Dental Assistant Requirements in Virginia: Registration, X-Ray Rules & Allowed Duties
Virginia defines two dental assistant credentials: dental assistant I, an unlicensed role working under a dentist or hygienist, and dental assistant II, which must register with the Board of Dentistry after showing current CDA certification and completing an accredited program.
Only the II tier requires registration.
Placing or exposing radiographs takes a radiation safety course and exam, ARRT certification, or the DANB Radiation Health and Safety Review Course and exam, for either level.
A dental assistant II's expanded duties are delegable only under a dentist's direct supervision.
Verify before you rely on this
At a glance
Entry-level assistant
Registration
Some levels
Dental assistant I
Credential levels
2
Verified September 2026
Regulated by
Virginia Board of Dentistry
The Short Version
- Registration or licensure
- Dental assistant I is an unlicensed role that the rules do not require to register; dental assistant II must register with the board by providing evidence of CDA certification and completed educational requirements.
- Taking x-rays
- No dental assistant I or II may place or expose dental radiographs without a radiation safety course and exam from a CODA-accredited program, ARRT certification, or the DANB Radiation Health and Safety Review Course and exam.
- Credential titles the state uses
- Dental assistant I · Dental assistant II
The two assistant levels Virginia defines
Dental assistant I is any unlicensed person under the direction of a dentist or dental hygienist who renders patient-care assistance not otherwise restricted to a dentist, hygienist, or dental assistant II.
Dental assistant II is registered by the board to perform specific reversible, intraoral procedures under a dentist's direction and direct supervision, and must meet the board's education and certification requirements to register.
A person who is employed to assist a licensed dentist or dental hygienist by performing duties not otherwise restricted to the practice of a dentist, dental hygienist, or dental assistant II, as prescribed in regulations promulgated by the Board may practice as a dental assistant I.
Registering as a dental assistant II
An application for registration as a dental assistant II must include evidence of a current CDA credential (or an equivalent ADA-recognized credentialing exam covering chairside assisting, radiation health and safety, and infection control) and verification of completed educational requirements.
The initial registration fee is $100; the active renewal fee is $50.
Dental assistant I has no registration process — it is defined only by the direction it works under.
All applications for registration as a dental assistant II shall include: 1. Evidence of a current credential as a Certified Dental Assistant (CDA) conferred by the Dental Assisting National Board or another certification from a credentialing organization recognized by the American Dental Association and acceptable to the board that was granted following passage of an examination on general chairside assisting, radiation health and safety, and infection control; and 2. Verification of completion of educational requirements set forth in 18VAC60-30-120.
The supervision terms that govern delegation
Virginia's rules define four supervision levels a dentist may exercise over a hygienist or assistant: immediate (the dentist is in the operatory), direct (the dentist examines the patient, records findings, and remains immediately available before delegating to a dental assistant II), indirect (the dentist examines the patient at some point and is continuously present in the office), and general (the dentist issues a written order and may or may not be present).
A dental assistant II's work is defined as occurring under a dentist's direction and direct supervision.
"Direct supervision" means that the dentist examines the patient and records diagnostic findings prior to delegating restorative or prosthetic treatment and related services to a dental assistant II for completion the same day or at a later date. The dentist prepares the teeth to be restored and remains immediately available in the office to the dental assistant II for guidance or assistance during the delivery of treatment and related services. The dentist examines the patient to evaluate the treatment and services before the patient is dismissed.
What a dental assistant II may perform
Because Chapter 30's own duties sections were repealed in 2024, the operative delegable-duties list for a dental assistant II now lives in the hygiene chapter.
Under a dentist's direction and direct supervision, a dental assistant II may perform pulp capping, packing and carving amalgam restorations, placing and shaping composite resin restorations with a slow-speed handpiece, taking final impressions, using a non-epinephrine retraction cord, and final cementation of crowns and bridges after the dentist has adjusted and fitted them.
The following duties may only be delegated under the direction and direct supervision of a dentist to a dental assistant II: 1. Performing pulp capping procedures; 2. Packing and carving of amalgam restorations; 3. Placing and shaping composite resin restorations with a slow-speed handpiece; 4. Taking final impressions; 5. Use of a non-epinephrine retraction cord; and 6. Final cementation of crowns and bridges after adjustment and fitting by the dentist.
A 2026 addition: scaling and polishing certification
A 2026 amendment to the Code of Virginia lets a dental assistant I or II with at least 1,800 hours of clinical experience obtain certification, through a dentist-verified training pathway, to perform supragingival scaling with hand and ultrasonic scalers and coronal polishing under a dentist's indirect supervision.
A licensed dentist may not indirectly supervise more than two dental assistants at a time performing this scaling or polishing.
A dental assistant I or dental assistant II, upon obtaining certification and under indirect supervision of a licensed dentist, may perform (i) supragingival scaling with hand and ultrasonic scalers and (ii) coronal polishing.
Taking x-rays
Neither a dental assistant I nor II may place or expose radiographs without completing one of the following: a radiation safety course and exam from a CODA-accredited dental assisting, hygiene, or dentistry program; certification by the American Registry of Radiologic Technologists; or the DANB Radiation Health and Safety Review Course plus its exam.
Any certificate earned under this rule must be posted in plain view of the patient.
No dental assistant I or II shall place or expose dental radiographs unless the dental assistant has one of the following: (i) satisfactory completion of a radiation safety course and examination given by an institution that maintains a program in dental assisting, dental hygiene, or dentistry accredited by CODA; (ii) certification by the American Registry of Radiologic Technologists; or (iii) satisfactory completion of the Radiation Health and Safety Review Course provided by the Dental Assisting National Board or its affiliate and passage of the Radiation Health and Safety Exam given by the Dental Assisting National Board. Any certificate issued pursuant to satisfying the requirements of this section shall be posted in plain view of the patient.
Duties that stay with the dentist
Chapter 25 lists the duties a dentist may never delegate to a dental hygienist, and that list carves out only one exception for a dental assistant II: condensing, contouring, or adjusting a final prosthodontic appliance or restoration is off-limits, except for the amalgam and composite placement a dental assistant II may perform with advanced training under 18VAC60-30-120.
Everything else on the list — final diagnosis and treatment planning, surgical or cutting procedures, prescribing or parenterally administering drugs, authorizing work orders for an appliance, prosthetic device, or restoration to be inserted in a patient's mouth, high-speed rotary instruments in the mouth, deep sedation or general anesthesia, final positioning of orthodontic bonds and bands, and final adjustment of crowns and bridges before cementation — stays with the dentist.
Condensing, contouring, or adjusting any final, fixed, or removable prosthodontic appliance or restoration in the mouth with the exception of packing and carving amalgam and placing and shaping composite resins by dental assistants II with advanced training as specified in 18VAC60-30-120;
Nitrous oxide and local anesthesia
Virginia's dental-assistant chapter names no nitrous oxide or sedation-monitoring role for a dental assistant I or II.
Administering nitrous oxide or local anesthesia is reserved to dental hygienists who meet separate qualification requirements, delegable only under indirect supervision — it is not on the dental assistant II duties list.
3. Administering nitrous oxide or local anesthesia by dental hygienists qualified in accordance with the requirements of 18VAC60-25-100.
Renewing a dental assistant II registration
A dental assistant II registration renews annually in the registrant's birth month.
To renew, the assistant must maintain and attest to current CDA (or equivalent ADA-recognized) certification and maintain evidence of a current, hands-on basic CPR course.
A registration that isn't renewed by the deadline automatically expires.
Dental assistant I has no renewal requirement since it is not a registered credential.
C. In order to renew registration, a dental assistant II shall be required to maintain and attest to current certification from the Dental Assisting National Board or another national credentialing organization recognized by the American Dental Association. D. A dental assistant II shall also be required to maintain evidence of successful completion of a current, hands-on course in basic cardiopulmonary resuscitation.
Confidentiality and professional conduct
A dental assistant may not breach the confidentiality between a practitioner and a patient, though a breach required or permitted by law or beyond the assistant's control is not treated as negligent or willful.
Misrepresenting the materials, methods, or techniques used or intended to be used to a patient or the public is unprofessional conduct under the chapter.
No dental assistant shall breach the confidentiality between a practitioner and a patient. A breach of confidentiality that is required or permitted by applicable law or beyond the control of the assistant shall not be considered negligent or willful.
Frequently Asked Questions
Do I need to register to work as a dental assistant in Virginia?
It depends on the tier.
Dental assistant I is an unlicensed role working under a dentist or hygienist's direction, and the rules name no registration process for it.
Dental assistant II must register with the Board of Dentistry, which under 18VAC60-30-115 requires a current CDA (or equivalent) credential and verification of completed educational requirements.
Confirm current forms and fees with the Virginia Board of Dentistry.
Can a dental assistant take x-rays in Virginia?
Yes, either level can, once qualified.
Under 18VAC60-30-80, a dental assistant I or II must complete a radiation safety course and exam from a CODA-accredited program, hold ARRT certification, or complete the DANB Radiation Health and Safety Review Course and pass its exam before placing or exposing radiographs.
The resulting certificate must be posted in plain view of the patient.
Verify current course options with the board.
What can a dental assistant II do that a dental assistant I cannot?
Under 18VAC60-25-40(D), only a dental assistant II, working under a dentist's direction and direct supervision, may perform pulp capping, pack and carve amalgam restorations, place and shape composite resin restorations, take final impressions, use a non-epinephrine retraction cord, and complete final cementation of crowns and bridges after the dentist has adjusted and fitted them.
Dental assistant I performs duties not otherwise restricted to the dentist, hygienist, or dental assistant II.
Check with the board for specifics.
Does the dentist have to be in the room while a dental assistant works?
It depends on the supervision level in force.
Direct supervision, which governs a dental assistant II's expanded duties, requires the dentist to examine the patient and record findings first and remain immediately available in the office, but the rule does not require the dentist to stand in the same room throughout.
Immediate supervision, used for sedation and treatment, does require the dentist in the operatory.
Verify the current definitions with the Virginia Board of Dentistry.
Can a dental assistant administer nitrous oxide or perform scaling in Virginia?
Nitrous oxide and local anesthesia are reserved to qualified dental hygienists under 18VAC60-25-40(B); the dental-assistant rules name no such role for either assistant tier.
Separately, a 2026 statutory amendment lets a dental assistant I or II with at least 1,800 clinical hours obtain certification to perform supragingival scaling and coronal polishing under a dentist's indirect supervision, capped at two such assistants per dentist at a time.
Confirm the current certification pathway with the board.
Who regulates dental assistants in Virginia?
Dental Assistants in Virginia are regulated by the Virginia Board of Dentistry.
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 Virginia & Dental Assistant Resources
Sourced from Virginia Administrative Code, Title 18, Agency 60, Chapter 30: Regulations Governing the Practice of Dental Assistants (sections 10, 20, 30, 80, 100, 110, 115, 116, 120, 130, 140, 150, 160, 170) (site date-stamp 9/9/2026 (Virginia Law's 'current as of' viewer date); most recent cited amendment effective October 24, 2024); Virginia Administrative Code, Title 18, Agency 60, Chapter 25: Regulations Governing the Practice of Dental Hygiene (sections 10 Definitions, 40 Scope of practice, 70 Delegation of services to a dental assistant, 80 Radiation certification — these contain the actual dental-assistant-II delegable-duties list since Chapter 30's own duties sections were repealed in 2024) (site date-stamp 9/9/2026); Code of Virginia § 54.1-2729.01. Practice of dental assistants (Title 54.1, Chapter 27, Article 4) (site date-stamp 9/9/2026; historical citation '2008, cc. 84, 264; 2026, cc. 439, 440' shows a 2026 legislative amendment). 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.