Dental Assistant Requirements in North Carolina: Registration, X-Ray Rules & Allowed Duties
North Carolina does not require a dental assistant to register with or obtain a license from the State Board of Dental Examiners.
Instead, the rule categorizes a dental assistant as a Dental Assistant I or a Dental Assistant II based on education, training and experience, with a Dental Assistant II delegated more intra-oral procedures under a dentist's direct control and supervision.
Both classifications must hold unexpired CPR certification, and neither may take radiographs before completing radiology training consistent with G.S. 90-29(c)(12).
Verify before you rely on this
At a glance
Entry-level assistant
Registration
Not required
Dental Assistant I
Credential levels
2
Verified September 2026
Regulated by
North Carolina State Board of Dental Examiners
The Short Version
- Registration or licensure
- The rule does not require a Dental Assistant I to register with or apply to the Board; classification as Dental Assistant I or II turns on the training, CPR certification and experience the rule lists, not on filing an application with the Board.
- Taking x-rays
- No Dental Assistant I or II may take radiographs before completing radiology training consistent with G.S. 90-29(c)(12), and 21 NCAC 16H .0105 sets the course requirements the Board recognizes as satisfying that training.
- Credential titles the state uses
- Dental Assistant I · Dental Assistant II
The two classifications North Carolina defines
Based on education, training and experience, a dental assistant is categorized as a Dental Assistant I or a Dental Assistant II.
A Dental Assistant I is anyone performing the permitted functions of .0201 who has not met Dental Assistant II's training and experience requirements and is not a licensed dentist or hygienist.
A Dental Assistant II is an expanded-duty assistant who has completed the training in .0104 and may be delegated intra-oral procedures under a dentist's direct control and supervision, with all delegated procedures required to be reversible.
A Dental Assistant I is anyone performing any of the permitted or delegable functions under 21 NCAC 16H .0201, who does not satisfy the training and experience requirements for classification as a Dental Assistant II set forth in 21 NCAC 16H .0104, and is not licensed by the Board as a dentist or dental hygienist.
No registration — classification runs on training and experience
The subchapter sets no application or registration process with the Board for either tier.
To be classified as a Dental Assistant II, an assistant must maintain unexpired CPR certification and complete one of several pathways: a CODA-accredited dental assisting program, a full school year in a CODA-accredited dental hygiene program, an armed-forces dental assisting program with a live-patient clinical rotation, DANB's Certified Dental Assistant exam with a passing score, or two of the preceding five years employed as a Dental Assistant I totaling at least 3,000 hours plus two 3-hour courses in sterilization/infection control and dental office emergencies.
the following: (A) employment as a Dental Assistant I for two years of the preceding five, consisting of at least 3,000 hours total; and (B) a 3-hour course in sterilization and infection control, and a 3-hour course in dental office emergencies. The courses shall be offered by Board-approved course sponsors as set out in 21 NCAC 16I .0202.
What "direct control and supervision" means here
Wherever the Board's rules or the Dental Practice Act require a Dental Assistant I or II to work under a dentist's direct control and supervision, that term means the dentist must be present in the office when the act or function is performed, and must directly and personally supervise, examine and evaluate the results of any acts done by anyone other than the dentist.
The rule does not require the dentist to be in the same room.
In any instance in which the rules adopted by the Board or any portion of the North Carolina Dental Practice Act shall require or direct that any act or function be performed by a Dental Assistant I or II under the direct control and supervision of a dentist, the term "direct control and supervision of a dentist" means that the dentist must be present in the office when the act or function is being performed and that the dentist must directly and personally supervise, examine, and evaluate the results of any and all acts and functions lawfully done or performed by any person other than the dentist.
What a Dental Assistant I and II may do
A Dental Assistant I may assist chairside and perform only routine procedures such as oral hygiene instruction, chairside assisting, applying topical fluorides or topical anesthetics, and exposing radiographs once radiography-trained.
A Dental Assistant II may perform everything a Dental Assistant I may perform, plus a 29-item list delegable under a dentist's direct control and supervision after the dentist has examined the patient and prescribed the procedure: taking impressions for study models, applying sealants and bonding agents, placing and removing rubber dams and temporary restorations, removing sutures and periodontal dressings, exposing radiographs and cone beam images, polishing the clinical crown after a coronal-polishing course, measuring vital signs, and more.
A Dental Assistant I may perform only routine dental assisting procedures such as oral hygiene instruction, chairside assisting, application of topical fluorides or topical anesthetics, and exposure of radiographs, provided that the assistant can show compliance with radiography training consistent with G.S. 90-29(c)(12).
Taking x-rays
Neither classification may take radiographs before completing radiology training consistent with G.S. 90-29(c)(12).
The Board recognizes a dental radiology course and its final exam only if the course includes at least 7 hours of didactic instruction and 14 hours of laboratory instruction, covers the listed clinical-radiology and digital-imaging topics, keeps no more than six students per instructor and two students per x-ray machine, and requires students to pass an 80%-or-better written radiation-safety exam before taking radiographs and an 80%-or-better final written and laboratory exam to complete the course.
If a dental radiology course and the course's final examination meet the requirements of this Rule, the Board will recognize the course and final examination as satisfying the dental radiology training and equivalency examination requirements set out in G.S. 90-29(c)(12).
Functions a dental assistant may never perform
Functions that may not be delegated to either classification include the procedures prohibited for dental hygienists under 21 NCAC 16G .0103, plus performing a prophylaxis, periodontal screening or probing, exploration for or removal of hard or soft deposits beyond what .0203 allows, sulcular irrigation, using ultrasonic scalers, applying antibiotic-coated materials or resorbable antimicrobial agents, performing root planing, applying oral cancer screening products, and using laser fluorescence detectors ahead of a dentist's exam and diagnosis.
The specific functions that shall not be delegated to either a Dental Assistant I or a Dental Assistant II include procedures prohibited in 21 NCAC 16G .0103 for dental hygienists.
CPR certification for both classifications
A Dental Assistant I must have unexpired CPR certification in effect at all times while performing the permitted functions of .0201.
A Dental Assistant II must have and maintain unexpired CPR certification too, valid at the time of classification and remaining valid throughout employment as a Dental Assistant II or while performing Dental Assistant II functions.
A Dental Assistant I shall have an unexpired CPR certification in effect at all times while performing any of the permitted functions under 21 NCAC 16H .0201.
Frequently Asked Questions
Do I need to register or get licensed to work as a dental assistant in North Carolina?
No. The rule categorizes a dental assistant as a Dental Assistant I or a Dental Assistant II by education, training and experience rather than by an application filed with the Board.
A Dental Assistant I performs the permitted functions of 21 NCAC 16H .0201; a Dental Assistant II has completed the training pathway in 21 NCAC 16H .0104.
Confirm current classification practice with the North Carolina State Board of Dental Examiners.
Can a dental assistant take x-rays in North Carolina?
Only after completing radiology training.
Under 21 NCAC 16H .0102(c) and .0104(d), no Dental Assistant I or II may take radiographs before completing radiology training consistent with G.S. 90-29(c)(12), and 21 NCAC 16H .0105 sets the course requirements the Board recognizes, including at least 7 hours of didactic instruction and 14 hours of laboratory instruction with passing exam scores.
Verify recognized courses with the Board.
Does the dentist have to be in the room while a dental assistant works?
Not necessarily the same room, but in the office.
For functions requiring direct control and supervision, 21 NCAC 16H .0206 defines that term to mean the dentist must be present in the office when the act is performed and must directly and personally supervise, examine and evaluate the results of the work.
Confirm the current definition with the North Carolina State Board of Dental Examiners.
What can a dental assistant never do in North Carolina?
21 NCAC 16H .0205 lists functions that cannot be delegated to a Dental Assistant I or II, including performing a prophylaxis, periodontal screening or probing, removing hard or soft deposits beyond what .0203 allows, sulcular irrigation, using ultrasonic scalers, applying antibiotic-coated materials or resorbable antimicrobial agents, performing root planing, applying oral cancer screening products, and using laser fluorescence detectors before a dentist's diagnosis.
Confirm the current list with the Board.
How does a dental assistant become a Dental Assistant II in North Carolina?
Under 21 NCAC 16H .0104, an assistant must maintain unexpired CPR certification and complete one of several pathways: a CODA-accredited dental assisting program, a full school year in a CODA-accredited dental hygiene program, an armed-forces dental assisting program with a clinical rotation, DANB's Certified Dental Assistant exam, or two of the preceding five years as a Dental Assistant I totaling at least 3,000 hours plus two 3-hour courses.
Confirm current pathways with the Board.
Who regulates dental assistants in North Carolina?
Dental Assistants in North Carolina are regulated by the North Carolina 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 North Carolina & Dental Assistant Resources
Sourced from 21 NCAC 16H - Dental Assistants (Sections .0100 Classification and Training; .0200 Permitted and Prohibited Functions), compiled by the NC Office of Administrative Hearings (state administrative code publisher) (Rule-by-rule effective dates embedded (most recent amendments through June 1, 2025 / August 1, 2024)). 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.