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Frequent Questions

Following are some of the common questions received by the MDA regarding the EFDA program and related topics. If you have a question you don't see answered, please ask us and we'll get you an answer.


Must all EFDA permit holders have the 16 CE hours by March 1, 2018 in order to renew their permit with the Missouri Dental Board? Is there any type of "prorating" on the CE required (if the permit was recently received, or issues during the middle of a renewal cycle, will the Dental Board require fewer hours)? Yes. Every Expanded Function Permit will need to be renewed by March 1, 2018. In order to renew a permit, the permit holder must show that they have obtained 16 hours of CE during the previous 5 years, regardless of how long they have had the permit.  


Do I have to have an EFDA permit to work as a dental assistant?

The new rule regarding EFDA permits DOES NOT require that all assistants must become Expanded Functions certified to work as a dental assistant. Only assistants who CURRENTLY have certification in Expanded Functions need to (and can) apply for the EFDA permit through the Missouri Dental Board. An assistant who is not presently Expanded Functions certified is not affected by this rule and will not need to do anything additional, unless, of course, they wish to be delegated expanded function duties by their dentist. In this case, they first will need to take the required expanded functions course(s) and then apply for permits.


What prerequisites are required to register for an EFDA course?

In order to register for an expanded functions course, you must have done one of the following:

  • Completed and passed the Missouri Basic Skills Mastery exam
  • Completed and passed the Certified Dental Assistant/Certified Orthodontic Assistant exam through DANB
  • For the Restorative II Course, the MDA requires assistants have a Restorative I Permit, issued by the Missouri Dental Board, in order to register


If I am certified in another state as an EFDA, can I perform expanded functions in Missouri?

Certification to perform expanded functions in another state does not qualify an assistant to perform expanded functions in Missouri nor take a Missouri EFDA course. The Missouri Dental Board does not currently offer reciprocity with EFDA and an EFDA certified assistant from another state must follow the same pathway as a non-EFDA in Missouri.


I am a Registered Dental Assistant. Can I take EFDA courses?

Missouri and other state's dental assisting programs may state that graduating assistants are certified as a Registered Dental Assistant or may be eligible to sit for a Registered Dental Assistant examination; however, an RDA is not recognized by the Missouri Dental Board in that they cannot automatically enroll in expanded functions courses—a CDA/COA certificate or Basic Skills Certificate is required.


What is a CDA?

A Certified Dental Assistant is a national certification designated by the Dental Assisting National Board (DANB). DANB certification is current for one year. To maintain certification, you must renew annually. Requirements include CPR certification, 12 hours of continuing education and paying a renewal fee. In order to become a CDA, you must meet the education and/or experience prerequisites, currently:

  • Graduation from a CODA Accredited Dental Assisting or Dental Hygiene Program and CPR certification
  • High school graduation or equivalent, Minimum of 3,500 hours work experience as a dental assistant, accrued over a period of at least two years to a maximum of four years and CPR certification
  • Pass DANB's Certified Dental Assistant (CDA) Examination, which is comprised of component exams covering Radiation Health and Safety (RHS), Infection Control (ICE), and General Chairside Assisting (GC)
  • Be CPR certified


Are the courses difficult? I am worried I may not pass.

Some assistants are fearful of classroom testing and of failure. Many have not been in a study environment for years and feel intimidated by written tests and by having their worked judged 'pass' or 'fail'. The best advice for someone taking an EFDA course is PREPARE, PREPARE, PREPARE! The course is rigorous but we give you everything you need to ensure you will do well. If you don't study and prepare, then expect that you may struggle throughout the process. Those who are committed to the program and who persevere will succeed in getting certified as an EFDA.


What can I expect from an EFDA course?

There are two components to all EFDA courses:

  • Required pre-work completed through online modules
  • Hands-on competency testing at the clinical session

Online coursework includes:

  • A separate Module for each of the expanded functions being taught
  • Presentation slides, comprised of text, photos, illustrations and instructional videos
  • Accompanying online practice quiz for each Module
  • Outline and Skills Standards (PDF) of the online instruction
  • Prerequisite Written Exam (Restorative and Removable Prosthetics only)
  • Clinical sessions include:
  • Overview of instruments and materials
  • Step-by-step instruction of each function, with coaching from lead/associate trainers
  • Skills Assessment developed for each expanded function


Do I have to take a written test at the clinical session?

No, there is no written test at the clinical session. However, students will be assessed, by calibrated dentists, on the proficiency of their skills. Students must demonstrate a certain, minimal competency in these procedures to receive certificate of course completion.


I graduated from a Missouri dental assisting program, but still can't be delegated expanded functions. Why?

There are many, many dental assisting programs around the state, but not all are created equal. Many dental assistants enroll in a non-CODA accredited program with the belief that upon completion, additional duties (expanded functions) could be delegated. The reality is that a dental assistant who has completed a non-CODA accredited program cannot perform any other duties than can be performed by a dental assistant who has had no formal training (on the job only). Only CODA-accredited programs are eligible to teach expanded functions as a part of the dental assisting curriculum. That said, while all CODA-accredited programs are eligible to teach expanded functions, not all do. Make sure to research the available options and look closely into each program, its coursework and certifications/diplomas.


Can Expanded Function dental assistants apply sealants?

Yes. In the 2013 legislative session, the General Assembly passed Senate Bill 330, which allows dentists to delegate to all assistants the tasks of placement of pit or fissure sealants and application of topical fluoride under the dentist's direct supervision. No additional training or educational requirement is needed. The bill took effect on August 28, 2013.


Where can I find an EFDA course near me?

The Missouri Dental Association schedules courses on a regular basis at dental offices around the state. Approved Missouri educators also provide courses on a regular basis at their educational institution. The key to finding a course is looking ahead of time (all courses suggest at least a 6 week study period) and registering early. Click here to find scheduled courses.


I have lost my EFDA certificate. Can I get another one?

Individuals who took an MDA-sponsored EFDA course may request duplicate certificates if originals have been lost/destroyed or if a name change has occurred. Please note that your certification always will be on record under the name with which you registered for the course at that time, but you may request a new certificate with a name change due to marriage, divorce, etc. Please complete the Request for Duplicate Certificate and return to the MDA with the appropriate fee. Please Note! If you took a course through Nichols Career Center or Ozarks Technical Community College or a CODA accredited dental assisting program, you will need to contact them direct to request your certificate. Nichols Career Center 573-659-3112 / Ozarks Technical College 417-447-8832


I have questions about displaying my permit: Does the permit need to be visibly displayed in the office or does it only need to be showed if asked? If it does need to be displayed, and I work in two different locations, can I simply make a copy of it for each location or am I required to have additional originals on display?

The Dental Board Rule (section 4(B)) states: (B) The board shall issue the appropriate expanded functions permit upon receipt of a completed application form, payment of the appropriate fee specified in 20 CSR 2110- 2.170, and proof of competence as defined in subsection (1)(I) that the dental assistant has complied with the requirements of subsection (4)(A) of this rule. The requirements of this section must be completed within one (1) year of the date of submission of the application form. The board-issued expanded functions permit must be displayed in plain view in any facility where the dental assistant will be providing expanded functions prior to delegation of expanded functions to that dental assistant.


If you need the permit displayed in more than one location, you can simply make a copy of it for display. However if you wish to have an official duplicate, you may contact the Dental Board to request. The Board will provide up to two duplicate permits; after this limit there is a $5/duplicate permit. You may contact the Dental Board at 573-751-0040.


Is it true that I have to have continuing education hours as an EFDA?

Yes, on February 28, 2013 a new rule went into effect, that states: Every expanded functions permit issued by the Board shall be renewed every five years. In order to renew an expanded functions permit, the dental assistant must complete 16 hours of CE and must have BLS certification, which can count toward this total. The renewal fee is not established yet.


I want to register for the Restorative II course. Is it true that I have to purchase a typodont with prepped teeth for this course?

Each student who registers for the EFDA Restorative II course is required to purchase a Columbia Dentoform M-PVR-1560 typodont. This cost is included in the total amount of the course registration. The MDA will provide, as a part of the course fee, one set of prepped teeth to practice 10 different restorations. Students may have their doctors drill out preps and refill the prepped teeth included, or students may purchase an additional set of 10 prepped teeth for $40. Call the Mandy at the MDA at 573-634-3436 to purchase an additional set of teeth.


Is it true that I have to purchase a Modern Dental Assisting textbook if I register for a course?

Purchase of the Modern Dental Assisting is not required, but is highly encouraged as the official textbook recommended by the MDA EFDA Program for all courses offered. We recommend assistants own a personal copy or have a dental office copy they can access for additional information related to topics discussed and procedures shown. Where applicable throughout the curriculum, the Modern Dental Assisting references will be noted. The MDA has chosen to offer an eBook because of the additional resources it provides. More than just words on a screen, Pageburst eBooks come loaded with a variety of interactive and time-saving study features—like highlighting, note taking and sharing, powerful searching capability and a personalized study guide creator. Click here to learn more and to purchase Modern Dental Assisting from the MDA at a reduced price.