How to Become a Dental Assistant in North Carolina

Who can apply

• North Carolina does not certify or license dental assistants. Assistants are classified as Dental Assistant I (DA I) or Dental Assistant II (DA II) based on training and experience, and the employer verifies which one you are.
• Every DA I and DA II must keep an unexpired CPR certification at all times while performing permitted functions (21 NCAC 16H .0102 and .0104).
• No dental assistant may take x-rays before completing radiology training that meets G.S. 90-29(c)(12).

Step by step

1. Get CPR certification and keep it current.
2. Start as a Dental Assistant I: chairside assisting, oral hygiene instruction, topical fluoride and topical anesthetics.
3. To take x-rays, finish a Board-recognized dental radiology course (at least 7 hours lecture and 14 hours lab, passed at 80%), unless you are a DANB CDA or a graduate of an ADA-accredited dental assisting or hygiene program.
4. Qualify as a DA II through one route: a CODA-accredited dental assisting program, one school year of a CODA-accredited hygiene program, the military program at the Medical Education & Training Campus, the DANB CDA exams, or two of the past five years (3,000+ hours) as a DA I plus 3-hour courses in infection control and office emergencies.
5. Before polishing with a slow-speed handpiece, a DA II completes a coronal polishing course of at least seven clock hours.
6. Give your employer proof of your training, CPR and radiology course so they can classify you.

Training and exam

Training: Radiology: a Board-recognized course with at least 7 hours of didactic instruction and at least 14 hours of lab on manikins, with no more than six students per instructor (21 NCAC 16H .0105, amended August 1, 2026). DA II: one of the routes in 21 NCAC 16H .0104, including the 3-hour sterilization and infection control course and 3-hour dental office emergencies course from Board-approved sponsors for the experience route. Coronal polishing: at least 7 clock hours, taught in an ADA-accredited program or by a licensed NC dentist or hygienist. Nitrous oxide: assisting needs a Board-recognized program of at least seven clock hours (G.S. 90-29(c)(13)).

Exam: There is no state licensing exam. To take x-rays you must pass the radiology course exams: at least 80% on a radiation safety written exam before taking x-rays in the lab, 80% on the written exam after the lecture portion, and 80% on a final lab exam that includes a full-mouth series on a manikin. Assistants who took a qualifying radiology course (7 hours lecture + 7 hours clinical) in another state may instead request an equivalency exam from a course instructor; if you fail it, you must take a full NC course. The DANB CDA exams are one route to DA II.

What it costs in North Carolina

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: None with the state. Your CPR certification must stay unexpired while you work as a DA I or DA II.

Good to know in North Carolina

Who may take x-rays without a course: A DANB Certified Dental Assistant or a graduate of an ADA-accredited dental assisting or dental hygiene program may take x-rays without further examination. Everyone else, including people moving from another state, must complete a Board-recognized course or pass an equivalency exam.

DA II duties: Under the dentist's direct control and supervision, after the dentist examines the patient and prescribes the procedure, a DA II may do 29 listed tasks, such as sealants on teeth that need no drilling, rubber dams, temporary restorations, retraction cord, suture removal, coronal polishing and exposing x-rays and cone beam images. All delegated procedures must be reversible.

Training before DA II hours: A DA I who has finished the two 3-hour courses but not the 3,000 hours may be trained by a dentist and perform DA II functions under the dentist's direct control and supervision.

Coronal polishing is not a cleaning: A coronal polish may not be represented to the patient as a prophylaxis, or billed as one unless a dentist checked for calculus and a dentist or hygienist removed it.

What no dental assistant may do: Neither a DA I nor a DA II may perform a prophylaxis, periodontal screening or probing, removal of hard or soft deposits (except coronal polishing as allowed), sulcular irrigation, root planing, or use ultrasonic scalers; apply antibiotic-coated materials, resorbable antimicrobial agents or oral cancer screening products; or use laser fluorescence cavity detectors (21 NCAC 16H .0205).

Sources

• NC State Board of Dental Examiners - Dental Assisting
• 21 NCAC 16H - Dental Assistants (NC Office of Administrative Hearings)
• N.C. Gen. Stat. 90-29 (NC General Assembly)