4.3 Qualified Dental Assistant Expanded Duties (Den 302.06 & 404.03)
Key Takeaways
- A dental assistant must be at least 18 years old to qualify in an expanded duty area by completing a course or challenging an exam (Den 302.06(a)).
- Traditional assistants need 200 hours of clinical assisting for the introduction, radiology, provisional crown and bridge, and orthodontic courses, and 400 hours for sealants, coronal polishing, nitrous oxide monitoring, and in-office whitening.
- The dental radiology course requires at least 8 lecture hours and 8 laboratory hours plus the DANB radiology exam, unless the assistant has practiced since before December 9, 1998 (Den 302.06(i)).
- Coronal polishing by an assistant uses a slow-speed handpiece of no more than 10,000 rpm, only after a dentist or hygienist confirms the teeth are free of calculus (Den 302.06(v)).
- Every qualified-assistant duty in Den 404.03, including radiography, sealants, and nitrous oxide monitoring, is performed under direct supervision.
Qualified Dental Assistant Expanded Duties
How an assistant becomes "qualified" — Den 302.06(a)–(g)
- An assistant 18 or older is qualified in a specific area after completing an expanded duty course, successfully challenging an examination in that area, or both.
- A course or exam given by an entity other than the Board must include the passing standard set by that entity.
- The assistant keeps the course records and completion certificate and provides them to the Board on request.
- Traditional assistants must first pass an introduction to dental assisting course and qualify in infection control before qualifying in any other area.
- No one is qualified until officially informed by the course or exam provider of successful completion (302.06(d)).
- Anyone may petition the Board to approve an expanded duty or equivalent course. The Board sends written approval or a request for more information within 60 days (302.06(c)).
Qualification courses at a glance
| Area | Traditional-assistant experience before the course | Minimum course | Key conditions once qualified |
|---|---|---|---|
| Infection control (302.06(b)) | None stated | 4 hours; follows current CDC recommendations; written exam | Prerequisite for sterilization and infection-control duties |
| Introduction to dental assisting (302.06(e)–(g)) | 200 hours | 6 hours: medical and dental histories, vital signs, oral and dental anatomy, charting, oral inspection, HIPAA; written exam | Prerequisite for all other expanded-duty courses |
| Dental radiology (302.06(h)–(j)) | 200 hours | 8 lecture hours (may be online) and 8 laboratory hours; asepsis and radiation safety; paralleling and bisecting techniques; full-mouth, panoramic, and extraoral projections; darkroom; landmarks and mounting; pass the DANB radiology exam; provider exam | Direct supervision |
| Provisional crown and bridge (302.06(k)–(m)) | 200 hours | 8 hours: provisional anatomy, occlusion, cementation; exam | Direct supervision; may fabricate intraorally, but all occlusal adjustments are made extraorally; the dentist examines the provisional before the assistant cements it |
| Orthodontics (302.06(n)–(p)) | 200 hours | 8 hours: separators, bracket bonding prep, band and bracket removal, band trial fitting, hand-instrument cement removal, headgear fitting, emergency adjustments, impressions, ligating wires, bending archwires; exam | Direct supervision |
| Sealants (302.06(q)–(s)) | 400 hours | 8 hours including chemical and light-cured sealants, isolation, lab practice, and application on an actual patient; exam | Direct supervision |
| Coronal polishing (302.06(t)–(v)) | 400 hours | 8 hours: handpiece maintenance, polishing agents and technique, infection control, history indications and contraindications, hands-on clinical polishing; exam. The rule states this course pathway for assistants other than graduate dental assistants | See conditions below |
| Monitoring nitrous oxide (302.06(w)–(y)) | 400 hours | 6 hours: pain and anxiety, respiratory physiology, CNS depression stages, N2O pharmacology, pros and cons, medical assessment, equipment, monitoring, reactions, hazards, complications; exam | Direct supervision; monitor only after the dentist initiates administration and brings the patient to the intended sedation level; current BLS-HCP |
| In-office tooth whitening (302.06(z)–(ab)) | 400 hours | 4 hours: prescription and non-prescription systems, mechanism, treatment methods, contraindications and side effects; exam | Direct supervision |
Assistants who have practiced radiography since before December 9, 1998 are exempt from the DANB radiology exam requirement (302.06(i)(3)f).
Coronal polishing conditions — Den 302.06(v)
- Use a slow-speed handpiece not exceeding 10,000 rpm with appropriate polishing agents and a rubber cup or bristle brush.
- Polish only after a dentist or dental hygienist has determined that the teeth are free of calculus.
- Work only under the direct supervision of a licensed dentist or dental hygienist.
- Never represent coronal polishing as a prophylaxis unless a dentist or hygienist determined the teeth were calculus-free immediately before the polishing.
The statute sets the outer limit. Board rules on coronal polishing by qualified assistants may not authorize a qualified dental assistant to perform a complete oral prophylaxis (RSA 317-A:12, XII-d).
Nitrous oxide monitoring by assistants from other states
An assistant qualified to monitor nitrous oxide in another jurisdiction qualifies by endorsement by showing equivalent training plus a letter from a supervising dentist attesting to monitoring experience within the previous 2 years (302.06(y)(4)).
The qualified-assistant duty list — Den 404.03
A dental assistant qualified under Den 302.06 performs these duties under direct supervision (Den 101.13):
- Dental radiography
- Pit and fissure sealants
- Orthodontic duties
- Fabrication of provisional crown and bridge restorations
- Coronal polishing
- Preliminary oral inspection
- Monitoring nitrous oxide administration
- In-office tooth whitening
Den 302.06(g) says completing the introduction course qualifies an assistant for the duties "set forth in Den 401.01 and Den 401.02." Those citations predate December 2025, when Document #14398 renumbered the assistant duty rules as Den 404.01 and 404.02.
Worked scenario
Tom is a traditional assistant with 300 hours of clinical experience. He has completed infection control and the introduction course and wants to (a) take the radiology course and (b) take the sealant course next month.
- (a) Radiology is open to him: the threshold is 200 hours. He must complete 8 lecture and 8 lab hours and pass the DANB radiology exam and the provider's exam. After that, he takes radiographs only under direct supervision.
- (b) Sealants is not yet open: he needs 400 hours of clinical assisting before taking the course.
A qualified dental assistant is coronal polishing a patient. Which condition is required by Den 302.06(v)?
A traditional dental assistant with 250 hours of clinical assisting experience asks to enroll in the Board-recognized sealant course. What does Den 302.06 require?
What must a traditional dental assistant complete to qualify in dental radiology under Den 302.06(i)?