Dental Assistant Requirements for Oregon, Pennsylvania, Rhode Island, South Carolina, and South Dakota

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 Content:


Oregon

Eight Levels of Dental Assistants

To legally operate dental x-ray equipment and perform dental radiographic procedures under general supervision* in Oregon, a dental assistant must meet the following requirements and hold a state certificate of radiologic proficiency.

Effective January 1, 2019, the Oregon Board of Dentistry no longer requires applicants for the Oregon Radiologic Proficiency Certificate to pass the Oregon Clinical Radiologic Proficiency Exam formerly administered by the Dental Assisting National Board (DANB). Dental assistants seeking to earn the certificate must now submit verification of proficiency as described under “submit verification**”.

Complete all of the following three requirements and apply to DANB for a state certificate of radiologic proficiency:

  • Complete a course approved by the Oregon Board of Dentistry (OBD)*, or
  • Submit evidence of equivalent training recognized by the Oregon Health Authority, Center for Health Protection, Radiation Protection Services; AND
  • Pass the national DANB Radiation Health and Safety (RHS) exam, AND
  • Submit verification** from an Oregon licensed dentist or Oregon licensed dental hygienist that the assistant is proficient to take radiographs.

*The DALE Foundation’s DANB RHS Review course is approved by the Oregon Board of Dentistry and meets the course requirement to earn the Oregon Radiologic Proficiency Certificate. For a complete list of accepted radiography courses, please contact the Oregon Board of Dentistry at information@oregondentistry.org

**Note: A dentist or dental hygienist may authorize a dental assistant who has completed the course and written exam requirements described above to perform radiographic procedures under the indirect supervision of a dentist, dental hygienist, or dental assistant who holds an Oregon Radiologic Proficiency Certificate. Within 6 months of beginning to expose radiographs, as authorized by an Oregon licensed dentist or Oregon licensed dental hygienist, the dental assistant must submit verification from an Oregon licensed dentist or dental hygienist that the assistant is proficient to take radiographs.

  • Complete one of the following two requirements and apply to DANB for a state certificate of radiologic proficiency by credential:
    • Be certified in another state that has training and certification requirements substantially similar to Oregon’s, OR
    • Obtain verification from an employer dentist that the assistant has been employed for at least 1,000 hours in the past two years as a dental assistant (in a state other than Oregon) and is competent to take radiographs.

Note: The Oregon state dental practice act specifies that, in addition to the exams, courses, and programs listed on this page, a dental assistant may complete any successor or otherwise Board-approved exams, courses, or programs. For more information, please contact the Oregon Board of Dentistry at www.oregon.gov/dentistry

1. Dental Assistant

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

2. Expanded Function Dental Assistant (EFDA)

To perform expanded functions in Oregon under the supervision of a licensed dentist, a dental assistant must earn an Oregon Expanded Function Dental Assistant (EFDA) certificate. To qualify, one must satisfy one of the following pathways to certification:

Pathway I:

Pathway II:

  • Hold an Oregon Certificate of Radiologic Proficiency (see requirements above), AND
    • Pass the Oregon Expanded Functions – General Dental Assisting (ORXG) exam* (administered by DANB), AND
    • Provide endorsement from an Oregon licensed dentist stating that the applicant has completed clinical requirements, AND

Pathway IIIA:

Pathway IIIB:

Pathway IV:

  • Be certified in another state that has training and certification requirements substantially similar to Oregon’s requirements or obtain verification from a licensed dentist of having been employed (in a state other than Oregon) for at least 1,000 hours in the past two years as a dental assistant performing expanded functions, AND
  • Apply for the Oregon EFDA certificate by credential (administered by DANB).

Note: An EFDA may apply pit and fissure sealants and temporary soft relines to full dentures upon successful completion of a course of instruction (in the desired expanded function) in a CODA-accredited program or other course of instruction approved by the Oregon Board of Dentistry.

Note: The Oregon state dental practice act specifies that, in addition to the exams, courses and programs listed on this page, a dental assistant may complete any successor or otherwise Board-approved exams, courses or programs. For more information, please contact the Oregon Board of Dentistry at www.oregon.gov/dentistry.

3. Expanded Function Dental Assistant (EFDA) with Restorative Functions Certificate

To perform placement and finishing of direct restorations, except gold foil, under the indirect supervision of a dentist, subject to OBD regulations, an EFDA must hold a Restorative Functions certificate. To qualify, an EFDA must:

  • Complete an OBD-approved restorative functions curriculum from a CODA-accredited program, AND
  • Pass the WREB Restorative Exam (or other equivalent exam approved by the OBD) within the five years preceding application, AND
  • Apply for the Oregon Restorative Functions certificate (administered by DANB), OR
  • If the applicant passed the WREB Restorative Exam or other equivalent OBD-approved exam more than five years before application, submit verification from another state or jurisdiction where the applicant is legally authorized to perform restorative functions and verification from the supervising dentist of successful completion of at least 25 restorative procedures within the immediate five years preceding application, AND
  • Apply for the Oregon Restorative Functions certificate (administered by DANB.)

4. Expanded Function Orthodontic Dental Assistant (EFODA)

To perform expanded orthodontic functions in Oregon under the supervision of a licensed dentist, a dental assistant must earn status as an Expanded Function Orthodontic Dental Assistant (EFODA). To qualify, one must successfully complete all of the following requirements in ONE of the following four pathways:

Pathway I:

Pathway II:

Pathway IIIA:

Pathway IIIB:

Pathway IV:

  • Be certified in another state that has training and certification requirements substantially similar to Oregon’s requirements or obtain verification from a licensed dentist of having been employed (in a state other than Oregon) for at least 1,000 hours in the past two years as a dental assistant performing expanded orthodontic functions, AND
  • Apply for the Oregon EFODA certificate by credential (administered by DANB).

5. Expanded Function Preventative Dental Assistant (EFPDA)

To perform expanded preventive functions in Oregon under the supervision of a licensed dentist, a dental assistant must earn an Oregon Expanded Function Preventive Dental Assistant (EFPDA) certificate. To qualify, one must:

Pathway I:

  • Hold an Oregon Certificate of Radiologic Proficiency (see requirements above), AND
  • Successfully complete a course of instruction in a program accredited by CODA, AND
  • Apply for the Oregon EFPDA certificate (administered by DANB).

Pathway II:

Pathway III:

Pathway IV:

  • Be certified in another state with requirements similar to Oregon’s, OR Obtain verification from a licensed dentist of having been employed (outside the state of Oregon) for at least 1,000 hours in the past two years as a dental assistant performing the permitted expanded preventive functions, AND
  • Apply for the Oregon EFPDA certificate by credential (administered by DANB).

6. Anesthesia Monitor

To perform the duties of an Anesthesia Monitor, a dental assistant must:

  • Receive training in monitoring patients under sedation and be capable of assisting with procedures, problems and emergency incidents that may occur as a result of the sedation or secondary to an unexpected medical complication, AND
  • Maintain current certification in BLS for Healthcare Providers Basic Life Support (BLS)/Cardio Pulmonary Resuscitation (CPR) training or equivalent, AND
  • Receive training in monitoring vital signs, AND
  • Be competent in the use of monitoring and emergency equipment appropriate for the level of sedation utilized.

7. Anesthesia Dental Assistant

A dental assistant in Oregon must hold state certification as an Anesthesia Dental Assistant in order to perform specified anesthesia assisting functions. To qualify, one must:

  • Hold a current Health Care Provider BLS/CPR certification, AND
  • Successfully complete the Oral and Maxillofacial Surgery Anesthesia Assistants Program* conducted by the American Association of Oral and Maxillofacial Surgeons, OR
  • Successfully complete the Oral and Maxillofacial Surgery Assistants Course* conducted by the California Association of Oral and Maxillofacial Surgeons, OR
  • Have passed the DANB Certified Oral and Maxillofacial Surgery Assistant (COMSA) exam* (prior to the discontinuation of the COMSA exam in 2000), OR
  • The Resuscitation Group – Anesthesia Dental Assistant course OR
  • Other course approved by the Oregon Board of Dentistry, AND
  • Apply for the Oregon Anesthesia Dental Assistant certificate (administered by DANB).

8. Anesthesia Dental Assistant with IV Therapy Certificate

To initiate intravenous (IV) lines in Oregon for a patient being prepared for IV medications, sedation or general anesthesia under the indirect supervision of a dentist holding the appropriate anesthesia permit, an Anesthesia Dental Assistant must earn an additional endorsement. To qualify, an Anesthesia Dental Assistant must:

Oregon Board of Dentistry


Pennsylvania

Two Levels of Dental Assistants 

To legally operate dental x-ray equipment and perform dental radiographic procedures in Pennsylvania under the direct supervision of a licensed dentist, a dental assistant must:

Evidence of having passed the required exam should be retained by the dental assistant and the licensed dentist as evidence of the individual’s authority to perform radiologic procedures.

Note: Prior to Dec. 12, 2009, a Pennsylvania-specific radiography exam administered by an entity other than DANB was required. If a dental assistant qualified to perform radiography procedures by taking the former Pennsylvania exam prior to Dec. 12, 2009, both the dental assistant and their employer should retain evidence of the dental assistant’s passing the former Pennsylvania radiography exam.

1. Dental Assistant

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

2. Expanded Function Dental Assistant (EFDA)

To perform expanded functions in Pennsylvania under the direct supervision of a licensed dentist, a dental assistant must hold a state certification as an Expanded Function Dental Assistant (EFDA). To obtain this state certification, one must:

  • Graduate from an expanded function dental assisting program at a two-year college or other Pennsylvania Board-approved institution which offers an associate degree, OR
  • Graduate from a CODA-accredited dental hygiene school, which requires the successful completion of at least 75 hours of clinical and didactic instruction in restorative functions, OR
  • Complete a state certification program in expanded function dental assisting of at least 200 hours of clinical and didactic instruction from either a CODA-accredited dental assisting program or a Pennsylvania Board-approved dental assisting program, AND
  • Apply for state certification in expanded functions to the Pennsylvania State Board of Dentistry, AND
  • Pass a Pennsylvania Board-acceptable written exam.

Notes: Expanded function dental assistants who are currently licensed or certified in another state or territory, or in Canada, maybe granted licensure or certification in Pennsylvania if their credentials meet the requirements of the Pennsylvania dental practice act.

Effective January 1, 2015, all applicants for a health-related license or certification, including EFDA certification, must complete three hours of Pennsylvania Department of Human Services-approved training in child abuse recognition and state reporting requirements as a condition of licensure.

Pennsylvania State Board of Dentistry


Rhode Island

Three Levels of Dental Assistants

To legally operate dental x-ray equipment and perform dental radiologic procedures in Rhode Island, a dental assistant must complete a course in dental radiography from an educational institution with a CODA-accredited program.

1. Dental Assistant

A dental assistant in Rhode Island may perform basic supportive dental procedures specified by the state dental practice act under the supervision of a licensed dentist.

  • All dental assistants practicing in a dental setting shall hold a current certificate of completion. Basic Life Support (BLS) for the Healthcare Provider that includes a hands-on skill component and conforms to the current American Heart Association Guidelines Update for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) offered by any accredited agency approved by the Board.
  • Every dental assistant in Rhode Island must receive a minimum of one (1) hour per year of training in the CDC Infection Control Guidelines.

2. DANB Certified Assistant

To perform expanded functions in Rhode Island under the direct supervision of a licensed dentist, a dental assistant must be a DANB-Certified assistant, holding one of the following DANB national certifications:

In Rhode Island, DANB-Certified assistants may perform the expanded functions listed in the state dental practice act provided they have graduated from a dental assisting education program that incorporated academic training in these procedures or completed academic clinical training to clinical competence.

Note: Individuals who have passed a DANB certification exam but have not renewed are no longer DANB-Certified assistants.

3. DAANCE Certified Maxillofacial Surgery Assistant

To perform specified maxillofacial surgery assisting functions, an assistant must be licensed by the Rhode Island Board of Examiners in Dentistry as a DAANCE Certified Maxillofacial Surgery Assistant. To qualify for licensure*, one must:

  • Be of good moral character; AND
  • Be eighteen (18) years of age or over; AND
  • Successfully complete an approved program for Dental Anesthesia Assistants National Certification Examination (DAANCE) accredited by the American Association of Oral and Maxillofacial Surgeons or its designated agency; AND
  • Be certified as a dental anesthesia assistant by the American Association of Oral and Maxillofacial Surgeons or its designated agency; AND
  • Hold a current certificate of completion of an approved course in Advanced Cardiac Life Support (ACLS); AND
  • Be in good standing in each state in which he/she holds a license; AND
  • Apply to the Rhode Island Board of Examiners in Dentistry for licensure

Rhode Island Board of Dental Examiners


South Carolina

Two Levels of Dental Assistants

To legally place and expose radiographic films in a dental office, a dental assistant must hold a certificate documenting training acceptable to the South Carolina Department of Health and Environmental Control (DHEC). Acceptable certificates include the following:

Note: At its July 8, 2016 meeting, the South Carolina Board of Dentistry voted that ex-active-duty military dental assistants entering the public sector be given a waiver for exemption from taking the radiography certification course, based on their documenting evidence of their military training and certification credentials.

1. Dental Assistant

A dental assistant in South Carolina may perform basic supportive dental procedures specified by the state dental practice act under the direct supervision of a licensed dentist.

  • There are no initial education or training requirements for this level of dental assisting. It is the responsibility of all dentists to ensure that their auxiliary staff who may be exposed to blood or other body fluids require and provide two (2) hours biennially of continuing education on sterilization and infection control and maintain records of such training.
  • In settings where sedation is administered, all dental staff who provide direct, hands-on patient care must be certified in CPR at the basic life support level by a board-approved training course, received within the last two years. The operating dentist must provide training for staff with hands-on patient care commensurate with the level and mode of sedation administered. This training must be documented and available for inspection by the department upon request.

2. Expanded Duty Dental Assistant (EDDA)

To perform expanded functions under the direct supervision of a licensed dentist in the state of South Carolina, a dental assistant must earn status as an Expanded Duty Dental Assistant (EDDA). To qualify, one must:

Note: In order to monitor nitrous oxide conscious sedation, EDDAs must complete a course approved by the South Carolina Board of Dentistry, successfully complete the state board examination, submit proof of Board-approved CPR certification within the three years preceding application, and apply for state certification from the South Carolina Board of Dentistry.

South Carolina Board of Dentistry


South Dakota

Two Levels of Dental Assistants

To legally operate dental x-ray equipment and perform dental radiographic procedures in South Dakota, an individual must be registered as a Dental Radiographer. To qualify for registration as a dental radiographer, one must:

OR

To qualify for dental radiographer registration by endorsement, one must:

  • Have been legally practicing dental radiography in another state within the three years prior to application, AND
  • Provide verification of completing a course including at least 16 hours of training in areas outlined in South Dakota rules, AND
  • Provide verification of registration number and status from the board of dentistry in each state in which the applicant is or has been registered to practice as a dental radiographer, OR
  • If not currently registered as a dental radiographer, verification of having legally practices dental radiography for a period of time during the three years preceding application (written documentation from an employing/supervising dentist attesting to current clinical proficiency of the applicant may be required) AND
  • Submit application for registration, required documentation, and fee to the South Dakota State Board of Dentistry.

1. Dental Assistant

A dental assistant in South Dakota may perform basic supportive dental procedures under the direct or indirect supervision of a licensed dentist or under the personal supervision of a licensed dental hygienist. There are no 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 South Dakota, a dental assistant must be registered as a Registered Dental Assistant. To qualify, one must:

  • Be at least 18 years of age AND
  • Hold a current American Heart Association Healthcare Provider or American Red Cross Professional Rescuer or board-approved equivalent CPR certification AND
  • Graduate from a CODA-accredited dental assisting program OR
  • Hold current national DANB Certified Dental Assistant (CDA) certification, OR
  • Complete a dental assisting education approved program approved by the South Dakota State Board of Dentistry (SDSBD) resulting in a registered dental assistant certificate of competency, OR
  • Hold or have held registration to perform expanded functions in another state, AND
  • Apply to the SDSBD for licensure as a Registered Dental Assistant.

Applicants who have completed a CODA accredited dental assisting program or obtained a certificate of competency must apply within five years of completion of the program or, if the program was completed more than five years prior to application, must have legally provided expanded functions within five years preceding application. Written documentation verifying the current clinical proficiency of the applicant to perform expanded functions may be required from a dentist who has employed or supervised the applicant within the five years prior to application.

Registered Dental Assistant or Dental Assistant with Training in Starting Intravenous Lines

Registered Dental Assistants and dental assistants may start an intravenous line if they have taken a board-approved anesthesia assisting course and received intravenous line training.

Registered Dental Assistant or Dental Assistant with a permit to monitor patients under general anesthesia, deep sedation, or moderate sedation

Registered Dental Assistants and dental assistants may apply for a permit to monitor patients under general anesthesia, deep sedation, or moderate sedation. To qualify, an assistant must:

  • Be certified in administering basic life support by the American Heart Association for the Healthcare Provider or the American Red Cross for the Professional Rescuer program AND
  • Have completed a SDSBD-approved educational course in anesthetic assisting of at least eight hours within 13 months of application OR
  • Have completed a SDSBD-approved educational course in anesthetic assisting (min. 8 hours) more than 13 months prior to application and have legally monitored patients receiving analgesic or anesthetic agents for a period of time during the 2 years preceding application and provide written documentation from an employing/supervising dentist attesting to clinical proficiency.
  • Registered Dental Assistant or Dental Assistant with a permit to monitor patients under general anesthesia, deep sedation, or moderate sedation

Registered Dental Assistant or Dental Assistant qualified in the injection of medication

A dentist holding a permit to administer general anesthesia/deep sedation or moderate sedation may authorize a Registered Dental Assistant or dental assistant, under the personal and direct visual supervision of the dentist and upon the dentist’s verbal command, to inject medication that the supervising dentist has drawn up through an intravenous (IV) site if the following requirements have been met:

  • The assistant holds a permit to monitor patients under general anesthesia, deep sedation or moderate sedation, AND
  • The assistant has passed the Dental Anesthesia Assistant National Certification Examination (DAANCE) administered by the American Association of Oral and Maxillofacial Surgeons (AAOMS) and is currently DAANCE-certified, AND
  • The supervising dentist holds a permit to administer general anesthesia and deep sedation or moderate sedation.

Registered Dental Assistant with permit to administer nitrous oxide inhalation analgesia

A Registered Dental Assistant may apply for a permit to administer nitrous oxide inhalation analgesia under the direct supervision of a dentist. To qualify, a Registered Dental Assistant must:

  • Be certified in administering basic life support by the American Heart Association for the Healthcare Provider or the American Red Cross for the Professional Rescuer program, AND
  • Have completed an SDSBD-approved educational course meeting specified requirements within 13 months of application, OR
  • Have completed an SDSBD-approved educational course more than 13 months prior to application and have legally administered nitrous oxide inhalation analgesia for a period of time during the 3 years preceding application and provide written documentation from an employing/supervising dentist attesting to clinical proficiency.
  • Registered Dental Assistant with permit to administer nitrous oxide inhalation analgesia

As you can see with the first forty-two 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 the remaining states state requirements for dental assistants!


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

Natalie Kaweckyj

Natalie Kaweckyj

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.