The following rule changes will be effective December 21, 2022.  Note: While the application for dental assistant trainee status will be eliminated, registration as a dental assistant continues to be required to practice in Iowa.  Please refer to ARC 6673C to see the notification of adoption for more information.

Board staff drafted a list of frequently asked questions to assist licensees and registrants in better understanding the changes related to dental assistants.  You may view the list of FAQs here.

Changes to the Definitions of Supervision

Updated the definitions for “direct supervision”, “general supervision of a dental assistant” and “personal supervision” to allow greater flexibility to dentists when delegating services.  The underlined portions of the definitions copied below reflect the changes. 

The biggest change is to the supervision of dental assistant trainees.  The change will permit a licensed dentist to delegate the supervision of a dental assistant trainee to a licensed dental hygienist or registered dental assistant.  This extends to intraoral services, which currently require a licensed dentist to personally supervise.

"Direct supervision" means that the dentist is present in the treatment facility, but it is not required that the dentist be physically present in the treatment room, or the dentist is not present in the treatment facility but is able to appear using live video upon request with a response time similar to what would be expected if the dentist were present in the treatment facility.

“General supervision of a dental assistant” means that a dentist has examined the patient and has delegated the services to be provided by a registered dental assistant, which are limited to all extraoral duties, dental radiography, intraoral suctioning, and use of a curing light and intraoral camera. The dentist need not be present in the facility while these services are being provided. If a dentist will not be present, the following requirements shall be met:

      1.          Patients or their legal guardians must be informed prior to the appointment that no dentist will be present and therefore no examination will be conducted at that appointment.
      2.          The dental assistant must consent to the arrangement.
      3.          Basic emergency procedures must be established and in place, and the dental assistant must be capable of implementing these procedures.
      4.          The treatment to be provided must be prior-prescribed by a licensed dentist and must be entered in writing in the patient record.

“Personal supervision” means a licensee or registrant is physically present in the room to oversee and instruct all services of the dental assistant trainee as delegated by a licensed dentist.

Trainee Requirements

  • The Board eliminated the formal application required to work as a dental assistant trainee.  In accordance with Iowa Code section 153.39, dental assistant trainees will have 12 months from the first date of employment to train on the job while meeting the requirements for registration.
  • The requirements for registration were moved to Iowa Administrative Code (IAC) 650—Chapter 11.  IAC 650—Chapter 20 will primarily focus on issues related to the scope of practice for dental assistants.
  • The Board also removed the requirements for a minimum age and high school graduation or equivalent to work as a dental assistant.  NOTE: Iowa law requires individuals who take x-rays to be at least 18 years of age.  Training in dental radiography continues to be prohibited for practitioners under the age of 18.
  • The minimum on-the-job training requirement for dental assistants has been eliminated.  Dental assistants will be eligible for registration after successfully completing the required examinations, having achieved clinical competency as determined by the supervising dentist, and meeting the other requirements established in rule.

Dental Radiography

Updated the requirements for training in dental radiography.  If 18 years of age or older, nurses and dental assistants may train on the job in dental radiography without the requirement for a formal application for trainee status.  This change was expanded to include registered dental assistants who did not previously train in dental radiography.


The Board approved additional options for testing in the areas of infection control/hazardous materials, jurisprudence and dental radiography.  The Board will accept results for examinations administered by accredited dental assistant schools.  Additionally, the Board has provided an option whereby continuing education courses, which include a post-test in the required areas of examination, may be approved for the purposes of registration.  Prior-approval by the Board will be required of the continuing education courses that include a post-test.