How to Become a Dental Assistant in Texas

A recent count showed 23,520 dental assistants working in Texas, with jobs found distributed throughout the state as follows:

  • 6,500 in Houston and its surrounding area
  • 6,100 in the Dallas-Fort Worth area
  • 4,430 in the Dallas-Plano-Irving area
  • 2,550 in San Antonio and its environs
  • 2,000 in Austin and its surrounding area
  • 1,670 in the Arlington-Fort Worth area
  • 660 in El Paso
  • 610 in the McAllen-Edinburg-Mission area
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Qualifying to Become a Dental Assistant in Texas

Dental assistants are permitted to perform the following activities without meeting state-mandated education or certification requirements:

  • Application of fluoride varnish
  • Interim treatment of a minor dental emergency to an existing patient, if this is authorized by the dentist beforehand in writing
  • Acts or procedures that are reversible
  • Acts that are part of a tooth-whitening process
  • Acts that do not specifically require a certificate or registration

Dental assistants who want to perform expanded duties need to complete an appropriate course of training or education and then apply for certification in their specific area of expanded expertise through the Texas State Board of Dental Examiners:

  • Pit and Fissure Sealant
  • Nitrous Oxide Monitoring
  • Coronal Polishing
  • Registered Dental Assistant X-Rays

Dental assistants who have never taken x-rays before are permitted to take x-rays during their first year of employment. After their first year, or if they have previously taken x-rays in another state, dental assistants must register with the Board and obtain an X-Ray Certificate.

To perform expanded and advanced duties dental assistants have the option of obtaining the following certificates:

Pit and Fissure Sealant Certificate This certificate will allow a dental assistant to place pit and fissure sealants as well as cleanse the smooth and occlusal surfaces of teeth in preparation for this task or for the placement of orthodontic bonding resin. To obtain this, dental assistants will need to meet the following eligibility requirements:

  • Work as a dental assistant for at least two years
  • Complete a course in basic life support
  • Complete a course that is approved by the Board and accredited by the American Dental Association in pit and fissure sealants that is at least eight hours in length and includes study of the following subjects:
    • Infection control
    • CPR
    • Microbiology and chemistry
    • Dental anatomy
    • Jurisprudence and ethics related to pit and fissure sealants
    • Clinical lab for the application of sealants

There are currently eight dental assistant schools in Texas offering pit and fissure sealant training. Once dental assistants have completed these requirements they may fill out an Application for Pit and Fissure Sealant Certification and submit this along with a $30 application fee to the Texas State Board of Dental Examiners in Austin.

Coronal Polishing CertificateThere are three pathways to becoming eligible for this certificate, and all require dental assistants to have at least two years of work experience:

Pathway 1

  • Complete an approved eight-hour dental assistant training program in clinical and didactic education dealing with coronal polishing. There are currently three approved coronal polishing programs in Texas that include the following coursework:
    • Polishing coronal surfaces of teeth
    • Oral anatomy and tooth morphology
    • Complications, contra-indications, and indications of coronal polishing
    • Infection control procedures
    • Coronal polishing principles, such as armamentarium, patient positioning, and polishing agents
    • Texas jurisprudence as it relates to coronal polishing

Pathway 2

  • Pass the Dental Assisting National Board’s Coronal Polish Exam, which covers:
    • Dental and oral anatomy
    • Oral prophylaxis
    • Coronal polish
    • Dental deposits
    • Precautions when polishing
    • Patient record keeping and education
    • Polishing agents and abrasives
    • Polishing technique
    • Infection control
  • Pass the State Board of Dental Examiners’ Texas Jurisprudence Assessment for Coronal Polishing Exam, covering:
    • $54 application fee
    • Can be taken online at any time
    • No time limit

Pathway 3

Once candidates have qualified they can complete an Application for a Coronal Polishing Certificate and return this plus a $12 application fee to the Texas State Board of Dental Examiners.

Nitrous Oxide Monitoring Certificate – Holding this certificate will allow dental assistants to monitor the administration of nitrous oxide. To be eligible, candidates must complete an approved course of education and submit an Application for a Nitrous Oxide Monitoring Certificate along with a fee of $12 to the Texas State Board of Dental Examiners. The course of study will be at least eight hours and include coverage of the following subjects:

  • Texas jurisprudence relating to the administration of nitrous oxide
  • Dental anatomy and physiology
  • Sedation equipment
  • Pharmacology
  • Patient monitoring
  • Management and recognition of medical emergencies

Registered Dental Assistant X-Ray Certificate – Dental assistants who want to take X-rays must register with the Texas State Board of Dental Examiners. Doing this requires passing a Board-approved class for registration that includes a study of:

  • Texas jurisprudence
  • Radiology
  • Infection control

Candidates who hold a current CDA (Certified Dental Assistant) credential from the Dental Assisting National Board may substitute this credential for a Board-approved class, however they must then also pass the Texas Jurisprudence Exam.

Once candidates have become eligible they can submit a Dental Assistant Registration Application along with a $36 application fee to the Board. This will be processed and if everything is complete and valid then the applicant will be issued an Activation Form with an accompanying pro-rated fee based on the applicant’s birth date. Once this Activation Form is returned and the fee paid, an applicant will become a Registered Dental Assistant with an X-Ray Certification. This must be renewed annually and expires on the dental assistant’s birthday.

Continuing Education Requirements for Dental Assistant Certificates and Registration

Dental assistants with advanced credentials must obtain a prescribed amount of continuing education according to the following:

  • 1 credential – 6 annual hours of continuing education
  • 2 or more credentials – 12 annual hours of continuing education

Continuing education must relate to the duties of a dental assistant may be comprised of:

  • Self-study
  • Classroom lecture courses
  • Interactive computer courses

Dental assistants must obtain their continuing education from an approved provider. There are currently at least 21 approved providers of continuing education throughout Texas, including:

Continuing education is not awarded for:

  • Hours that are carried over from year to year
  • CPR or Basic Life Support (BLS) training
  • OSHA training

Specific expiration and continuing education requirements are as follows:

  • Pit and Fissure Sealant Certificate – expires every year on January 1st
  • Coronal Polishing Certificate – does not expire but does require continuing education
  • Nitrous Oxide Monitoring Certificate – no renewal or continuing education required
  • Registered Dental Assistant X-Ray Certificate – expires annually and requires continuing education

Renewal applications can be made by mail or online.

Pursuing Dental Assistant Jobs in Texas

A recent sampling of dental assistant employment advertisements from across Texas revealed that employers are looking for job candidates with the following qualifications:

  • The Health Science Center in a periodontic department in Houston recently advertised the following two jobs and accompanying requirements:

    • Dental Assistant I: completion of a three-month dental assistant training program or an equivalent length of employment as a dental assistant and Dental Assistant Registration with the Texas State Board of Dental Examiners
    • Dental Assistant II: preferred Certified Dental Assistant (CDA) credential issued by the Dental Assisting National Board (DANB) and Dental Assistant Registration with the State Board.
  • Smile Brands in Austin recently posted a dental assistant job description that specified the following requirements:

    • Two years of work experience as a dental assistant
    • Registered Dental Assistant with the State Board
    • CPR certification
  • Aspen Dental in Odessa was recently searching for a dental assistant who possessed the following qualities:

    • Registered Dental Assistant with the ability to take x-rays
    • High school diploma or equivalent
    • Stable employment history

While candidates explore the requirements to become a dental assistant in Texas, they may also wish to consider looking through resources provided by professional organizations such as the Texas Dental Assistants Association (TDAA).

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