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What Is an EFDA, and What Can One Actually Do?

An EFDA is a dental assistant a state has authorized to perform additional reversible procedures beyond basic chairside assisting, most often placing and finishing restorations the dentist has already prepared. It is entirely a creature of state law. The title varies by state, and so do the duties: Pennsylvania and Ohio EFDAs place restorative material, California RDAEFs have the broadest scope in the country, North Carolina prohibits final restorations to every assistant level, and some states have no expanded function credential at all. There is no national EFDA credential and no reciprocity between states.

EFDA is one of the most confusing terms in dentistry, because it is not one thing. It is a shorthand for whatever additional duties a particular state has decided a trained assistant may perform, and states have decided very differently. This guide explains what the credential generally is, what it usually lets you do, and why the answer to what can an EFDA do always has to start with which state.

The general idea

A dentist diagnoses, administers anesthetic, and prepares the tooth. In a state with expanded functions, a trained and credentialed assistant can then place, contour, and finish the restorative material while the dentist moves to another patient.

That is the core of it. The dentist retains the irreversible part of the procedure and the assistant takes the reversible finishing work under the dentist's supervision.

Around that core, states add and subtract. Some include coronal polishing, sealants, temporary crowns, impressions, or nitrous oxide monitoring. Some break each of those out into its own separate certificate rather than bundling them into one credential.

What is consistently excluded everywhere: diagnosis, treatment planning, tooth preparation, extraction, and anything else that permanently alters hard or soft tissue. A few states permit trained assistants to administer local anesthesia, but that is a separate and narrower authorization than expanded functions generally.

The name changes at the state line

This is the first thing that trips people up. Searching for EFDA in a state that does not use the term will make you think the state has nothing, when it may simply call it something else.

Expanded Function Dental Assistant or Auxiliary, abbreviated EFDA, is used in Ohio, Pennsylvania, Washington, Massachusetts, Maryland, Illinois, and others.

Expanded Duty Dental Assistant, EDDA, is Georgia's term.

Dental Assistant II, DA II, is used in North Carolina and Virginia.

Registered Dental Assistant in Extended Functions, RDAEF, is California's, and note that California says extended rather than expanded.

Licensed Dental Assistant, LDA, is Minnesota's, where the expanded scope is built into the license itself rather than added on top of a basic registration.

And in some states the answer is that there is no credential. Indiana issues no titled expanded function credential and qualifies assistants duty by duty instead. Texas discontinued its sealant and coronal polishing certificates in 2017 and issues no expanded function certificate at all. New York has no level above registered dental assistant.

Duties that commonly appear, and where they do not

The table below is a general orientation, not a rule for your state. Verify every line against your own board before you rely on it, because the exceptions are the whole story.

Three examples of why. Ohio's EFDA credential does not include coronal polishing; Ohio treats that as a separate certificate. North Carolina prohibits the placement or cementation of final restorations to every assistant level, including DA II. Florida's restorative tier permits placing and contouring restorations but restricts assistants to hand instruments and the slow-speed handpiece.

None of those are edge cases. They are exactly the kind of detail that determines whether the training you are about to pay for is useful where you live.

Duties commonly associated with expanded function credentials, and the caution on each
Duty	General pattern	Why you must check your state
Placing and finishing restorations after the dentist preps	The defining expanded function in most states that have one	Prohibited outright to assistants in some states; instrument-restricted in others
Coronal polishing	Widely permitted with training	A separate certificate in several states; prohibited to assistants in a few
Sealants	Commonly permitted with training	Separate certificate in some states; hygiene-only in others
Temporary crowns and temporization	Common in expanded function scopes	Sometimes included in basic assisting, sometimes not permitted at all
Impressions	Study models widely permitted	Final impressions for a prosthesis are prohibited to assistants in many states
Stainless steel crowns	Permitted in a minority of states	Explicitly prohibited to all assistant levels in some
Local anesthesia	A small number of states permit trained assistants	Always a separate authorization, never bundled into a general EFDA credential

How you get it, in general terms

Almost every state that has an expanded function credential requires three things in some combination: a board-approved course, a clinical examination, and a base credential or experience requirement underneath it.

The base varies. Pennsylvania accepts an associate degree program, a certificate program of at least 200 hours, or a hygiene background with restorative coursework. Ohio requires certified assistant or hygienist status plus an approved EFDA course plus a specific examination plus board registration. Minnesota requires graduation from an accredited program, DANB certification, and a state jurisprudence exam before licensure. California requires you to already be a registered dental assistant, then complete a board-approved RDAEF program and pass the state exam.

Course length varies just as much and is not comparable across states, because a 200-hour Pennsylvania certificate and a California RDAEF program are not the same product.

One thing to be careful about: expanded function training is clinical. Programs marketed as fully online almost always still require an in-person clinical and typodont component, and a program without one is unlikely to satisfy your board. If a program's marketing is vague about this, treat that as the answer.

Where DANB fits, and where it does not

DANB is the national certifying board for dental assistants. Its CDA certification is built from three component exams: Radiation Health and Safety, Infection Control, and General Chairside. DANB also offers CRFDA, a restorative functions credential made up of four exams, and CPFDA, a preventive functions credential made up of three.

Here is the part that gets misreported constantly. DANB certification is not universally required for expanded functions. It is required in some states, is one accepted route among several in others, and is not a route at all in a few.

States where a DANB credential is required as part of the expanded function pathway include Maryland, New Jersey, Massachusetts, Minnesota, Virginia, and Missouri, according to DANB's published state overviews.

States where it is one route among several include Georgia, Iowa, Washington, and North Carolina.

And Florida removed the DANB CDA as an expanded functions pathway effective May 2009. Ohio's pathway runs through a different examination entirely.

So never plan around the sentence you will read on many websites, which is that DANB certification is required for expanded functions. Check what your specific state accepts.

One more correction while we are here: DANB's CDPMA, the practice management administrator credential, is often listed in older career articles. DANB discontinued that exam in 2008 and it can no longer be earned.

Why practices want one

The business case is straightforward and it is worth understanding, because it is the argument you will make when you ask your employer to fund the training.

When an assistant can place and finish the restoration, the dentist leaves after the preparation and starts the next patient. Two operatories run in parallel instead of one running in sequence. In a busy restorative practice that is a substantial change in daily capacity.

It also changes what the day feels like for the assistant. The most common phrasing we found from assistants pursuing this is wanting to do more than hand instruments, and that is an accurate description of what the credential changes.

The pay question is harder to answer honestly and we have written a separate guide on it, because there is no defensible EFDA-specific wage data published by anyone.

Common questions

What is an EFDA in dentistry?

An expanded function dental assistant: an assistant whose state has authorized them to perform additional reversible procedures beyond basic chairside assisting, most commonly placing and finishing restorations after the dentist has prepared the tooth. The exact title and scope are set by each state individually.

What can an EFDA do that a regular dental assistant cannot?

In most states that have the credential, place, contour, and finish restorative material the dentist has already prepared. Depending on the state, it may also add coronal polishing, sealants, temporary crowns, or impressions. Diagnosis, tooth preparation, and anything irreversible is never included.

Does every state have EFDA?

No. Indiana issues no titled expanded function credential and qualifies assistants duty by duty instead, Texas discontinued its sealant and coronal polishing certificates in 2017 and issues none, and New York has no level above registered dental assistant. Published counts of how many states have an expanded function level disagree with each other, so check your own state directly.

Do I need DANB certification to be an EFDA?

It depends entirely on the state. Several states require a DANB credential as part of the pathway, several accept it as one route among others, and Florida removed it as an expanded functions pathway in 2009. Never assume it is required or that it is sufficient.

Can I take EFDA training online?

Not entirely. Expanded function training is a clinical skill and board-approved programs include hands-on typodont and clinical components. Programs marketed as fully online should be checked against your board's approved program list before you pay for anything.

Every expanded function pathway is built on top of being excellent chairside.

Start with the chairside foundation

Sources

Written by Elizabeth Carr, DHA, Program Director, DentalReady; former Dental Hygiene Department Chair, UMMC School of Dentistry

Keep reading

Does My State Have EFDA? Twenty-Five States, Checked EFDA or Dental Hygienist? How to Choose Is Becoming an EFDA Worth It?