Dental Assistant Requirements in Hawaii: Registration, X-Ray Rules & Allowed Duties
Hawaii does not license or register dental assistants.
The rules define a dental assistant as a non-licensed person who performs supportive dental procedures under a dentist's direct supervision.
HAR section 16-79-69.1 lists sixteen procedures an assistant may perform, including exposing, processing, mounting and labeling radiographs and monitoring the nitrous oxide/oxygen unit, and requires the dentist to train assistants in sterilization, ethics, records, and CPR.
Direct supervision governs all of it.
Verify before you rely on this
At a glance
Entry-level assistant
Registration
Not required
Dental assistant
Credential levels
1
Verified September 2026
Regulated by
Hawaii State Board of Dental Examiners
The Short Version
- Registration or licensure
- The rule defines a dental assistant as a non-licensed person and sets no application, examination, or fee process for the title; the requirement is that the assistant work under a licensed dentist's direct supervision.
- Taking x-rays
- Exposing, processing, mounting, and labeling radiographs is one of the sixteen supportive procedures HAR section 16-79-69.1(a)(6) lists as something a dental assistant may perform under direct supervision; the chapter names no separate radiography permit, course, or exam for it.
- Credential titles the state uses
- Dental assistant
How Hawaii defines the dental assistant role
Hawaii's rules use a single title, dental assistant, and create no tiers, permits, or credential levels within it.
Subchapter 7 groups the dental assistant together with the licensed dental hygienist, but only the hygienist is a licensed title; the dental assistant is defined as a non-licensed role performing supportive procedures under a dentist's direct supervision.
"Dental assistant" means a non-licensed person, who may perform dental supportive procedures authorized by the provisions of this chapter under the direct supervision of a licensed dentist.
No registration or license required
The chapter defines the dental assistant as a non-licensed person and does not establish an application, examination, or fee process for the title.
What makes the role lawful is a licensed dentist's direct supervision, not a credential the assistant holds.
Direct supervision governs every dental assistant duty
Direct supervision means the supervising dentist has examined and diagnosed the condition to be treated, authorizes each procedure, remains in the dentist's office or a facility defined in section 447-3, HRS, while the procedures are performed, and is responsible for all delegated acts.
A separate general supervision definition exists in the same rule, but by its own terms it applies to licensed dental hygienists' work, not to dental assistants.
"Direct supervision" means that the supervising licensed dentist examines and diagnoses the condition to be treated, authorizes each procedure, remains in the dentist's office or in any facility defined in section 447-3, HRS, while the procedures are being performed, and shall be responsible for all delegated acts and procedures performed by dental assistants and licensed dental hygienists.
Supportive procedures a dental assistant may perform
Under a licensed dentist's direct supervision, direction, evaluation, and responsibility, section 16-79-69.1 lists sixteen supportive procedures: chairside assisting (tray setup, tissue retraction, debris removal, the rubber dam, mixing materials, four-handed dentistry); assisting a hygienist within the rule's limits; collecting histories and photographs and charting as directed; completing prescription and appliance authorization forms for the dentist to sign; mouth-mirror inspections reported to the dentist (not an oral cancer screening); radiographs; impressions for study casts and several appliance types; orthodontic measurements, band and separator work, and arch-wire removal; recording vital signs; monitoring the nitrous oxide/oxygen unit; matrix retainers and topical anesthetics; pre- and post-operative instructions and oral hygiene education; removing dressings, sutures, and excess cement; and try-ins that the dentist then adjusts.
A dental assistant may perform the following supportive dental procedures under the direct supervision, direction, evaluation, and responsibility of a licensed dentist:
Training the supervising dentist must provide
The board requires the supervising dentist to train dental assistants, at minimum, in sterilization and disinfection procedures meeting OSHA, Hawaii Department of Labor and Industrial Relations, CDC, and ADA guidelines; ethics; record keeping and patient confidentiality; and CPR.
The rule directs that these training courses be provided by sponsors approved under section 16-79-142.
The board requires the supervising licensed dentist to appropriately train or provide training to dental assistants which shall include, but not be limited to:
Taking, processing, and mounting x-rays
Exposing, processing, mounting, and labeling radiographs is one of the listed supportive procedures a dental assistant may perform under the dentist's direct supervision.
The rule does not create a separate radiography permit, course, or certification for the duty — it sits on the same delegable list as chairside assisting and recording vital signs.
Exposing, processing, mounting, and labeling radiographs;
Duties a dental assistant may never perform
The rule bars a dental assistant from any procedure that is irreversible, permanently changes hard or soft tissue, or represents the practice of dentistry or dental hygiene.
Named examples include administering local anesthetic, sedation, or general anesthesia; diagnosing or prescribing a treatment plan; surgical or cutting procedures, extractions, and suturing; placing, condensing, carving, or finishing final restorations, cavity liners, or pulp cap materials; placing materials subgingivally; cementing or adjusting prostheses, orthodontic bands, or brackets; endodontic procedures; testing pulp vitality; and using ultrasonic instruments to polish tooth surfaces.
A dental assistant shall not perform the following intra-oral functions or any other activity deemed to be irreversible as to cause change in the affected hard or soft tissues and is permanent or may require reconstructive or corrective procedures; and any other activity which represents the practice of dentistry and dental hygiene or requires the knowledge, skill, and training of a licensed dentist or licensed dental hygienist:
Nitrous oxide monitoring and sedation limits
A dental assistant may monitor the nitrous oxide/oxygen unit and report any adverse observations to the supervising dentist, provided the dentist evaluates, initiates, and administers the sedation.
Administering local anesthetic, sedation, or general anesthesia is on the prohibited list — an assistant may watch the gas flow, not give it.
Monitoring the nitrous oxide/oxygen unit and reporting to the supervising dentist any adverse observations, provided the licensed dentist evaluates, initiates, and administers the sedation;
Frequently Asked Questions
Do I need to register or get certified to work as a dental assistant in Hawaii?
No. HAR section 16-79-2 defines a dental assistant as a non-licensed person who may perform supportive procedures under a dentist's direct supervision, and the chapter sets no application, exam, or fee process for the title.
The dentist does have to directly supervise you and train you in sterilization, ethics, records/confidentiality, and CPR under section 16-79-69.1(b).
Confirm current expectations with the Hawaii State Board of Dental Examiners.
Can a dental assistant take x-rays in Hawaii?
Yes.
Exposing, processing, mounting, and labeling radiographs is listed in HAR section 16-79-69.1(a)(6) as a supportive procedure a dental assistant may perform under the dentist's direct supervision.
The rule names no separate radiography permit, course, or exam for this duty.
Confirm any additional training expectations with the Hawaii State Board of Dental Examiners.
Does the dentist have to be in the room while a dental assistant works?
Not necessarily in the operatory, but nearby.
HAR section 16-79-2 defines direct supervision — the standard governing dental assistants — as requiring the dentist to examine and diagnose the condition, authorize each procedure, remain in the dentist's office or the facility while the procedures are performed, and be responsible for all delegated acts.
Verify the current definition with the Hawaii State Board of Dental Examiners.
What can a dental assistant never do in Hawaii?
HAR section 16-79-69.5 bars a dental assistant from any irreversible procedure or one that represents the practice of dentistry or dental hygiene, naming examples including administering anesthesia or sedation, diagnosing or prescribing, surgical or cutting procedures, extractions, placing or adjusting final restorations, endodontic procedures, and using ultrasonic instruments.
Ask the Hawaii State Board of Dental Examiners before assuming an unlisted task is allowed.
Can a dental assistant monitor nitrous oxide in Hawaii?
Yes, within limits.
HAR section 16-79-69.1(a)(10) lets a dental assistant monitor the nitrous oxide/oxygen unit and report adverse observations to the supervising dentist, but only while the dentist evaluates, initiates, and administers the sedation.
Administering sedation or anesthesia is itself on the prohibited-duties list in section 16-79-69.5.
Confirm expectations with the Hawaii State Board of Dental Examiners.
Who regulates dental assistants in Hawaii?
Dental Assistants in Hawaii are regulated by the Hawaii State Board of Dental Examiners.
The rules on this page come from the state's own statute and board rules as published on the dates shown; they change over time, so verify current requirements with the board before relying on them.
More Hawaii & Dental Assistant Resources
Sourced from DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS — AMENDMENT AND COMPILATION OF CHAPTER 16-79, HAWAII ADMINISTRATIVE RULES (Subchapter 7: Dental Assistants and Licensed Dental Hygienists, §§16-79-67 to 16-79-71) (Compilation dated 5/16/2016 (most recent amendment note on each section reads 'am and comp 8/22/16'); hosted at a 2026-dated URL by the Board's own licensing division site); Same document, Subchapter 1, §16-79-2 Definitions (Compilation dated 5/16/2016 (history note 'am and comp 8/22/16')). Verified September 2026. This page summarizes the state's own statute and board rules as published on the dates shown. It is general information, not legal advice, and rules change: confirm anything you intend to rely on with the state dental board before acting on it.