Pathways to DAND certification

Aug. 24, 2009
Dental assistants interested in taking the DANB CDA exam must meet certain prerequisites, called “eligibility pathways.” Determining eligibility pathways is a challenging task, but DANB has conducted extensive research and surveys to ensure its exams meet the highest standards.

More than 32,000 dental assistants have enhanced their careers by becoming Certified Dental Assistants (CDAs) through the Dental Assisting National Board, Inc. (DANB). Dental assistants interested in taking the DANB CDA exam must meet certain prerequisites, called “eligibility pathways.” Determining eligibility pathways is a challenging task, but DANB has conducted extensive research and surveys to ensure its exams meet the highest standards.

About the CDA exam

The DANB CDA exam is made up of three component exams: Radiation Health and Safety (RHS), Infection Control (ICE), and General Chairside Assisting (GC). A dental assistant can take all three component exams at once in the full CDA exam, or take the component exams separately. However, the dental assistant must pass all three components within a five-year period to earn the CDA Certification mark, and then meet DANB recertification requirements to maintain it.

The RHS and ICE component exams have no eligibility requirements. Anyone can take these exams. Those interested in taking the full CDA exam (all three components) or the GC component of the CDA must meet some prerequisites to be eligible.

Currently, there are three eligibility pathways for those who want to take the GC or full CDA exams. Graduates of dental assisting or dental hygiene programs accredited by the Commission on Dental Accreditation (CODA) can apply to test through Pathway I, while on-the-job-trained dental assistants can apply to test through Pathway II. Former CDAs, as well as U.S. or foreign-trained dentists, can apply to test through Pathway III. All CDA and GC exam candidates must hold a current DANB-accepted cardiopulmonary resuscitation (CPR) certificate.

Which path is right for you?

Pathway I

  • Graduate from a CODA-accredited dental assisting or dental hygiene program


Pathway II

  • Hold a high school diploma or GED
  • Accrue 3,500 hours’ work experience as a dental assistant over a continuous two- to four-year period, which must be verified by a dentist/employer


Pathway III

  • Status as a current or former DANB CDA, or a U.S. or foreign-trained dentist


Importance of eligibility pathways

DANB is a member of the National Organization for Competency Assurance (NOCA). The National Commission For Certifying Agencies (NCCA), a NOCA Commission with responsibility for accrediting credentialing programs, has evaluated DANB national certification exam programs, and found that DANB programs meet NCCA’s highest standards, thus helping to assure validity, reliability, and objectivity in the testing process.

To ensure compliance with the NCCA Standards for the Accreditation of Certification Programs, DANB monitors the exam performance of candidates from different eligibility pathways. All candidates should have a statistically equivalent opportunity to pass DANB national exams. Although the NCCA Standards do not require alternative pathways in all situations, they recommended that certification programs have a standardized means of evaluating the equivalence of education. For DANB, Pathway I for graduates of CODA-accredited programs is considered the standard educational pathway. Currently, no states have mandatory education requirements for dental assistants. Therefore, without the alternative Pathway II and Pathway III options, DANB risks restricting accessibility to its exams for the substantial segment of the approximately 286,000 dental assistants in the United States who are unable to meet the requirements of the educational pathway.

In addition, the American Dental Association House of Delegates, in its Current Policies for Allied Dental Education and Personnel (“Maintenance of Multi-Pathway Options for Dental Assistants” [1996:696]) has resolved that more than one pathway will always be available for a candidate to become a dental assistant, including any new category of dental assistant that may be created in the future. While this ADA policy is likely to apply conceptually to support multiple overall pathways to a career as a dental assistant, and since the DANB CDA exam or CDA component exams are recognized as meeting dental assisting requirements in 38 states and the District of Columbia, offering alternate, empirically equivalent eligibility pathways to CDA certification supports this ADA policy in practice.

Determining eligibility pathways

DANB is recognized by the American Dental Association (ADA) as the national certification agency for dental assistants. This means that DANB meets the “Criteria for Recognition of a Certification Board for Dental Assistants,” as set forth by the ADA’s Council on Dental Education and Licensure (CDEL). Under CDEL’s criteria, the main eligibility pathway for certification is the completion of a CODA-accredited dental assisting program. DANB’s Pathway I meets this criterion.

CDEL’s criteria also include a waiver for recognizing candidates who do not meet the educational training requirement. To determine appropriate requirements for CDA/GC exam eligibility for Pathway II, DANB conducted a three-year study from 1984 to 1986 that demonstrated that on-the-job-trained dental assistants with at least 3,500 hours of work experience passed the GC component of the CDA exam at a rate equivalent to the passing rate of CODA-accredited dental assisting program graduates. Since 1986, Pathways II and III have allowed access to the full CDA exam and the GC component exam for individuals who have not graduated from a CODA-accredited dental assisting program.

The NCCA recommends conducting pilot studies to assess statistically equivalent pass rates before implementing any new eligibility pathways. Like the pilot study that led to Pathway II, DANB conducted a three-year pilot study before implementing any new pathways. DANB’s Board of Directors is currently gathering information from its communities of interest to provide to CDEL to consider the implications of conducting a new CDA/GC exam eligibility pilot study. Pending feedback from all DANB communities of interest, including CDEL, the DANB Board of Directors may decide to initiate a three-year pilot study of a new exam pathway, called the CDA/GC Exam Pilot Pathway. This three-year pilot study could begin as early as January 2010.

If the study is conducted, DANB will accept CDA/GC exam applications from graduates of DANB-approved dental assisting vocational-technical programs that also have one year of dental assisting work experience. DANB would use the pilot study exam pass rate data to determine whether dental assistants who test under the pilot pathway pass the CDA/GC exam at a rate equivalent to those testing under the current pathways. If the pass rate were not found to be statistically equivalent, the CDA/GC Exam Pilot Pathway study would then conclude with no further opportunity for testing under the pilot study. However, if participants passed the CDA/GC Exam Pilot Pathway study at a statistically equivalent rate, the pilot pathway would then become an additional exam eligibility pathway.

With NCCA Accreditation of DANB’s CDA (and Certified Orthodontic [COA]) certification programs, and DANB’s recognition by the ADA as the national certification agency for dental assistants, DANB must maintain high standards when determining alternate eligibility pathways for exams. These standards help DANB accomplish its mission of creating visible, valuable, and accessible exams, and of serving the public good by providing a means of identifying qualified and competent dental assistants and measuring and promoting excellence in oral health-care delivery.

If you are interested in taking one of DANB’s national exams and need help determining the right eligibility pathway for you, please call 1-800-FOR-DANB or e-mail [email protected].