • Apply to the OBD for an Oral Maxillofacial Surgery Assistant permit.

An oral maxillofacial surgery assistant permit shall be considered a temporary training permit until all of the training requirements have been completed and approved by the OBD. A temporary training permit shall not be extended beyond two years.

Note: The OBD’s anesthesia committee may make a recommendation to the OBD for an oral maxillofacial surgery assistant holding a temporary training permit to substitute training received from another state university, dental school or technical training institute or training acquired in a surgery center or hospital while working under the authority of a licensed physician, to qualify as a partial substitute for the requirements to attain an oral maxillofacial surgery assistant permit.

Oklahoma Board of Dentistry    State Dental Practice Act    Rules and Regs of OK BOD


Dental Assistant Requirements in Other States

As you can see with these several states explored, requirements do vary greatly from one state to the next.

To learn more about the specific requirements for other states, check out the following state comparisons.

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.


Natalie Kaweckyj, BA, LDA, CDA, RF, CDPMA, COA, COMSA, CPFDA, CRFDA, MADAA, is a senior moderator of the Dental Peeps Network and a past president of the ADAA.

Photo by Andrea Piacquadio from Pexels