Expanded Functions Dental Assistant: Duties, Certification, Training and Salaries

A career in dental assisting can be rewarding and also provide good job security and a solid income. To earn even more and be able to take on more responsibilities in a dental office, consider becoming an expanded functions dental assistant.

In addition to the typical duties of a dental assistant, like getting patients comfortable and assisting dentists during procedures, those with expanded functions can take X-rays, apply sealants, do coronal polishing for patients, and more.

Exactly what these assistants are allowed to do depends on the state in which they practice. Each state also sets its own requirements for how to become an expanded functions dental assistant. Generally, you will need to have some type of formal education or training and be licensed through the state’s dental board.

It’s worth looking into this as a career if you are interested in healthcare and working with patients. As an expanded functions dental assistant you will have the pleasure of helping patients feel more comfortable and enjoy better dental health. And you can get into this career without spending a fortune and years of your life on school and training.

What is an Expanded Functions Dental Assistant?

An expanded functions dental assistant, or EFDA, is a dental assistant or with extra responsibilities and duties. They have more training and additional licenses or certifications than dental assistants and their permitted duties are extended to include procedures such as coronal polishing, taking impressions or applying sealants or topical anesthetic.

The duties of an EFDA may include all of those of a typical dental assistant as well. A dental assistant is a professional who works under the supervision of a dentist and alongside dentists and dental hygienists. The exact duties that an assistant may perform vary by state, but some of the typical responsibilities include:

  • Guiding patients to the chair and making sure they are comfortable and ready for the appointment
  • Talking to patients and educating them about good oral hygiene and the dentist’s instructions
  • Preparing rooms for appointments
  • Sterilizing instruments
  • Handing instruments to the dentist during a procedure
  • Using the suction hose to keep the patient’s mouth dry
  • Maintaining and organizing patient records
  • Taking phone calls and scheduling appointments
  • Communicating with patients about billing and making payments

In a smaller dental office the EFDA is probably responsible for all these duties as well as their expanded functions. Larger offices that hire more employees may have EFDAs responsible only for the extra duties. Other, non-certified dental assistants in these offices are in charge of the simpler tasks.

The expanded functions that EFDAs are allowed to perform in a dental office are dictated by each state’s dentistry board. There is a lot of overlap, and many states define EFDAs with the same duties, but there are some variations. The American Dental Association (ADA) states that the types of tasks delegated to dental assistants should be limited to reversible procedures that are only performed under the supervision of a licensed dentist.

These are some of the expanded functions that are EFDAs are allowed to perform in one or more states:

  • Radiography – taking and exposing patient X-rays
  • Sealants application – applying a thin layer of plastic on teeth to seal them and prevent cavities
  • Fluoride application – applying fluoride gel to the teeth for cavity prevention
  • Topical anesthetic – numbing an area of a patient’s mouth using a local, topical application, not an injection
  • Coronal polishing – buffing away small, soft plaque deposits from the teeth for additional cleaning
  • Gas monitoring – monitoring a patient under nitrous oxide
  • Dental charting – creating a chart that lists and describes the condition of a patient’s teeth
  • Suture removal – taking out stitches following a surgical dental procedure
  • Crown application – putting in a dental crown, temporary only
  • Dental impressions – taking a mold of a patient’s teeth for creating retainers, mouth guards, crowns, bridges, dentures or veneers

According to the ADA, the most common expanded function that EFDAs perform in dental offices is radiography. More than 90 percent of EFDAs are responsible for radiography and X-ray tasks. This is followed by coronal polishing, monitoring the use of nitrous oxide and applying sealant.

Some states have an additional level of licensing for EFDAs working with orthodontists. They do most of the same duties as regular dental assistants and EFDAs but perform them in an orthodontics setting and assist with orthodontic procedures, such as fitting braces.

How Do I Become an Expanded Functions Dental Assistant?

Depending on the state in which you work, an EFDA may be officially called a certified dental assistant, a licensed dental assistant, registered dental assistant or a registered dental assistant with expanded functions. Regardless of the name, this role is distinct from that of dental assistant, which may not require any kind of formal training or education, certification or licensing.

Some states have several levels of dental assisting and licensing. California, for example, defines different roles and licensing requirements for dental assistants. These include dental assistant, registered dental assistant, registered dental assistant in extended functions, orthodontic assistant and oral surgery/periodontal practice.

To know exactly what you need to do to become an expanded functions dental assistant, you will need to check the requirements in the state in which you want to work. You can contact your state’s dental board or check with the Dental Assisting National Board (DANB) to find the requirements.

Education Requirements

While the requirements for becoming an EFDA vary by state, there is a typical pathway. Most states will require, for instance, that you begin by earning a degree, certificate or diploma from an appropriate dental assisting program and school. Many states require that the program you complete be accredited by the Commission on Dental Accreditation (CODA) or that the program meets all the requirements of its dental board and include expanded functions courses.

Getting an associate’s degree or a certificate in dental assisting is a good first step in becoming an EFDA. An accredited program will provide you with all the knowledge you need to get started in the career. Coursework in these programs generally includes topics like oral anatomy, dental materials, radiography, clinical procedures and operative techniques. You can also expect to do lab work and earn credits for an externship, getting hands-on experience in a real dental office.

Most academic programs for dental assisting take between one and two years to complete if you attend full-time. A certificate program is likely to be just one year long, while associate degree programs take two years and include about 100 credit hours.

Examinations for Certification

A good academic program will set you up to successfully complete any required exams. Most states require that you pass either a specific exam or allow you to choose from among a few appropriate exams that test your dental and clinical knowledge.

Many states accept the DANB’s Certified Dental Assistant (CDA) exam. If you can pass this test, you earn the CDA certification, which is enough to prove you have the skills and knowledge to work as an EFDA in most states. Some states have their own exam that you need to pass.

The CDA exam costs $425 to take. You also have to meet the eligibility requirements to take it. There are three pathways you can take to be eligible:

  1. Complete a CODA-accredited dental assisting program and have CPR certification
  2. Graduate from high school or hold a GED, have 3,500 hours of work experience and hold CPR certification
  3. Have an expired CDA certification or a dental degree and be certified in CPR

Applying for State Licensing

Once you have completed your education and passed any required exams, you are ready to apply to your state’s dental board for licensing, certification or registration, depending on the terms the state uses. At this stage you may have to complete a few additional requirements, like having fingerprints made and passing a criminal background check or a drug test.

Some states also want to see proof that you completed a course in specific areas of dental assisting expanded functions. For instance, many states  must see that you completed a radiography course before you can be allowed to take X-rays. Others require that you earn a certificate in using nitrous oxide in order to work with patients monitoring the use of this gas.

You will have to complete an application to submit to the dental board with proof of your education and exam scores, a clean background check and any other information needed. Some states may require you submit letters of recommendation with the application. These can come from former instructors, dentists you have worked with or other employers—anyone who can attest to your good qualities as an employee or student. And, of course, there are fees to apply for licensing, which vary by state.

How Much Do EFDAs Earn?

According to the U.S. Bureau of Labor Statistics (BLS), the median salary for a dental assistant in May of 2018 was $38,660 per year and $18.59 per hour. However, these numbers include all dental assistants, those that are not certified as well as EFDAs. The BLS also reports that the top 10 percent of earners in the field make more than $54,800 per year. The EFDAs are more likely to earn on this higher end.

DANB reports that, according to surveys they conducted, dental assistants with the CDA certification, which includes many EFDAs, earn $20.76 per hour on average. This is $2 more than the average for non-certified dental assistants. Of course, there are variations in pay by state.

The BLS also reports that career growth is strong for all dental assistants. From 2016 to 2026, the increase in number of dental assisting jobs is expected to be 19 percent. This is much faster than average job growth of seven percent for all careers. While there are differences by state and region, this career is growing rapidly in all areas of the country. You should not find it difficult to land your first job, and you can expect excellent job security as an EFDA.

How Can I Find EFDA Classes Near Me?

Your state may or may not require that you take your classes through a CODA-accredited program. Most do require this, though, or that the program you complete is comparable to one accredited by CODA. So it makes sense to start your search with these programs. The ADA website includes a search tool you can use to find a program. You can search by state, program type and even city.

If you cannot find an accredited program near you, check with the community colleges in your area. Many of these colleges, and others that are career-focused, do have dental assisting programs, whether they are accredited or not. Before enrolling in a non-accredited program, check with your state dental board to make sure they will accept it for your licensing or certification.

Becoming an expanded functions dental assistant is a great goal to have. All healthcare careers are growing now, and trained professionals are in big demand. This is a health-related career that does not require you complete a four-year college degree or go through years of training. It’s a good choice if you are eager to begin working soon and have a career that allows you to work hands-on with patients. Research your state’s requirements and prepare to work toward your goal of being an EFDA.

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