Dental Assistant requirements for Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming

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:


Tennessee Dental Assistant Requirements

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 Tennessee, a dental assistant must hold a certificate in dental radiology from the Tennessee Board of Dentistry. A dental assistant must:

  • Successfully complete a comparable training program in dental radiology in another state, OR
  • Be enrolled in a CODA-accredited or Board-approved dental assisting program that offers a dental radiology course as part of its curriculum, OR
  • Apply to the Tennessee Board of Dentistry for state certification in dental radiology.

Practical Dental Assistant

A Practical Dental Assistant is an auxiliary employee of a licensed dentist who is receiving practical chairside dental assisting training from a licensed dentist or is a dental student in an educational program accredited by CODA.

Registered Dental Assistant (RDA)

Registered Dental Assistants in Tennessee may perform the procedures listed for this level in the state dental practice act. To register as an RDA, one must:

Registered Dental Assistant Qualified to Perform Expanded Functions

To perform expanded functions in Tennessee, Registered Dental Assistants (RDAs) must earn state certification by completing the following requirements for each of the desired expanded functions:

Perform coronal polishing procedures:

  • Successfully complete a Tennessee Board-approved coronal polishing course, including both a written and clinical exam (to qualify for the course, an individual must be an RDA in Tennessee), or complete a CODA-accredited dental assisting program that included coronal polishing in the curriculum, AND
  • Receive a certificate in coronal polishing from the Tennessee Board of Dentistry.

Apply sealants:

Monitor nitrous oxide:

  • Successfully complete a Tennessee Board-approved nitrous oxide monitoring course (to qualify, one must be a current RDA), or be enrolled in a CODA-accredited or Tennessee Board-approved program which offers such a course as part of its curriculum, AND
  • Receive a certificate in monitoring nitrous oxide from the Tennessee Board of Dentistry.

Perform restorative and/or prosthetic functions:

  • Have a minimum of two years of continuous, full-time registered dental assisting employment in the three years prior to enrolling in course, AND
  • Complete a Tennessee Board-approved certification course, AND
  • Receive a certificate in restorative and/or prosthetic functions from the Tennessee Board of Dentistry.

Expose dental radiographs:

See top of the section above.

Note: RDAs who have successfully completed a comparable training program in expanded functions in another state may be eligible to apply directly to the Tennessee Board of Dentistry for an expanded functions certificate without additional training. The expanded functions course must have been approved by the dental board in the other state and the Tennessee Board of Dentistry consultant must determine that the course is equivalent to the Tennessee Board-approved course. The information regarding the content of the course and proof of completion must be sent directly from the course provider to the Board’s administrative office. If a certification or permit was issued by the other state, verification of the certificate or permit must be received directly from the other board. For more information, contact the Tennessee Board of Dentistry.

To learn more, visit: Tennessee Board of Dentistry

Information gathered from DaleFoundation.com


Texas Dental Assistant Requirements

Three levels of Dental Assistants

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

  • One must be a Registered Dental Assistant.
  • A dental assistant will not be considered to be positioning, exposing or otherwise making dental x-rays if the dental assistant only performs radiological procedures in the course of training (or for other educational purposes) and is at all times under the direct supervision of the employer dentist. A dental assistant performing radiological procedures in the course of on-the-job training may only do so for a period of one year.

Dental Assistant

A dental assistant in the state of Texas 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.

Registered Dental Assistant (RDA)

A dental assistant in the state of Texas can earn status as a Registered Dental Assistant (RDA) by formally registering with the Texas State Board of Dental Examiners (TSBDE). To qualify, one must:

  • Graduate from an accredited high school or hold a GED, AND
  • Successfully complete a current hands-on course in basic life support, AND
  • Successfully complete a mandatory course of training specified by the TSBDE that includes procedures for positioning and exposing dental x-rays, jurisprudence, and infection control, OR
  • Earn the national DANB CDA certification and complete the Texas Jurisprudence Assessment, AND
  • Apply to the TSBDE for registration AND
  • Submit fingerprints for the retrieval of criminal record information.

To qualify to monitor the administration of nitrous oxide, an RDA must:

  • Complete a minimum of 8 hours of didactic education and testing in monitoring the administration of nitrous oxide taken through a CODA-accredited dental, dental hygiene or dental assisting program approved by the Texas State Board of Dental Examiners (TSBDE) AND
  • Complete a current course in Basic Life Support, AND
  • Apply to the TSBDE for a nitrous oxide monitoring certificate.

Dental Assistant Qualified to Perform Expanded Functions

To perform expanded functions under the general or direct supervision of a licensed dentist in Texas, a dental assistant must successfully complete the following requirements:

Perform pit and fissure sealant procedures:

  • Work at least two years as a dental assistant, AND
  • Complete a current course in basic life support, AND
  • Complete a minimum of eight hours of Texas Board-approved clinical and didactic education in pit and fissure sealants taken through a CODA-accredited dental, dental hygiene, or dental assistant program and approved by the TSBDE.

Perform coronal polishing procedures:

  • Work at least two years as a dental assistant, AND
  • Complete a minimum of eight hours of clinical and didactic education in coronal polishing taken through a dental school, dental hygiene school, or dental assisting program accredited by the Commission on Dental Accreditation (CODA) and approved by the TSBDE, OR

Note: Effective September 1, 2017, the pit and fissure sealants certificate and coronal polishing certificate are discontinued. Effective March 18, 2018, the Texas State Board of Dental Examiners has passed the above requirements for dental assistants to be eligible to perform these functions.

To learn more, visit: Texas State Board of Dental Examiners

Information gathered from DaleFoundation.org


Utah Dental Assistant Requirements

One level of Dental Assistant

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

Dental Assistant

A dental assistant in the state of Utah may perform basic supportive dental procedures under the supervision of a licensed dentist. All dental assistants must have current CPR or Basic Cardiac Life Support (BCLS) certification.

To learn more, visit: Utah Board of Dentistry

Information gathered from DaleFoundation.com


Vermont Dental Assistant Requirements

Three levels of Dental Assistants

To legally operate dental x-ray equipment and perform dental radiographic procedures in the state of Vermont, a dental assistant must be an Expanded Function Dental Assistant or a DANB Certified Dental Assistant (CDA) (see requirements below).

Traditional Dental Assistants can earn a special endorsement to perform dental radiographic procedures by completing the following requirements:

  • Be at least 18 years of age, AND
  • Successfully complete a CODA-accredited radiography course within 10 years of application for endorsement, AND
  • Work for at least six months as a dental assistant, OR
  • Hold a radiography endorsement equivalent to that required in Vermont.

AND ALL MUST THEN

  • Apply to the Vermont Board of Dental Examiners for endorsement.

Traditional Dental Assistant

Dental Assistants in Vermont can earn status as a Traditional Dental Assistant by becoming employed as a Traditional Dental Assistant in a dental office and registering with the Vermont Board of Dental Examiners within 30 days of being hired. All dental assistants shall complete emergency office procedures training within six months of their date of hire.

DANB Certified Dental Assistant (CDA) with State Certification

Dental assistants who hold the national DANB Certified Dental Assistant (CDA) certification can also earn Vermont state certification. To qualify, one must:

  • Hold a current national DANB CDA certification, AND
  • Be employed by a Vermont-licensed dentist, AND
  • Apply to the Vermont Board of Dental Examiners for registration.

Expanded Functions Dental Assistant (EFDAs)

To perform expanded functions in Vermont under the direct supervision of a licensed dentist, a dental assistant must earn status as an Expanded Function Dental Assistant. To qualify, one must:

  • Hold a current national DANB CDA certification, AND
  • Be employed by a Vermont-licensed dentist, OR
  • Be a licensed dental hygienist, AND
  • Successfully complete a formal program in each of the desired expanded functions at a CODA-accredited program of dental assisting, AND
  • Apply to the Vermont Board of Dental Examiners for registration.

To learn more, visit: Vermont Board of Dental Examiners

Information gathered from DaleFoundation.org


Virginia Dental Assistant Requirements

Two levels of Dental Assistants

To legally operate dental x-ray equipment and perform dental radiographic procedures in Virginia, a dental assistant must:

  • Satisfactorily complete a radiation safety course and exam given by an institution that maintains a CODA-accredited dental assisting, dental hygiene, or dentistry program, OR

Any person who was qualified to place or expose dental x-ray film by satisfactorily completing a course and passing an examination in compliance with guidelines provided by the board prior to May 11, 2011, continues to be so qualified.

Dental Assistant I (DAI)

A dental assistant I (DA I) in Virginia may perform basic supportive dental procedures specified by the state dental practice act under the direction of a licensed dentist. There are no education or training requirements for this level of dental assisting.

A dental assistant (DA I or DA II) in Virginia who assists in the administration and monitoring of any form of minimal sedation, conscious/moderate sedation, deep sedation, or general anesthesia must meet one of the following requirements:

  • Training and current certification in basic resuscitation techniques with hands-on airway training for health care providers, such as Basic Cardiac Life Support for Health Professionals or a clinically ­oriented course devoted primarily to responding to clinical emergencies offered by an approved provider of continuing education, OR

Dental Assistant II (DAII)

To qualify as a dental assistant II (DA II) by education, one must:

  • Hold current certification as a DANB Certified Dental Assistant (CDA), AND
  • Successfully complete board-approved expanded functions requirements from a CODA-accredited program, AND
  • Apply to the Virginia Board of Dentistry for registration.

To qualify for registration as a DA II by endorsement, one must:

  • Hold current DANB CDA certification or certification from another national credentialing organization recognized by the American Dental Association, AND
  • Be currently authorized to perform expanded duties in a jurisdiction of the United States, AND
  • Hold a credential with qualifications substantially equivalent to the Virginia DA II requirements or document experience in the Virginia DA II functions for at least 24 of the 48 months preceding application, AND

All DA II applicants must attest that they have read and understood and will remain current with Virginia dental laws and regulations governing the practice of dentistry and dental assisting. A renewing Dental Assistant II must show proof of current DANB CDA certification and successful completion of training in basic CPR.  

18VAC60-20-61 (B)(2), (3), and (4) of the Regulations Governing Dental Practice specifies four modules of laboratory training, clinical experience, and examination that may be completed in order to qualify for registration as a dental assistant II. The board interprets these provisions to permit someone to complete one or more of the modules to qualify for registration. An applicant does not have to complete all four modules. However, the educational institution offering the dental assistant II program has the discretion to decide how to structure its program.

A dental assistant (DA I or DA II) in Virginia who assists in the administration and monitoring of any form of minimal sedation, moderate sedation, deep sedation, or general anesthesia must meet one of the following requirements:

  • Training and current certification in basic resuscitation techniques with hands-on airway training for health care providers, such as Basic Cardiac Life Support for Health Professionals or a clinically-oriented course devoted primarily to responding to clinical emergencies offered by an approved provider of continuing education OR
  • Current certification as a certified anesthesia assistant by the American Association of Oral and Maxillofacial Surgeons (AAOMS) or the American Dental Society of Anesthesiology (ADSA).

To learn more, visit: Virginia Board of Dentistry

Information gathered from DaleFoundation.org


Washington Dental Assistant Requirements

Three levels of Dental Assistants

All dental assistants (registered dental assistants and EFDAs) operating x-ray equipment in the state of Washington shall be adequately instructed in safe operating procedures and shall be able to demonstrate competence, upon request from the Washington State Dental Quality Assurance Commission (DQAC), in the correct use of the equipment.

The following are areas in which the DQAC considers it important that an individual have the expertise for the competent operation of x-ray equipment:

(1) Familiarization with equipment

    (a) Identification of controls

    (b) Function of each control

    (c) The use of a technique chart

(2) Radiation protection

    (a) Collimation

    (b) Filtration

    (c) Gonad shielding and other patient protection devices

    (d) Restriction of x-ray tube radiation to the image receptor

    (e) Personnel protection

    (f) Grids

(3) Film processing

    (a) Film speed as relates to patient exposure

    (b) Film processing parameters

    (c) Quality assurance and quality control

A registered dental assistant requires close supervision and an EFDA requires general supervision by a licensed dentist to perform dental radiography procedures. Every dental assistant in the state of Washington must be registered. To be eligible for registration as a dental assistant, one must:

  • Provide a completed application on forms provided by the Washington State Dental Quality Assurance Commission (DQAC), AND
  • Pay applicable fees, AND
  • Provide evidence of completion of seven clock hours of AIDS education and training as required by chapter 246-12 WAC, Part 8, AND
  • Provide any other information determined by the Washington State Dental Quality Assurance Commission.

The dental assistant registration must be renewed annually on or before the dental assistant’s birthday.

Registered Dental Assistant (RDA)

A registered dental assistant must hold a current and valid health care provider basic life support (BLS) certification. A registered dental assistant in the state of Washington may earn an endorsement in sealant/fluoride varnish solely for the purpose of treating children in school-based and school-linked programs. Applicants must:

  • Have had 200 hours of employment by a Washington State-licensed dentist that has included theoretical and clinical training in the application of dental sealants and fluoride varnish treatments, verified by a declaration provided by the licensed dentist who provided the training, AND
  • Provide proof of completion of a training program meeting Washington state requirements, AND
  • Submit an application and fee.

Note: Registered dental assistants monitoring patients receiving deep sedation or general anesthesia must receive a minimum of 14 hours of documented training in a course specifically designed to include instruction and practical experience in the use of equipment.

Note: A volunteer dental assistant is an individual who, without compensation, provides supportive services in a charitable dental clinic.

Expanded Function Dental Auxiliary (EFDA)

To become an Expanded Function Dental Auxiliary (EFDA) in Washington, a dental assistant must:

An EFDA must hold current and valid health care provider basic life support (BLS) certification.

Note: DANB administers the Washington State Dental Hygiene Drug and Law Examination under agreement with the Washington State Department of Health. To obtain an application or for additional information, contact the Washington State Dental Hygiene Program at 360-236-4837 (dental hygiene department). 

Dental Anesthesia Assistant (DAA)

Each applicant for certification as a dental anesthesia assistant must submit to the Washington State Dental Quality Assurance Commission (DQAC):

  • An application, on a form provided by the department, AND
  • An application fee, AND
  • Evidence of completion of one of the following:
    • The “Dental Anesthesia Assistant National Certification Examination (DAANCE)” or predecessor program, provided by the American Association of Oral and Maxillofacial Surgeons (AAOMS), OR
    • The “Oral and Maxillofacial Surgery Assistants Course” course provided by the California Association of Oral and Maxillofacial Surgeons (CALAOMS), OR
    • Substantially equivalent education and training approved by DQAC, AND
    • Evidence of completion of training in intravenous access or phlebotomy that includes 8 hours of didactic training and hands on experience starting and maintaining intravenous lines with at least ten successful intravenous starts on a human or simulator/manikin, OR
    • Evidence of completion of substantially equivalent education and training approved by DQAC, AND
  • A current and valid certification for health care provider basic life support (BLS), advanced cardiac life support (ACLS), or pediatric advanced life support (PALS), AND
  • A valid Washington state general anesthesia permit of the oral and maxillofacial surgeon or dental anesthesiologist where the dental anesthesia assistant will be performing his or her services, AND
  • Completion of seven clock hours of AIDS education and training, AND
  • Any other information determined by DQAC.

Note: A certified dental anesthesia assistant shall notify DQAC in writing on a form provided by DQAC of any changes in his or her supervisor. DQAC must be notified of the change prior to the certified dental anesthesia assistant accepting delegation from another supervisor.

To learn more, visit: Washington Board of Dentistry

Information gathered from DaleFoundation.org


West Virginia Dental Assistant Requirements

Two levels of Dental Assistants

There are no radiography requirements for dental assistants in the state of West Virginia.  All dental assistants may legally operate dental x-ray equipment and perform dental radiographic procedures.

Dental Assistant

A dental assistant in the state of West Virginia 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.

Note: A chairside assistant assisting a dentist holding a permit to administer conscious/moderate sedation or general anesthesia/deep sedation must maintain BLS/CPR certification.

Dental Assistant Qualified in Expanded Duties

To qualify to perform specified restorative and/or orthodontic expanded duties in West Virginia, a dental assistant must:

To qualify to perform visual monitoring of nitrous oxide analgesia units in West Virginia, a dental assistant must:

  • Complete a WVBD-approved course and exam in monitoring nitrous oxide, AND
  • Be currently certified in health care provider CPR through the American Red Cross or the American Heart Association, AND
  • Apply to WVBD for a certificate.

To qualify to perform coronal polishing on children under age 21 in West Virginia, a dental assistant must:

  • Complete two years, at least 3,000 hours, of clinical experience in a dental office, as attested to by the supervising dentist, AND
  • Hold the expanded duties certificate issued by the WVBD, AND
  • Complete a WVBD-approved coronal polishing course, AND
  • Complete required clinical experiences under the observation of the supervising dentist, who attests to the dental assistant’s competent performance of the function, AND
  • Apply to WVBD for a certificate.

Qualified Monitor

Any individual, including a dental assistant, acting as a Qualified Monitor during sedation procedures must have received training and be competent in the recognition and treatment of medical emergencies, monitoring vital signs, the operation of nitrous oxide delivery systems, and the use of the sphygmomanometer and stethoscope AND must meet the following requirements:

For relative analgesia/minimal sedation:

  • Possess a current health care provider BLS/CPR certification (qualified monitor certificate is not required)

For anxiolysis/minimal sedation:

For conscious sedation/moderate sedation (limited enteral or comprehensive parenteral) and general anesthesia/deep conscious sedation:

  • Possess a current health care provider BLS/CPR certification, AND
  • Successfully complete an American Association of Oral and Maxillofacial Surgeons (AAOMS) or American Academy of Pediatric Dentistry (AAPD) anesthesia assistant’s certification program or equivalent, AND
  • Apply to the WVBD for a qualified monitor certificate.

In addition to the above requirements for a Qualified Monitor, for all levels of sedation, including relative analgesia/minimal sedation, when monitoring a nitrous oxide unit, a certificate to monitor nitrous oxide must be obtained from the Board, as described above under “Dental Assistant Qualified in Expanded Duties.”

A dentist holding an anesthesia permit must report the names and qualifications of each Qualified Monitor providing services to that permitholder to the WVBD.

To learn more, visit: West Virginia Board of Dentistry

Information gathered from DaleFoundation.org


Wisconsin Dental Assistant Requirements

One level of Dental Assistant

There are no radiography requirements for dental assistants in the state of Wisconsin. All dental assistants may legally operate dental x-ray equipment and perform dental radiographic procedures.

Dental Assistant (Unlicensed person)

An unlicensed person in Wisconsin may perform basic supportive dental procedures specified by the state dental practice act under the supervision of a licensed dentist.

  • Any dentist who delegates any remediable dental procedure or function to an unlicensed person must first provide training to or verify competence of the person in the performance of the procedure or function.

To learn more, visit: Wisconsin Board of Dentistry

Information gathered from DaleFoundation.org


Wyoming Dental Assistant Requirements

One level of Dental Assistant

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

*DANB’s Radiation Health and Safety (RHS) exam meets the examination requirement.

https://www.danb.org/en/Become-Certified/Exams-and-Certifications/CDA.aspx

Dental Assistant

A dental assistant in Wyoming may perform basic supportive dental procedures specified by the state dental practice act under the supervision of a licensed dentist. Dental assistants may be trained by their employer or by an accredited or WBDE-approved program for dental assistants.

In settings where nitrous oxide anxiolysis, sedation and/or anesthesia are administered, all dental personnel shall be certified in administering Basic Life Support (BLS) for Healthcare Providers. A dentist, operating dentist or sedation/anesthesia permit holder may delegate patient monitoring to qualified dental personnel.

Dental Assistant Qualified in Placement of Pit and Fissure Sealants

To perform placement of pit and fissure sealants under the direct supervision of a licensed dentist in Wyoming, a dental assistant must:

The WBDE accepts successful performance on DANB’s Sealants (SE) exam to meet requirements to earn the Wyoming Pit and Fissure Sealants permit.

To learn more, visit: Wyoming Board of Dental Examiners

Information gathered from DaleFoundation.org


Dental Assistant Requirements in All 50 States

So, there you have it – all in a nutshell…the dental assisting requirements for all 50 states and the District of Columbia.

Not one is identical to another and some have very stringent requirements. In researching the requirements for each state and coming from a state that requires a lot to be licensed, there are definitely several states that I would purposely avoid relocating to because of the quagmire of requirements.

Requirements may be difficult for the other professional team members (dentists and hygienists) to relocate their practice, but for dental assistants, it is very difficult and many end up leaving the profession…adding to the already growing shortage of competent and passionate team members!

Keep smiling!

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 cottonbro 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.