How to Become a Dental Assistant in North Carolina

The North Carolina State Board of Dental Examiners regulates the practice of dentistry and dental hygiene. Although dental assistants in North Carolina are not licensed, they are classified by the Board. The classification process looks at a dental assistant’s experience and/or training. It is up to employers to verify the classification of their dental assistant employees.

The two classifications of North Carolina dental assistants are:

  • Dental Assistant I (DAI): Permitted to perform basic supportive dental procedures under the direct supervision of a licensed dentist
  • Dental Assistant II (DAII): Permitted to perform expanded functions under the direction supervision of a licensed dentist
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Dental Assistant Training and Experience Requirements

Dental assistants who perform basic supportive dental procedures in North Carolina are classified as a Dental Assistant I (DAI) and are not required to complete any specific training or education.


However, to perform expanded functions in North Carolina and earn the classification of Dental Assistant II (DAII), individuals must meet ONE of the following:

  • Complete a Commission on Dental Accreditation (CODA)-accredited dental assisting program and hold CPR certification


  • Complete at least one year in an CODA-accredited dental hygiene program and hold CPR certification


  • Complete at least two years of full-time experience within the past five years; must include:
    • The completion of a three-hour course in sterilization and infection control
    • The completion of a three-hour course in dental office emergencies
    • The completion of radiology training
    • Possess current CPR certification


  • Complete the Certified Dental Assistant (CDA) examination administered by the Dental Assisting National Board (DANB) and hold CPR certification

Nitrous Oxide and Coronal Polishing Requirements

DAIs and DAIIs may qualify to monitor patients under nitrous oxide if they complete a North Carolina Board-approved 7-hour course in nitrous oxide-oxygen conscious sedation.

DAIIs may qualify to perform coronal polishing if they complete a seven-hour coronal polishing course that meets Board requirements. The course must include at least 3 hours of didactic and 4 hours of clinical study.

Radiography Requirements

All DAIIs in North Carolina are permitted to perform dental x-rays and handle radiographic equipment. DAIs may meet the radiography requirements if they complete at least one of the following:

  • The North Carolina radiography equivalency examination
  • An CODA-accredited dental assisting program
  • The DANB Certified Dental Assistant (CDA) certification

Dental Assisting Programs Available in North Carolina

One of the most streamlined routes to becoming a DAII in North Carolina so as to perform expanded functions is through the completion of a Commission on Dental Accreditation (CODA)-accredited dental assisting program. There are currently 19 CODA-accredited programs in North Carolina.

A dental assisting program, which is usually 9 to 11 months long, consists of study in both the clinical and administrative aspects of dental assisting, hands-on experiences, and a clinical externship.

Programs are offered through dental schools, junior/community colleges, and technical/vocational schools. A few institutions offer dental assisting programs as associate degrees.

Coursework in a dental assisting program often includes:

  • Chairside dental assisting
  • Radiography
  • Specialty practice procedures
  • Dental sciences
  • Infection control
  • Dental health education
  • Office emergency procedures
  • Dental office business practices

Dental hygienists who want to go on to earn an associate’s degree in the dental field do so through a dental hygiene program. Dental hygienists, who are state-licensed professionals, are permitted to perform a number of independent duties in a dental office, such as teeth cleaning.

DANB Certification Options for Dental Assistants

The Dental Assisting National Board (DANB) is the certifying body for a number of national credentials in dental assisting, including:

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

The CDA credential through DANB may allow dental assistants to meet requirements to perform expanded functions as a DAII and to perform dental x-rays and operate radiography equipment.

To qualify to take the 3 component exams of the CDA credential, candidates must either graduate from a CODA-accredited dental assisting program or possess at least 3,500 hours of experience in dental assisting.

All DANB credentials must be renewed on an annual basis upon completion of at least 30 continuing education credits.

Permitted Dental Assistant Duties and Functions in North Carolina

A dental assistant I in North Carolina is permitted to perform the following:

  • Apply topical anesthesia
  • Apply topical fluoride
  • Expose radiographs (upon meeting training requirements)
  • Instruct patients in oral hygiene
  • Monitor patient under nitrous oxide (upon completion of required training)
  • Perform extraoral adjustment of temporary restorations or appliances
  • Polish dentures
  • Take patient blood pressure, pulse, and temperature
  • Write laboratory orders
  • Write prescriptions

A Dental Assistant II in North Carolina is permitted to perform all of the functions of the DAI, as well as:

  • Apply acid etch materials and rinses
  • Apply bonding agents
  • Apply dentin desensitizing solutions
  • Apply sealants after dentist has examined patient
  • Cement temporary restorations using temporary cement
  • Coronal polishing
  • Fit orthodontic bands or brackets
  • Flush, dry, and temporarily close root canals
  • Insert interdental spacers
  • Insert matrix bands and wedges
  • Place and remove temporary restorations
  • Place cavity bases and liners
  • Place gingival retraction cords
  • Place or remove orthodontic arch wires
  • Place/remove rubber dams
  • Remove excess cement
  • Remove periodontal dressings
  • Remove sutures
  • Remove sutures
  • Take impressions for study models and opposing casts
  • Tax wax bites

Pursuing Dental Assistant Jobs in North Carolina

According to the North Carolina Department of Commerce, there were 8,310 dental assistants in the State in 2010. By 2020, the Department projects that there will be 10,290 dental assistants working in the sate, representing an increase of 1,980 within this ten-year period.

According to the North Carolina Department of Commerce, the areas (Workforce Development Board regions) of North Carolina who employed the highest number of dental assistants in 2010 were:

  • Cape Fear: 450 dental assistant jobs
  • Centralina: 420 dental assistant jobs
  • Cumberland: 310 dental assistant jobs
  • Durham: 240 dental assistant jobs
  • Gaston: 180 dental assistant jobs
  • High Country: 140 dental assistant jobs
  • Turning Point: 290 dental assistant jobs
  • Western Piedmont: 320 dental assistant jobs

Professional associations for dental assistants in North Carolina may be an excellent resource for professional opportunities:

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