How to Become a Dental Assistant

By: Stephanie Curreli, MD, PhD

Last Updated: Dec 23, 2018

Almost no one looks forward to sitting in the dentist’s chair. But when we find ourselves there, a pleasant and skillful dental assistant can make all the difference between a positive and negative visit to the dentist, and subsequently between good and bad dental health. Dental assistants work under the direction of dentists and dental hygienists to provide routine care. They generally have a good deal of “face time” with patients and play an important role in keeping them relaxed and comfortable. And the quality care they deliver makes a huge difference in patients’ overall health and wellbeing.

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The duties of dental assistants vary widely across the country, largely because some states allow for a wider scope of practice than others. Common duties include:

• Setting up the work area by laying out the dentist’s tools and materials
• Conducting patient intakes, including medical and dental history, vital signs and blood pressure testing
• Assisting the dentist and hygienist during procedures by handling tools and suctioning excess fluids from the patient’s mouth
• Educating patients on brushing, flossing, dental hygiene and post-procedure home care
• Preventing infection through proper equipment sterilization and handling
• Conducting and processing diagnostic tests like X-rays and lab tests
• Taking impressions of patients’ teeth
• Managing the practice’s inventory
• Handling clerical tasks like scheduling, payment and claims processing

Some states also allow qualified dental assistants to:

• Clean and polish patients’ teeth
• Administer anti-cavity treatments like sealant and fluoride application
• Apply topical anesthetics before procedures

Dental assistants are part of a growing and important industry. Thanks to high profile research studies, consumers have begun to understand the benefits of good oral care. What’s more, demand for dental care is growing thanks to federal laws that expanded access to health insurance in 2014.

Opportunities within the field are also growing. As patient numbers swell, dentists are turning more and more tasks over to their assistants. Scope of practice for dental assistants is therefore likely to expand in coming years.

Experienced dental assistants say they love having a versatile job that gives them a chance to work in many aspects of patient care. They also report a high level of satisfaction that comes from helping others look and feel their best. And when patients are anxious or in pain, the compassion and connection assistants provide truly makes a difference.

Workplace Details

Most dental assistants work in dentists’ offices. These practices may employ one dentist or several. Some offices are dedicated to specialties like oral surgery, orthodontics (braces) or pediatric dentistry. In addition, some hospitals employ dental assistants to care for bedridden patients. Dental assistants also work in the public sector caring for school children and the medically underserved in our communities.

Dental assistants generally work regular business hours. Some evening and weekend shifts may be required to accommodate patients’ schedules. About two-thirds of dental assistants work full time. Many assistants say that flexible scheduling is a major perk of the job.

Working conditions for dental assistants are usually quite pleasant. Dentists’ offices are clean, well lit and welcoming. Working in a dental setting involves some exposure to environmental hazards, notably radiation (from X-rays) and infectious diseases. These risks are minimized through proper use of protective clothing (apron, gloves, mask) and by following established safety procedures.

Hover over any state to explore local income and job growth data.

Salaries vary with education level, experience, responsibilities and geographic location. The median salary for all dental assistants is $36,940, or $17.76 per hour, according to the US Bureau of Labor Statistics. The lowest-paid 10 percent earn a median of $25,460, and the highest-paid 10 percent earn a median of $52,000.

Salaries are generally greatest for certified and licensed dental assistants; those with some college education; those with several years of experience; and those who are qualified to perform advanced patient care tasks (X-rays, cleanings and fluoride treatments).

Because more people are seeking dental care today than ever before, the job outlook for dental assistants should be excellent in the near future. According to the US Bureau of Labor Statistics, employment is expected to grow by 18 percent between 2014 and 2024, which is much faster than the average for all professions.

Increased public awareness is one reason for this growing demand. More and more people are making the connection between good oral health and overall health. This leads consumers to seek regular preventative dental care and to continue that care throughout their lives.

The growing elderly population is also a factor. Thanks to advances in dental care, older people are keeping their natural teeth longer - often for their entire lives. Demand for dental services is expected to swell as members of the Baby Boomer generation enter their sixties, seventies and beyond.

Finally, in 2014, the Affordable Care Act extended healthcare coverage, including dental coverage, to millions of Americans who were uninsured or underinsured. This will allow more people to obtain dental care in the future.

In addition to excellent job prospects, dental assistants are enjoying an increasing scope of practice in many states. Where permitted by law, busy dentists are handing over more routine patient care tasks to their assistants. For this reason, assistants with the highest levels of licensing, certification and experience will generally be most employable going forward.

Dentist office websites, local newspapers, community employment offices and online career sites are good sources of job listings for dental assistants.

Educational requirements for dental assistants vary from state to state. In some states, a candidate must complete a postsecondary program in order to become a dental assistant. In other cases, however, only on-the-job training is required. However, a high school diploma and GED are always recommended for several reasons:

• They’re generally necessary for certification, especially for assistants who train on the job
• They’re often required to enter an accredited training program (which is a licensing requirement in some states)
• They may be required in order to perform certain regulated tasks like coronal polishing (cleaning)
• Education will make you a more competitive job candidate and may allow you to negotiate higher pay

To learn more about education requirements in your state, contact your state board of dentistry.

High school students can prepare for a career as a dental assistant by studying biology, chemistry and anatomy. Experience with computers is also helpful.

Students who opt for a postsecondary program have several options, including one-year certificate programs and two-year associate degree programs. These programs are available through community colleges, vocational and technical schools, dental schools and private career colleges. It’s important to choose a program accredited by the Commission on Dental Accreditation (CODA), as this often simplifies the certification and licensure processes.

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During the program, dental assisting students learn about the anatomy of the mouth, teeth, jaws and gums. They also gain practical experience with dental instruments and materials. Instruction includes a mixture of lecture, lab work and supervised clinical experience.

On-the-job training is an option for candidates living in states that do not regulate the practice of dental assistants. Instruction is provided by dentists, dental hygienists and senior dentals assistants.

Dental assistants who train on the job and who hold a high school diploma or equivalent are eligible for national certification after the completion of 3,500 work hours (or about two years of full-time experience).

Again, state regulations vary when it comes to the licensure of dental assistants:

• Some states require national certification and/or state licensure of all assistants. State licensure generally involves graduation from a CODA-accredited training program and passage of a licensing exam. Some states mandate continuing education for practicing dental assistants.
• Other states regulate certain job functions like coronal polishing (cleaning) or X-rays
• A few states have no licensing requirements for dental assistants. However, training and certification still tend to lead to better job prospects and higher pay.

The Dental Auxiliary Learning and Education (DALE) Foundation maintains a useful state-by-state listing of licensing requirements for dental assistants.

The Certified Dental Assistant (CDA) credential is administered by the Dental Assisting National Board (DANB). In many states, holding a CDA can streamline the licensing process. Often, it also allows for a wider scope of practice.

To earn CDA designation, candidates must:

• Graduate from a CODA-accredited training program or complete 3,500 hours of documented, supervised work experience
• Hold current CPR certification
• Pass a national board exam consisting of three components: radiation health and safety (RHS), infection control (ICE) and general chair-side exam skills (GC)

DANB also offers several advanced credentials for dental assistants who pass additional component exams. These include:

• Certified Orthodontics Assistant (COA)
• Certified Preventative Functions Dental Assistant (CPFDA)
• Certified Restorative Functions Dental Assistant (CRFDA)

Working as a dental assistant is a great way to learn about other health professions before committing to a more rigorous educational program. Some assistants go on to become dental hygienists, dentists, physicians and nurses. Others choose to remain dental assistants but to focus on a clinical area like orthodontics, hospital practice or geriatric or pediatric dentistry.

Advancement is also possible beyond the clinical realm. Insurance companies sometimes hire assistants to process dental claims. Some dental assistants go on to lucrative careers as sales representatives for dental products companies.

Experienced dental assistants are in a great position to train entry-level professionals. Depending on state regulations, this might take place in a formal training program or on-the-job in a dentist’s office.

You may not need to graduate from high school in order to work as a dental assistant. However, as a diploma holder, you’ll be:

• Eligible for national certification
• Qualified to perform more complicated procedures (for example, tooth cleaning and polishing)
• Prepared to enroll in a dental assisting certificate or associate degree program

Where permitted by state law, dental assistants can train entirely on the job. After about two years of full-time experience, these assistants can sit for the national certification exam (see the advanced credentials section for more information).

This level of education is the minimum requirement for licensure in some states. Even where not required, holding a dental assisting certificate can make it easier to get a job (especially in more competitive job markets).

Community colleges, technical schools, dental schools, and even some high schools offer dental assisting certificate programs. Before enrolling in a program, contact your state dental board to verify that it’s approved for licensure purposes. Some states only license dental assistants who graduate from programs accredited by the Commission on Dental Accreditation (CODA).

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Dental assistant training blends classroom learning, labs, simulations, and supervised fieldwork. Students can expect to study:

Most programs also include an internship or fieldwork component. During this phase, students practice assisting dentists in the care of real-life patients. The experience is typically structured to cover a variety of dental specialties, practice settings, and populations.

Earning an associate degree in dental assisting allows you study advanced topics in the field. You’ll also round out your education with general education courses. An associate degree is also a good idea if you eventually plan to pursue an associate degree in dental hygiene, a bachelor’s degree, or graduate school.

Associate degree programs are most commonly found at 2-year colleges and vocational schools. Before enrolling, verify that your chosen program meets your state’s licensure requirements (most commonly, state dental board approval and/or CODA accreditation).

Associate degree programs in dental assisting cover all the same classes as certificate programs. However, they allow you to go above and beyond by studying advanced topics in the field. You’ll also round out your education with courses in communications, technology, and the humanities.

Some examples of dental assisting courses at the associate degree level:

Like certificate students, dental assistant AAS students complete extensive practical training under supervision.

The Dental Assisting National Board (DANB) offers a variety of voluntary credentials for dental assistants. Many employers prefer to hire certified candidates.

To earn a DANB credential, you’ll need to be up to date on your CPR certification and pass several component exams (for example, infection control). To finalize your certification, you’ll also need to meet DANB’s education and experience requirements.

DANB offers two primary certifications for dental assistants:

• National Entry-Level Dental Assistant (NELDA) - for candidates working toward CDA eligibility
• Certified Dental Assistant (CDA) - candidates must graduate from an accredited training program OR document 3,500 hours (about 2 years) of work experience

In order to earn the following DANB specialty certifications, candidates must meet additional education and experience requirements and pass the relevant component exams:

• Certified Orthodontic Assistant (COA)
• Certified Preventative Functions Dental Assistant (CPFDA)
• Certified Restorative Functions Dental Assistant (CRFDA)

In addition, some states have credentialing programs for dental assistants (for example, Expanded Duties Dental Assistant in Colorado). Check with your state dental board for more details.