Inside Dental Assisting
A History of Dental Assisting Certification
A look at more than 65 years of dental assisting certification and what’s to come
Last year marked the 65th anniversary of national dental assisting certification, which was established by the American Dental Assistants Association (ADAA) in 1948. Since then, much has changed, as the importance of dental assistants in the delivery of quality oral healthcare has become more evident and the scope of dental assisting duties has increased greatly. Dental assisting provides many opportunities for growth and development.
The ADAA established the Dental Assisting National Board, Inc. (DANB) as a separate nonprofit corporation in 1980. The American Dental Association has officially recognized DANB as the national certification board for dental assistants since 1989, when the recognition criteria for a national certification board for dental assistants were established.
• Today, DANB offers four national certifications:
• Certified Dental Assistant (CDA)
• Certified Orthodontic Assistant (COA)
• Certified Preventive Functions Dental Assistant (CPFDA)
• Certified Restorative Functions Dental Assistant (CRFDA)
• Earning and maintaining DANB certification has numerous benefits, including greater earning power, personal pride, employer recognition, and professional advantages.
“DANB offers certifications for dental assistants at many stages of their careers,” explains DANB Executive Director Cindy Durley, MEd, MBA. “DANB is committed to offering valid dental assisting certifications and exams to elevate the profession, to benefit employers and others in the oral healthcare profession, and to protect the public.”
A Historic Relationship
The story behind what we know as DANB certification began nearly a century ago with the inception of the first dental assisting membership association. Many dental assistants don’t realize the historic relationship between DANB and the ADAA. Today, the two organizations are independent of each other, although they often collaborate.
In 1924, Juliette A. Southard founded the ADAA. According to the ADAA, Southard worked for a New York dentist, Dr. Henry Fowler, in the early 1900s. In 1921, Southard formed a local dental assistants’ society in New York. However, she envisioned forming an organization that would bring dental assistants together from across the country. Southard and Jessie Ellsworth, president of the Chicago and Cook County Dental Assistants Association, were allowed to attend the 1923 American Dental Association convention. The following year, the ADAA was officially incorporated in Chicago, IL.
Certification: A Milestone for Assistants
For the next 24 years, the ADAA was hard at work, establishing state constituents, growing its membership numbers, and developing a national certification that would recognize the knowledge and professionalism of dental assistants nationwide. The July/August 1947 issue of The Dental Assistant had an article titled “Certification for Dental Assistants,” which declared the association’s intent to establish a certification.
The dream was realized in 1948 when the association founded an affiliate certification board, called the American Dental Assistants Certification Board, Inc. The first CDA certifications were awarded later that year. These efforts were the building blocks for DANB’s CDA certification.
An Independent Board
In 1980, the American Dental Assistants Certification Board became a separately incorporated organization and changed its name to the Dental Assisting National Board. In the subsequent years, many changes occurred in dental assisting certification—all with the goals of elevating the profession and protecting the public.
DANB’s mission is to promote the public good by providing credentialing services to the dental community. Over the years, DANB has evolved to serve an increasing number of stakeholders in the dental assisting community, including educators, regulators, dentists, federal agencies, and oral healthcare organizations. In all its work, DANB strives to follow the guiding principles of trust, communication, respect, initiative, and teamwork.
DANB-Certified Dental Assistant
DANB’s CDA exam, as we know it today, has evolved over many years. Following passage of the federal Consumer-Patient Radiation Health and Safety Act of 1981, DANB began developing the Radiation Health and Safety (RHS) component exam in 1982. The RHS exam was first administered in 1983 and was incorporated as a separate component of the CDA exam in 1985.
Following the 1987 discovery of the human immunodeficiency virus as the cause of AIDS, DANB identified leaders in infection control in the oral healthcare environment to develop a separate Infection Control (ICE) exam for dental assistants. In the early 1990s, DANB’s ICE exam committee members included well-known experts such as Dr. James Cottone, Dr. John Molinari, and Dr. Chris Miller, and the DANB certificants who chaired the committee, including Connie Garland and Jackie Krueger.
DANB’s ICE exam was first administered in 1991, and became the third component of DANB’s CDA certification exam, joining RHS and General Chairside Assisting (GC) in 1993. This established the “laddering” approach to certification, with each of the CDA component exams (GC, RHS, and ICE) offered and scored separately, and the CDA certification awarded to dental assistants who passed all three component exams within a 5-year period.
Today, more than 35,000 dental assistants hold CDA certification. Since 1997, more than 130,550 assistants have passed DANB’s RHS exam and more than 71,175 have passed DANB’s ICE exam.
“DANB’s CDA exam is a national certification that verifies the knowledge required to perform the critical duties that dental assistants do each day,” Durley explains. “We are proud of the growth our flagship certification and component exams have had over the years.”
Certifications for a Growing Field
The CDA certification is just one of the certifications DANB offers. For more than 25 years, DANB has also offered the COA certification for dental assistants who work in orthodontic settings.
Janice Tunis, CDA, COA, CDPMA, has worked in dentistry for 33 years and believes in the rewards DANB certification brings. “I have been employed in orthodontics and practice management for most of my career,” she says. “My credentials prove that I am who I say I am, and that I know what I say I know.”
More recently, DANB launched two additional certification programs: CPFDA and CRFDA. “DANB’s CPFDA certification was introduced in 2011 and includes component exams on Coronal Polish, Sealants, Topical Anesthetic, and Topical Fluoride,” explains Durley. “We saw there was a need for a preventive functions certification because so many states have expanded the duties that assistants are allowed to perform.” Currently, dental assistants holding DANB’s CPFDA certification work in 42 different states.
Following a year of development and a year of pretesting, DANB introduced the CRFDA certification program in May 2013. Dental assistants in 32 different states have earned CRFDA certification. Those who hold CRFDA certification have passed exams in Anatomy, Morphology, and Physiology (AMP); Impressions (IM); Isolation (IS); Sealants (SE); Temporaries (TMP); and Restorative Functions (RF) and have met eligibility requirements by education or experience.
“DANB is committed to promoting public protection and enhancing dental-assistant job satisfaction by providing a defined career ladder for the dental assisting profession,” Durley says. “The CRFDA certification program is one way DANB is meeting the always-advancing and ever-changing needs of the field.”
Dental assistants have many reasons to earn CRFDA certification, such as demonstrating commitment and professionalism to the field, setting an example to others, and maintaining a professional edge.
Julie Davis, CDA, CPFDA, CRFDA, said her certifications are an asset to the office and a point of pride when working with patients. “I felt it was really important to demonstrate to my patients that I go the extra mile,” she explains. “It’s a way for me to improve myself and benefit the office. I learned so much in the studying process.”
Many dental assisting educators and program directors said CRFDA certification was something they believed they had the responsibility to earn—for themselves, their programs, and their students. “I decided to earn CRFDA certification to further my professional career and show my students what is out there and how much they can achieve,” said Kim Plate, CDA, CPFDA, CRFDA.
In addition to DANB’s CDA, COA, CPFDA, and CRFDA certifications, DANB also previously offered two other certifications: Certified Oral and Maxillofacial Surgery Assistant (COMSA) and Certified Dental Practice Management Administrator (CDPMA). “Both the COMSA and CDPMA certifications were introduced in 1983,” recalls Durley. “These certifications have since been discontinued, but we continue to honor the nearly 190 COMSAs and more than 300 CDPMAs who maintain their certification statuses by meeting DANB’s recertification requirements annually.”
After DANB’s Board of Directors reviews feedback from various national dental organizations and other communities of interest this year, DANB plans to introduce the Certified Entry Level Dental Assistant (CELDA) certification program. CELDA certification is intended for entry-level or trained-on-the-job dental assistants who do not yet qualify for DANB’s CDA certification. CELDA certification will help state regulatory agencies identify dental assistants who have completed dental assisting programs in high school or community college settings, or within the U.S. Department of Labor’s Job Corps program, which are not accredited by the Commission on Dental Accreditation. CELDA certification can also provide feedback to regulators and employers on these dental assistants’ knowledge-based competencies in concepts important to functions commonly delegated to entry-level dental assistants.
“Dental assistants enter the profession through many different pathways,” Durley explains. “Many are trained-on-the-job and must therefore wait at least 2 years before being eligible for DANB’s CDA certification exam. CELDA certification will help to retain quality, motivated dental assistants who are recognized as members of the oral healthcare team. Many dental assistants, as well as the dental community and the public, will benefit from the availability of an entry-level certification.”
Benefits of Certification
The benefits of DANB certification are far reaching, positively impacting not only the dental assistants who maintain certification, but also employers, patients, and the dental community.
DANB certification elevates the profession, increases patient safety, and provides dental assistants who hold certification with a source of personal pride. DANB’s exams and certifications are currently recognized or required by 39 dental boards to perform dental assisting functions. In these states, DANB certification is one way or, in some cases, the only way to qualify to perform expanded functions or meet state radiography requirements. In addition, because it’s a national credential, DANB certification makes state-to-state job relocation easier.
At the federal level, the U.S. Department of Veterans Affairs requires DANB certification for dental assistant promotions. The U.S. Air Force requires its airmen enrolled in the Air Force Dental Services’ dental assisting education program to complete DANB’s RHS and ICE exams. Major General Gerard Caron, DMD, the Assistant Surgeon General for Dental Services, Office of the U.S. Surgeon General for the Air Force, encourages airmen working as dental assistants to earn DANB certification.
Greater earning power is another key benefit to certification. According to DANB’s 2012 Salary Survey, DANB certificants can earn as much as $1.54 more per hour compared with non-certified assistants. Also, DANB certificants maintain a professional advantage in the job market. Dentists and other employers often look for or require DANB certification because DANB certificants can help improve office efficiency, productivity, and profitability—as well as improve the patients’ experience.
“From my experience, DANB CDAs are more flexible and able to adapt to the different ways that doctors like to work,” notes Dr. Lisa Gushin, a dentist with her own practice. “DANB CDAs also tend to require less training and are easy to integrate into the practice, which can save valuable time for a busy dentist.”
Some employers also prefer DANB certificants because CDAs tend to show high employer loyalty, averaging 8 years in their current positions. “One of our CDAs has only missed 2 days of work in 3 years — and that’s only because one day she was so sick, we forced her to go home,” Gushin recalls.
In the dental office, DANB certificants stand out as professionals in the industry, which translates to improved marketability in the job market. DANB certification demonstrates to colleagues and employers that the dental assistant has passed rigorous exams and stays current with continuing education. As a result, many DANB certificants benefit from greater job satisfaction and are often role models for their colleagues.
Networking and employment opportunities are also available to DANB certificants. Many employers and recruiting firms turn to DANB for mailing lists of certificants to aid in staffing and recruitment efforts. DANB certificants can also post their resumes on dentalworkers.com.
DANB provides its certificants with:
• A professional, personalized certificate,suitable for framing
• A wallet-sized certification card
• A certification lapel pin
• Direct delivery of the Certified Press quarterly newsletter
• Anniversary milestone gifts
Dental Assisting Requirements and Resources
One of the most common questions DANB hears is: “How can I perform expanded functions?”
Unfortunately, because every state is different, there is no simple answer. In fact, not all states use the title Expanded Functions Dental Assistant (EFDA). The United States has more than 40 job titles for dental assistants. (Editor’s Note: To read more about which expanded functions that states allow and don’t allow, be sure to read the feature article from a previous issue of Inside Dental Assisting by clicking here.)
Because duties, job titles, and requirements vary from state to state, dental assistants need to be informed about the duties that they are allowed to perform or are prohibited from performing, and any education, exam, certification, or other requirements in their states and any state in which they plan to work.
Another popular question from dental assistants is: “What do I need to do to meet state requirements?”
Fortunately, the answer is simple: DANB has in-depth resources to help dental assistants navigate their careers.
DANB has compiled the dental assisting requirements for each state. To read about each state’s job titles, requirements, and allowable duties, visit the “Meet State Requirements” section of DANB’s website at www.danb.org and click on the “search by state” map.
“DANB’s state resources are a useful tool for dental professionals who are looking for the latest information on dental assisting regulations and requirements—all in one place,” Durley says. “All of this is on DANB’s website, so the information can be accessed at the click of a button.”
And although there are not uniform requirements for dental assistants, many states recognize or require DANB certification and exams to perform expanded duties. Passing DANB’s RHS exam or earning CDA certification could be the foundation for performing more dental assisting functions and pursuing career growth.
DANB and the Dental Community
To fulfill its mission of public protection, DANB is committed to developing psychometrically sound exams and certifications. That’s why DANB is a member of the Institute for Credentialing Excellence and DANB’s CDA and COA certification programs are accredited by the National Commission for Certifying Agencies (NCCA). DANB will be applying for NCCA accreditation of its CPFDA and CRFDA certification programs this year.
DANB’s Board of Directors consists of seven directors elected by DANB after nomination by organizations, including the American Dental Association, the American Dental Assistants Association, the American Association of Dental Boards, and the American Dental Education Association. In addition, a certificant-at-large and a public member are elected to serve on DANB’s board for a total of nine board directors. Therefore, when changes to DANB policies and programs are first considered, communities of interest are involved directly at the board level.
To assess the needs and opinions in the dental community and to stay current with the scope and practice of dental assisting, DANB conducts periodic surveys of its certificants and other dental assistants. This understanding informs many important decisions, including the development of current and future exams and certifications.
All of DANB’s exams are developed by committees that are comprised of dental professionals from organizations with members on DANB’s Board of Directors, and from other professional oral healthcare organizations, such as the Academy of General Dentistry; the Organization for Safety, Asepsis and Prevention; the American Academy of Oral and Maxillofacial Radiology; and the American Association of Orthodontists. DANB exam committees make recommendations to DANB’s board about national certifications, exams, and other credentialing topics. DANB certificants play a vital role in exam development, often serving on various exam committees.
Dental assistants, certificants, employers, state regulators, and others in the dental community can be assured that DANB always has and always will continue to meet the industry standards and best practices to uphold the value of its certifications for many years to come.
About the Author
Communications and Public Relations Manager
Dental Assisting National Board, Inc.