There are two basic classes of dental assistants recognized by the Tennessee Board of Dentistry:
- Practical Dental Assistants – those training in a dental office
- Registered Dental Assistants – those that have met Tennessee Board of Dentistry education and experience requirements
Licensed and registered dentists in Tennessee are permitted by law to assign duties to Practical Dental Assistants and Registered Dental Assistants so long as the duties are aligned with the assistants’ professional purview.
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These duties must be conducted under the supervision of a dentist except in authorized public health programs, and cannot include the following:
- Duties that require the professional skill or judgment of a dentist
- Duties that infringe on specific tasks that may only be assigned to a dental hygienist
- Diagnosis and treatment planning
- Oral surgery or the cutting of hard and soft tissue
- Placing of permanent fillings
- Administration of a general or local anesthetic
- Administration of nitrous oxide
Dental Assistant Schools in Tennessee
There are nine dental assistant schools in Tennessee that are accredited by the American Dental Association (ADA), with even more programs approved by the Tennessee Board of Dentistry.
ADA programs are located in the following cities:
- Chattanooga
- Nashville
- Murfreesboro
- Memphis
- Knoxville
- Kingsport
- Gallatin
- Dickson
Both practical and registered dental assistants are authorized to perform a range of duties under the supervision of a dentist. Registered Dental Assistants have the additional option of gaining certifications from the Tennessee Board of Dentistry in six areas of specialization:
- Dental Radiology
- Coronal Polishing
- Monitoring Nitrous Oxide
- Sealant Application
- Prosthetic Function
- Restorative Function
Earning these certifications will typically involve completing Board-approved education in the specific area of certification and may involve additional qualifications that will be explored below in detail.
Becoming a Registered Dental Assistant in Tennessee
Registered Dental Assistants are professionals who have gone through a registration process with the Tennessee Board of Dentistry. To become a Registered Dental Assistant candidates will need to meet the following requirements:
- Obtain two letters of recommendation from licensed dental professionals that attest to the candidate’s good moral character
- Obtain a CPR certification through any of the following courses:
- Basic Life Support (BLS) Healthcare Provider course
- CPR/AED for the Professional Rescuer
- Equivalent course that includes a skills exam on a manikin
- Have proof of graduation from high school or a GED program
- Be legally permitted to work in the United States
Once candidates have met these requirements they may complete an Application for Registration as a Dental Assistant, and return this and any relevant application material to the Tennessee Board of Dentistry in Nashville. Candidates also have the option of submitting an Application for Certification in six different areas of specialization:
- Coronal Polishing Certification
- Sealant Application Certification
- Monitoring Nitrous Oxide Certification
- Restorative Function Certification
- Prosthetic Function Certification
- Dental Radiology Certification
If candidates have already completed courses in these through a nationally-recognized dental assistant certification program they may also be qualified to submit an application for certification in these areas, as may candidates who hold equivalent certifications in different states.
Coronal Polishing Certification
To earn this certification, Registered Dental Assistants must complete an approved course that includes the following:
- A course of study that is 14 hours long over a two-day period, including:
- Didactic study of:
- Principles of stain and plaque formation
- Clinical appearance of plaque, calculus, and clean polished teeth
- Tooth morphology and the anatomy of the oral cavity
- Principles of polishing
- Principles of aseptic technique
- Principles of application, and preparation of teeth for, fluoride treatment
- Clinical study of:
- Polishing exposed teeth surfaces
- Identification of plaque, calculus, and stains
- Application of fluoride and desensitization agents
- Jurisprudence study of:
- Limits of practice in accordance with the statutes and rules of the Tennessee Board of Dentistry
- Reporting violations
- Penalties relating to dental malpractice
- Final written and clinical examinations
Sealant Application Certification
To earn this certification, Registered Dental Assistants must complete an approved course that includes the following:
- At least six hours of instruction, including at least four hours of clinical instruction
- Didactic instruction that includes:
- Indications and contra-indications for sealants
- Education of patients and/or parents of sealant purpose
- Preparation of teeth for sealants
- Teeth isolation and moisture control techniques, such as rubber dams, dri-angles, cotton roles, and retractors
- Armamentarium
- Clinical instruction that includes:
- Patient assessment and patient education
- Infection control
- Sealant placement evaluation
- Placement of pit and fissure sealants
- Final written exam that includes successfully sealing four teeth
Monitoring Nitrous Oxide Certification
To earn this certification, candidates must complete a Board-approved course of education that is at least five hours in length. Registered Dental Assistants or students enrolled in an American Dental Association-approved course of study are permitted to register for this course, which will include the study of:
- Psychology, philosophy, and history of nitrous oxide sedation by inhalation
- Physiological and psychological aspects of pain and anxiety
- Stages of drug-induced central nervous system depression
- Anatomy and physiology of respiration
- Physiological and pharmacological effects of nitrous oxide inhalation
- Advantages and disadvantages of nitrous oxide sedation
- Prevention and management of life-threatening situations arising from nitrous oxide inhalation
At the end of the course students must pass a cumulative final exam.
Restorative Function Certification
To earn this certification candidates must complete an approved course in expanded restorative functions. To be eligible to enroll in this course applicants must be a Registered Dental Assistant with at least two years of continuous and full time employment as such within the preceding three years. The course must consist of at least 96 hours that are taught over the course of three weeks, and include:
First week:
- Dental occulution and morphology
- Dental product safety and hazardous materials
- Principles of cavity preparation
- Instrumentation for restorations
- Bases and liners, placement and types
Second week:
- Rubber dam placement and isolation
- Caries
- Insertion, carving, and packing of amalgam, including a lab on this topic
- Placement and selection of matrix retainers
Third week:
- Carving, insertion, and packing of glass ionomers
- Laboratory on the carving, insertion, and packing of glass ionomers
At the end of each week students will need to complete a cumulative exam. Students must also complete a final clinical exam.
Prosthetic Function Certification
To earn this certification candidates must complete an approved course in prosthetic function. To be eligible to enroll in this course candidates must be a Registered Dental Assistant with at least two years of continuous and full time employment as such in the past three years. The course will last for at least 64 hours over the course of at least two weeks, and include:
First week:
- Anatomy and physiology
- Dentulous soft tissue, such as the gingival sulcus
- Edentulous soft tissue
- Principles of soft-tissue management
- Tray selection and impression materials
- Master impressions and border molding
- Fixed prosthodontic impressions
Second week:
- Methods of gingival retraction
- Pharmacology of medicaments and techniques for placement
- Techniques of making impressions
- Laboratory practice for fixed impressions with infection control techniques
- Fabrication, placement, and polishing of temporary restoration
At the end of each week students will need to pass a cumulative exam. At the end of the course students will also need to pass a final exam.
Dental Radiography Certification
To become certified in radiography candidates will need to pass an approved course of study. This course is open to Registered Dental Assistants or students who are completing a Board-approved or American Dental Association-accredited dental assistant training program. This certification course must be at least 14 hours in length and include the study of:
- Radiographic exposure and evaluation techniques
- Radiographic equipment
- Patient management techniques
- Radiation safety for the patient and operator
- Quality assurance
- Exposure errors
- Mounting and labeling radiographs for diagnostic assessments
Upon completion of the course students must then pass a final exam.
Maintaining Dental Assistant Certifications in Tennessee
Except during a Registered Dental Assistant’s first renewal cycle, every two years these professionals must earn at least 24 hours of continuing education by taking courses approved by the Tennessee Board of Dentistry. At least two of these hours must be related to chemical dependency education. In general, these courses should contribute to a greater understanding in the field of dentistry, and specifically relate to the duties carried out by advanced dental assistants.
The continuing education must be completed prior to the expiration of a Registered Dental Assistant term, which occurs biannually.
While researching how to become a dental assistant in Tennessee, candidates may also find additional resources on this topic, continuing education, and employment through professional organizations such as the Tennessee Dental Assistants’ Association (TNDAA).