The case for a universal dental assistant license in the United States
In a health-care system that strives for consistency, accessibility, and equity, there’s a glaring omission in dental care policy—the lack of a universal dental assistant license. Despite playing a vital role in delivering safe, efficient, and compassionate dental care, dental assistants in the US operate under a fractured regulatory framework that varies significantly by state.
This inconsistency undermines professional mobility, complicates hiring for dental practices, and ultimately affects the quality of patient care. It’s time to ask: Shouldn’t dental assistants be held to a standardized national credential just like nurses or radiologic technologists?
Dental assisting: A profession without a passport
Licensing and certification requirements for dental assistants differ dramatically across the 50 states. Some states, such as Minnesota and Oregon, require formal certification and continuing education for advanced duties. Others, like Alabama or Hawaii, have minimal regulatory standards.
This disparity means a dental assistant trained and certified in one state may be ineligible to perform the same duties when moving to another state, not because of competency, but because of bureaucratic barriers.
According to the Dental Assisting National Board (DANB):1
- Only 38 states recognize or require certification for expanded functions dental assistants.
- 12 states have no requirement for formal credentialing, even for invasive or technical procedures.
- Over 400,000 dental assistants are currently employed in the US, many of whom are affected by this fragmented system.
What message does that send to professionals committed to their field, or to patients expecting standardized care?
Quality of care and patient safety: What’s at stake?
Dental assistants aren’t just “extra hands”—they’re essential partners in clinical procedures, infection control, radiographic imaging, and patient communication. Inconsistent training standards can lead to variability in sterilization techniques and infection prevention, radiographic image quality and radiation safety, emergency response protocols, and chairside assistance during surgical procedures.
From a patient’s perspective, a dental visit in Texas should offer the same level of safety and professionalism as one in Massachusetts. Right now, that’s not guaranteed.
Dental assistant workforce mobility: A national need
The US Bureau of Labor Statistics projects 7% growth in dental assistant jobs from 2022 to 2032, faster than the national average. But growth means little if professionals are trapped by geography.2
Consider this: a certified dental assistant from Arizona relocates to Maryland to support a spouse’s military transfer. Despite years of experience and continuing education, they may face delays in recredentialing, redundant coursework or exams, or temporary underemployment or job loss.
This isn’t just inefficient; it’s unjust. A universal license would facilitate interstate mobility, allowing skilled professionals to meet shifting health-care needs, especially in rural or underserved areas where staffing shortages are most acute.
Economic and operational efficiency within the dental profession
Redundant credentialing costs time and money, not only for assistants, but for dental practices, state boards, and educational institutions. According to DANB, assistants can spend upwards of $1,000 on state-specific exams, fees, and retraining, not including lost wages.3
For employers, inconsistent regulations mean hiring delays, onboarding challenges, and legal uncertainty about who is allowed to do what in the operatory. A universal license would reduce this administrative burden, streamline hiring practices, and foster a more flexible, responsive dental workforce.
A national standard for DAs is within reach
What’s the solution? It’s a nationally recognized, portable dental assistant license, based on a core set of standards for education, ethics, safety, and clinical competence. This could be administered through an expanded role for the ADAA or under the umbrella of a national accrediting body similar to the National Council of State Boards of Nursing (NCSBN).
Benefits would include a clear career path for students entering the field, enhanced credibility and respect for dental assistants, a stronger, more unified dental workforce, and improved consistency in patient care across the country.
We must ask: why do we hold different standards for dental assistants based solely on state lines? How can we expect excellence in care when the professional standards behind that care vary so widely? What could a unified system mean for the future of dental health access in America?
Dental assistants are more than support staff—they’re trained professionals who deserve recognition, mobility, and respect. A universal dental assistant license isn’t just a policy proposal; it’s a commitment to equity, safety, and progress in oral health care.
Let’s hope the dental profession can soon move toward a system that supports the professionals behind the smiles, no matter where they practice.
References
1. 1. DANB exam content validation study summary reports. Dental Assisting National Board Inc. August 2, 2921. Accessed June 16, 2025. https://danbsfprodassets.azureedge.net/assets/docs/default-source/content-validation-study-reports/danb-exam-content-validation-study-2021-summary-reports.pdf?sfvrsn=2fd5d416_3
2. 2. Occupational Outlook Handbook. Dental Assistants. US Bureau of Labor and Statistics. Last modified April 18, 2025. Accessed June 15, 2025. https://www.bls.gov/ooh/healthcare/dental-assistants.htm
3. 3. State dental assisting requirements. Dental Assisting National Board Inc. Accessed June 16, 2025. https://www.danb.org/state-requirements
