Evolving Standards: Key Dental Assisting Requirement Changes Across the U.S.

In the past year, the landscape of dental assisting in the United States underwent notable regulatory transformations, reflecting the evolving needs of both the dental workforce and patient care systems. Across multiple states, legislation was introduced or revised to expand the scope of duties for dental assistants, streamline licensure pathways, and address persistent staffing shortages in the dental field. These changes mark a shift toward greater flexibility, accessibility, and professional recognition for dental assistants.

Arizona

Arizona established the role of Oral Preventive Assistants (OPAs). OPAs are trained dental assistants authorized to perform supragingival scaling and polishing on periodontally healthy patients or those with mild gingivitis, under the direct supervision of a dentist or dental hygienist. To qualify, dental assistants must complete a Board-approved training course comprising at least 120 hours of didactic and clinical instruction, and meet specific certification requirements, including CPR, coronal polishing, and radiography .

Additionally, House Bill 2639 amended Section 32-1291 of the Arizona Revised Statutes to permit dental assistants to expose radiographs and perform coronal polishing under the general supervision of a dentist or the direct supervision of an affiliated practice dental hygienist.

California

Effective July 1, 2025, the bill establishes a new preceptorship pathway for Registered Dental Assistants (RDAs), allowing for 800 supervised hours of on-the-job training, aligning with current educational program standards. Additionally, individuals holding a certified dental assistant certificate from the Dental Assisting National Board (DANB) can apply for RDA licensure without repeating training. The scope of practice for dental assistants has also been expanded; unlicensed assistants may perform coronal polishing under direct supervision upon completing a board-approved course, and licensed assistants are now authorized to attach orthodontic buttons and add or remove bands under direct supervision. Furthermore, the bill eliminates work experience requirements for Orthodontic Assistant Permit holders, facilitating easier entry into the field. 

To enhance infection control, starting January 1, 2025, unlicensed dental assistants must complete a Dental Board-approved eight-hour infection control course before performing any procedures involving potential exposure to blood or saliva. The course includes six hours of didactic instruction and two hours of laboratory instruction.

Minnesota

The Board approved a motion on Oct. 11, 2024, for rule variance allowing for licensure as Licensed Dental Assistants without completing the state Dental Assistant State Licensure Exam and to commence rulemaking formally eliminating the exam as a prerequisite for licensure.

Mississippi

Mississippi’s dental assistant regulations stipulate that to legally operate dental x-ray equipment, assistants must hold a current national DANB Certified Dental Assistant (CDA) certification, complete a Mississippi Board-approved radiology seminar and exam, or graduate from a CODA-accredited dental assisting program within the past 12 months. They must also apply to the Mississippi State Board of Dental Examiners for a radiology permit.

Montana

Montana introduced provisions allowing certified dental assistants (CDAs) to perform certain intraoral procedures under general supervision, including placing pit and fissure sealants and exposing radiographs. To qualify, dental assistants must hold CDA certification from the Dental Assisting National Board and meet specific training requirements. Additionally, Montana established guidelines for dental auxiliaries—non-licensed personnel—permitting them to perform tasks such as coronal polishing, radiographic exposures, and applying topical fluoride agents under direct supervision, provided they have received appropriate training or certification

Nevada

As of Dec. 15, 2024, rule now authorizes the supervision of dental assistants by dental therapists.

New York

A new law effective Nov. 15, 2024, and subsequent emergency rulemaking permits the application of topical fluoride varnish by registered dental assistants to patients under direct supervision by a licensed dentist. This amendment provides important clarification to the RDA scope of practice, as prior law only permitted the application of “anticariogenic agents” to teeth.

North Carolina

North Carolina State Board of Dental Examiners proposed eliminating the 3,000-hour patient care requirement for Dental Assistant IIs (DA IIs) seeking coronal polishing certification. This change intends to streamline the certification process and address workforce shortages, though it maintains the requirement for a seven-hour coronal polishing course.

North Dakota

On Oct. 1, 2024, rulemaking clarified existing permissible functions to allow the delegation of new functions to unlicensed dental assistants, including application of topical fluoride, nitrous oxide monitoring (with training), and taking of digital impressions. It also modifies supervision requirements for functions performed by Qualified Dental Assistants; authorizes their performance of coronal polishing and the placing of orthodontic brackets; and creates a registration by reciprocity pathway for QDAs and RDAs. 

Additionally, the rule establishes registration as a Qualified Dental Assistant-Limited Radiology Registrant permitted to perform dental radiography without having to complete other QDA requirements; the DANB RHS exam is recognized to obtain this registration. It further establishes continuing education requirements for QDA-limited radiology registrants and dental anesthesia assistants and opens access to application for dental anesthesia permits to any individual — not just an RDA — who meets requirements.

Oregon

Effective January 1, 2025, the Oregon Board of Dentistry approved a rule allowing Expanded Function Dental Assistants (EFDAs) to administer local anesthetics and reversal agents under indirect supervision, contingent upon completing a Board-approved curriculum accredited by the Commission on Dental Accreditation.

These developments not only aim to strengthen the dental care infrastructure but also empower dental assistants with clearer career trajectories, increased responsibilities, and improved job stability—positioning them as essential contributors to the future of oral healthcare.