Frequently Asked Questions

Following are common topics, and questions within those, regarding the EFDA program. If you have a question not answered, contact us.


Who do I contact about EFDA permits?

Expanded function permits are under the purview of the Missouri Dental Board. All questions pertaining to permits, including applications, renewals, duplicate permits, name changes, etc., should be directed to them at 573-751-0040 or

Must I have CE hours as an EFDA?

Every expanded function permit issued by the Missouri Dental Board shall be renewed every five years. Regardless of when you receive your permit, every permit holder is on the same renewal cycle. Current permits will expire as of February 29, 2028. 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.

Is there any type of "prorating" on the CE required if the permit was issued during the middle of a renewal cycle?

The answer depends on when your permit was issued. For any permits that are issued twelve (12) months or less from the expiration date of that permit, the permit holder shall only be required to obtain four (4) hours of board-approved continuing education to renew those permits. 

What if my EFDA permit has expired?

An expired permit can be renewed at any time within one (1) year of the permit expiration date. Any expired expanded functions permit that is not renewed within one (1) year of the expiration date shall be void. 

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

Dental assistants in Missouri may work without a permit. Only those assistants wishing to perform Expanded Functions must go through the certification process and apply for the EFDA permit through the Missouri Dental Board. 

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 shown 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 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 Missouri Dental Board at 573-751-0040.

I have lost my EFDA certificate required for a permit. 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 will always 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.

Note! If you took a course previously through Nichols Career Center, Ozarks Technical Community College or another CODA-accredited dental assisting program, you will need to contact that program directly to request your certificate.

  • State Technical College (formerly Nichols), 573-897-5348
  • Ozarks Technical Community College, 417-447-8832


What prerequisites are required to register for an EFDA course?

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

  • Completed and passed the Missouri Dental Assisting Skills (MDAS) exam through DANB.
  • Completed and passed the Certified Dental Assistant (CDA) or Certified Orthodontic Assistant (COA) (for Ortho EFDA only) exam through DANB.
  • For the Restorative II Course, the MDA requires assistants to have a Restorative I Permit, issued by the Missouri Dental Board, to register. 

Read more about the MDAS and CDA/COA here.

Are EFDA 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 work judged 'pass' or 'fail'. The best advice for someone taking an EFDA course is PREPARE, PREPARE, PREPARE! The courses are 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 take preparation seriously will succeed in getting certified as an EFDA.

What can you 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 I and Removable Prosthetics only)

Clinical sessions include:

  • Overview of instruments and materials
  • Step-by-step instruction of each function, with coaching from trainers
  • Competency testing on the expanded function procedures

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 a certificate of course completion.

Where can I find an MDA EFDA course near me?

The MDA schedules courses on a regular basis. Click here to view available dates.

Prior to January 2024, EFDA courses were scheduled at dental offices around the state before the MDA opened its Clinical Training Center at the MDA Executive office in Jefferson City. Now, all MDA EFDA courses are hosted at this location. The key to finding a course is looking ahead of time (all courses suggest at least a 6 week study period) and registering early, before the course fills up. Courses are listed one date at a time. As the specific course fills up or registration deadline passes, the next course date will be listed. 

Must I purchase a typodont with prepped teeth for the Restorative II course?

Each student who registers for the EFDA Restorative II course is required to use a new Columbia Dentoform M-PVR-1560 typodont. This cost is included in the total amount of the course registration.

The MDA will also 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 then refill the prepped teeth included, or students may purchase an additional set of prepped teeth from the MDA. Click for a form to purchase additional preps.

Must I purchase the Modern Dental Assisting eBook if I register for a course?

Purchase of the Modern Dental Assisting eBook is not required but is highly encouraged as the official text 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 reference will be noted.

To facilitate assistants/supervising dentists owning this text, the MDA offers Modern Dental Assisting as a Pageburst eBook for a reduced price. This has been negotiated with the book publisher, Elsevier, so that we may provide EFDA students with this excellent resource to assist in study for the course preparation, but also to accompany their life-long learning in the dental profession.

Click for an order form to purchase the Modern Dental Assisting eBook from the MDA.

Other Certifications

If I am certified as an EFDA in another state, 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 expanded functions 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 and CDA/COA certificate, or Basic Skills Certificate is required.

What is a CDA?

A Certified Dental Assistant (CDA) is a national certification designated by the Dental Assisting National Board (DANB). To become a CDA, you must meet the education and/or experience prerequisites, which currently are:

  • Graduate of a Commission on Dental Accreditation (CODA)-accredited dental assisting or hygiene program OR hold a Registered Dental Hygienist (RDH) license  OR
  • High school graduation or equivalent, minimum 3,500 hours dental assisting work experience accrued over a period of at least two to four years; must be verified by a licensed dentist … AND
  • Pass the Radiation Health and Safety (RHS), Infection Control (ICE) and General Chairside Assisting (GC) exams within a five-year period. The exams may be taken together or separately  … AND
  • Be CPR certified.
DANB certification is renewed on an annual basis. Renewal requirements include CPR certification, 12 hours of continuing education and paying a renewal fee. 

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

There are 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 allowed to teach expanded functions as a part of the dental assisting curriculum. That said, while all CODA-accredited programs are allowed 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.

Dental Assistant Duties

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

Dental assistants in Missouri may work without a permit. Only those assistants wishing to perform Expanded Functions must go through the certification process and apply for the EFDA permit through the Missouri Dental Board. 

Must you be an EFDA to apply sealants and fluoride, and do coronal polishing?

EFDA certification is not required for these procedures? A dentist may delegate to any dental assistant the following: polishing teeth, placing pit or fissure sealants, or applying topical fluoride.