Ask a dental assistant: What do all of those credentials mean and how can I obtain them?

I am a social media stalker. I love to keep up with friends and colleagues on Facebook, visit different group pages, and see what dental assistants are talking about. What is it that makes us tick? What are the issues that concern us most?

Time and time again, I see that there is a huge misunderstanding about what a Certified Dental Assistant (CDA) is and how you go about obtaining that certification. There is also a misunderstanding of exactly what an RDA is, what that entails and how each state differs. Are these state or national certifications? Let’s examine those two valuable designations and help set the record straight.

A CDA or Certified Dental Assistant is a national certification (not state-specific) awarded by the Dental Assisting National Board (DANB). You earn this certification by completing all three components of DANB’s CDA exam. The three components are General Chairside, Infection Control and Radiation Health and Safety. There are three pathways to be eligible to obtain CDA certification. All the information I’m about to give you can also be found on the DANB website and it has some great information about other national exams available for dental personnel. It’s important to note that DANB owns the Certified Dental Assistant^TM and the CDA® marks, so only those who earn and maintain CDA certification are allowed to use this credential after their names.

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Pathway I: 
1. Graduation from a CODA-accredited dental assisting or dental hygiene program, AND
2. Current CPR from a DANB-accepted provider

If you graduated from a CODA (Commission on Dental Accreditation from the American Dental Association)-accredited dental assisting or dental hygiene program, you are eligible to sit for the CDA exam. You must also be current in CPR.

Even if you didn’t attend a CODA-accredited program, but you would like to better yourself and further your career, you can still sit for the CDA exam given by DANB but you must adhere to pathway II.

Pathway II: 
1. High school graduation or equivalent, AND
2. Minimum of 3,500 hours of approved work experience, AND
3. Current CPR from a DANB-accepted provider

DANB notes that the 3,500 hours of experience is about two years of full-time employment. Your current employer must sign off on your application to DANB stating that you have indeed completed the 3,500 hours necessary to take the exam.

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DANB's CDA exam is given at testing centers around the country. You must apply to take the test first (applications can be found on the DANB website), and then DANB will provide you with a window of time in which to take the test. The three components of the exam can be taken separately or altogether. Taken separately, you will spend a little more money but it allows you to just study that component. Some people find that easier and less stressful. The results or your pass/fail are immediately given to you when you are finished.

Of the three components, there are currently no eligibility requirements for taking the RHS (radiology) or the ICE (infection control) exams. Once you take your first component of the CDA exam, you have five years to complete all three components. Meaning that while you are working towards completing your 3,500 hours, you can go ahead and take the RHS and ICE. When your 3,500 hours are complete, you’re ready to sit for the GC (general chairside) portion of the exam.

There is one last pathway to obtain a CDA…

Pathway III: 
1. Former DANB CDA status, or graduation from a CODA-accredited DDS or DMD program or graduation from a dental degree program outside the U.S. or Canada, AND
2. Current CPR from a DANB-accepted provider

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Note that Pathway III is for “former DANB CDAs.” You only hold “CDA status” if you are current in paying your renewal fees, hold current CPR, and receive a minimum of 12 continuing education hours each year. Many times I’ve met assistants who say they are CDA certified, but they have not kept up with the yearly requirements. If you haven’t met your early requirements, you are not a DANB CDA certificant. If you think this credential isn’t important, keep your dues paid and your continuing education requirements current! You simply never know where life is going to take you and you may want them!

Why obtain CDA certification? Out of approximately 300,000 dental assistants across the U.S., only 35,000 currently hold this national certification. Obtaining this status means taking and passing this national exam, and committing yourself to continuing education and a lifetime of learning. It shows you’ve dedicated yourself to this profession and you hold yourself to the highest standards of patient care and educational excellence. Many states require one or more of the components of this exam in order to hold a license or permit through that state. Many federal or government agencies, state institutions, and schools require you to be a current CDA certificant in order to be employed with them. At this very moment, many more states are considering legislation for minimal standards of education and training for dental assistants. The DANB CDA certification is already the gold standard in many states and I believe will be adapted by more states as the need for qualified dental assistants grows and public awareness demands that the dental community hold us to minimal educational requirements.

That’s national, what about state requirements? It seems confusing to me, but each state has its own set of rules. Some states are strict and require licenses and/or permits for radiology and infection control, while some states don’t allow their dental assistants to perform any extra task and have no licensure. For this, DANB has also compiled a list on their website to help sift through the muck and identify what each state requires.

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Many states have regulations and rules set into place for dental assistants working within the state to become registered dental assistants (RDAs). An RDA status that is granted in one state is only valid in that state. An RDA status does not move from state to state and what one state may require to obtain RDA status will be completely different in another state.

A Kentucky RDA doesn’t require an exam but does require current certification in CPR that meets or exceeds the guidelines of the American Heart Association (AHA). In addition, the dental assistant’s employer dentist must register the dental assistant on his or her application for renewal of dental licensure and maintain a personnel file for the registered dental assistant containing the following:

• a copy of proof of having current CPR certification

• a copy of the certificates of completion of the coronal polishing, radiation safety, radiation techniques course and starting IV access lines courses, if the dental assistant has completed these courses

• the licensee's statement attesting to the competency of the dental assistant in the procedures delegated the assistant from the delegated duties list

There are no yearly requirements except for CPR.

A dental assistant in the state of Texas can earn status as an RDA by formally registering with the Texas State Board of Dental Examiners (TSBDE). To qualify, one must successfully complete a current course in basic life support, 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.

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The Massachusetts Board of Registration in Dentistry published new regulations effective October 10, 2014, related to registration and scope of practice of dental assistants. They have four levels for dental assistants: dental assistant trained on the job (OJT), formally trained dental assistant (FTDA), certified assistant (CA) and expanded function dental assistant (EFDA). Each of these carries their own criteria and regulations.

Missouri has no radiology or infection control requirements. However, the state requires its assistants to hold either the DANB CDA or sit for the Missouri Basic Skills Exam (this exam is also given by DANB and the information is available on its website). Once either of these exams have been taken and passed, the assistant is eligible to take any of the five expanded functions courses that Missouri allows. After passing those courses, the assistant obtains a permit for that expanded function. Missouri doesn’t recognize RDA status.

Wow, doesn’t that make your head spin? In a perfect world, we would all be on the same page. If your state doesn’t hold you to minimal standards, hold yourself accountable for continuing your education in this growing profession. There is no limit to what you can do. Know the laws that pertain to you, work hard to better yourself, and never, ever stop learning!

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