Dental Assistant Requirements in Texas: Registration, X-Ray Rules & Allowed Duties

Registration or certification is required only for dental assistant services the chapter names as needing one — the radiology certificate and the nitrous oxide monitoring registration are the two Board-issued credentials the source describes.

To hold any registration or certification the chapter creates, an applicant must submit identity and immigration documentation, pass a criminal background check, complete a current basic life support course, pass a jurisprudence assessment, pay the required fees, complete a human trafficking prevention course, and submit a National Practitioner Data Bank self-query report.

General supervision means the dentist employs or is in charge of the dental assistant and is responsible for supervising the assistant's services, but the dentist may or may not be present on the premises while the assistant performs the procedures.

Direct supervision means the dentist employs or is in charge of the assistant and is physically present in the office when the task is performed, though not necessarily in the treatment room.

A dentist may delegate to a dental assistant only acts or procedures that are reversible — capable of being reversed or corrected — and the dentist remains responsible for any delegated act.

Under general supervision alone, the clinical tasks a dental assistant may perform are limited to making dental x-rays under Occupations Code §265.001 and providing interim treatment of a minor emergency dental condition to an existing patient under Occupations Code §265.003(a-1), with a follow-up appointment required within 30 days.

A dental assistant may not position or expose dental x-rays without a dental assistant radiology certificate issued by the Board.

Qualifying requires a high school diploma or GED, fingerprints for a criminal history check, a current basic life support course, and passing either the Board's course and exam or, for an assistant already certified by the Dental Assisting National Board, a jurisprudence exam alone.

The required course curriculum covers radiation safety, infection control, and jurisprudence.

A narrow exemption in §114.11 allows an assistant to perform radiological procedures for up to one year without the certificate, for training purposes and only under the employer dentist's direct supervision.

Texas does not publish a separate list of prohibited acts.

Instead, the rule caps delegation at acts or procedures that are reversible, and separately bars a dentist from delegating any task for which a certificate or additional training is required under Chapter 114 unless the dental assistant holds that certificate or has obtained the training.

A dentist may delegate monitoring the administration of nitrous oxide to a dental assistant who works under the dentist's direct supervision and holds a current nitrous oxide monitoring registration.

Obtaining that registration requires an unexpired dental assistant registration, a current basic life support course, and a minimum of 8 hours of didactic education and testing — covering jurisprudence, dental anatomy and physiology, pharmacology, sedation equipment, infection control, patient monitoring, and management of medical emergencies — through a CODA-accredited program approved by the Board.

Courses taken to satisfy this requirement are valid for five years.

A dentist may delegate applying pit and fissure sealants to a dental assistant who has at least two years of experience as a dental assistant, a current basic life support course, and a minimum of 8 hours of clinical and didactic education in sealants through a CODA-accredited program approved by the Board.

Coronal polishing may be delegated to an assistant who works under direct supervision and has either graduated from a CODA-accredited dental assisting program covering coronal polishing or completed a separate minimum 8-hour course in it.

Neither may be billed to the patient as a prophylaxis.

To renew a certificate of registration issued under Chapter 114, a dental assistant must complete 12 hours of continuing education biennially covering dental assistant duties, at least 6 of which must be clinical.

Continuing education may be completed through Board-approved self-study, interactive computer courses, or lecture courses, and a human trafficking prevention course is a prerequisite to renewal.