How to Become a Dental Assistant in New Hampshire

Who can apply

• New Hampshire does not license basic dental assistants. Any dental assistant may do the basic duties in Den 404.01, such as seating patients, processing x-rays, retracting tissue, suction, placing topical anesthetic, applying topical fluoride after a prophylaxis and taking vital signs. A traditional assistant must first qualify in infection control before processing and sterilizing instruments.
• An assistant 18 or older becomes qualified in specific added duties by completing Board-approved expanded duty courses (Den 302.06).
• A traditional dental assistant (not DANB-certified and not a graduate of a CODA-accredited program) needs 200 hours of clinical dental assisting experience before taking the introduction to dental assisting course, which must come before any other expanded duty course.
• Traditional dental assistants must also qualify in infection control with a course of at least 4 hours that follows the CDC infection control recommendations and ends with a written exam.
• To take x-rays you must complete a dental radiology expanded duty course and pass DANB's radiology written exam (assistants practicing since before December 9, 1998 are exempt from the DANB exam).

Step by step

1. Get hired by a New Hampshire-licensed dentist.
2. If you are a traditional dental assistant, log 200 hours of clinical dental assisting, then pass a 6-hour introduction to dental assisting course and a 4-hour infection control course.
3. Take the dental radiology expanded duty course (at least 8 lecture hours, which may be online, and 8 lab hours) and pass DANB's radiology exam and the provider's written exam.
4. Add other duties with their own courses: provisional crowns and orthodontics (200 hours of experience first), and sealants, coronal polishing, nitrous oxide monitoring and in-office whitening (400 hours first).
5. Keep your course completion certificates; the Board can ask to see them.
6. Optional: with 4,500 clinical hours and DANB CDA or CODA graduate status, complete the EFDA restorative course and register for an EFDA permit.

Training and exam

Training: Each expanded duty requires a course from an approved provider that ends with a written exam: introduction to dental assisting (6 hours; covers histories, vital signs, anatomy, charting, oral inspection and HIPAA), infection control (4 hours), dental radiology (8 lecture + 8 lab hours), provisional crown and bridge (8 hours), orthodontics (8 hours), sealants (8 hours), coronal polishing (8 hours), nitrous oxide monitoring (6 hours) and in-office whitening (4 hours). Traditional assistants need 200 hours of clinical experience before the introduction, radiology, provisional crown and orthodontic courses, and 400 hours before the sealant, coronal polishing, nitrous oxide and whitening courses. You are not qualified until the provider officially tells you that you passed.

Exam: The dental radiology course requires passing DANB's radiology written exam, except for assistants practicing since before December 9, 1998, plus the course provider's written exam. Every expanded duty course ends with a written exam set by the provider. There is no state licensing exam for basic assisting.

What it costs in New Hampshire

Fixed amounts are set by the state. Items marked “your quote” are priced by private sellers, so enter what you’re quoted.

Keeping your credential

Renewal: Expanded duty qualifications do not need renewing. An EFDA permit must be renewed in odd-numbered years before May 1 if you keep working as an EFDA, with 10 CEUs in restorative dentistry each biennium.

Good to know in New Hampshire

Supervision: Radiology, provisional crowns, orthodontic duties, sealants, nitrous oxide monitoring and whitening must be done under a licensed dentist's direct supervision. Coronal polishing must be under the direct supervision of a dentist or hygienist, only after they confirm the teeth are free of calculus, using a slow-speed handpiece of no more than 10,000 rpm.

Graduates and DANB CDAs: Graduates of CODA-accredited dental assisting programs and DANB Certified Dental Assistants are not 'traditional dental assistants', so the 200- and 400-hour experience prerequisites and the introduction course requirement apply only to traditional assistants.

Nitrous oxide: An assistant qualified to monitor nitrous oxide may monitor only after the dentist starts it and brings the patient to the intended level, must hold current BLS for Healthcare Providers, and may qualify by endorsement with equivalent out-of-state training plus a dentist's letter on experience in the past 2 years.

Course approval: Any dental assistant may petition the Board to approve an expanded duty or equivalent training course. The Board responds within 60 days.

EFDA permit: An EFDA places, contours and adjusts direct restorations. You need to be a DANB CDA, a CODA graduate or a hygienist, have 4,500 clinical hours, a NH dentist's recommendation and BLS-HCP, then complete a CODA-accredited course (50 didactic + 100 pre-clinical hours) followed by 120 hours of supervised office training. A practice may employ no more than 2 EFDAs. Dental assistants who are not CODA graduates must also be qualified in preliminary oral inspection before the course, and the dentist must tell the Board within 10 days of employing an EFDA.

Duties without a course: Rules readopted December 2, 2025 (Den 404.01) let any assistant, with no course, do tasks such as sterilizing instruments, taking vital signs and oral hygiene instruction (general supervision), and retracting tissue, suction, placing cotton rolls and topical anesthetic, applying fluoride after a prophylaxis, handling impression trays and intraoral scanning (direct supervision).

Extra duties for CDAs and CODA graduates: DANB CDAs and CODA graduates may also take histories, place and remove rubber dams and matrices, do pulp vitality tests and remove sutures. After 400 clinical hours they may make final impressions, place liners and bases, place and remove retraction cord and temporary restorations, cement bands and bond brackets, and make bite registrations (Den 404.02).

Sources

• N.H. Admin. Rules Den 100-500 (Den 101 definitions, Den 302.06 Dental Assistant Qualification in Specific Area, Den 302.07 EFDA) - NH General Court
• N.H. Admin. Code Den 302.06 (Cornell LII)