Trying to decide if you should pursue a career as a dental assistant or a dental hygienist?  Both dental assistant and dental hygienists are members of the support team within a dental office. Although their jobs may seem interchangeable to those outside the industry, the responsibilities of each role and the training required are different.

Key Points:

  • Dental hygiene involves a greater degree of patient education and preventative dental care than does the work of dental assistants who largely provide support and general office management.
  • While dental assistants may complete a training program lasting about one year to become registered, there is no requirement in California to do so and you can begin a career in this field right after high school. Indeed, many dental assistants are trained on-the-job. In contrast, dental hygienists need a minimum of an associate’s degree to work in a private dental office and must become registered by passing written and clinical examinations.
  • The entry-level salaries of dental hygienists are nearly double that of dental assistants due to their advanced education and skill set.

Below we will provide an overview of each career so that you may plan accordingly.

Career Overview Dental Assistants

The work of a dental assistant is varied as they perform direct patient care, routine office duties, as well as laboratory work.

Select duties of a non-registered dental assistant (under the direct supervision of a licensed dentist) include:

  • Prepare patients for examination.
  • Provide assistance during treatment (i.e. using suction to keep patient mouths dry, hand tools to dentists, etc.)
  • Sterilize dental instruments and equipment
  • Lay out needed dental instruments
  • Update and maintain patient records
  • Take X-rays for analysis by dentist
  • Perform intraoral and extraoral photography
  • Perform measurements of instruments in preparation for dental procedures
  • Prepare materials for dental impression, remove sutures and dressings, and apply topical anesthetics to gums.
  • Provide education to patients with regard to oral health care
  • Make appointments and perform office management
  • For a full description of all duties visit the Web site of the California Dental Assistant Association

Select Duties of Registered Dental Assistant (under the supervision of a licensed dentist) include:

  • All duties that a non-registered dental assistant is allowed to perform.
  • Mouth-mirror inspections of the oral cavity, to include charting of obvious lesions, existing restorations and missing teeth.
  • Apply and activate bleaching agents using a non-laser light-curing device.
  • Obtain intraoral images for computer-aided design (CAD), milled restorations.
  • Pulp vitality testing and recording of findings.
  • Place bases, liners, and bonding agents.
  • Chemically prepare teeth for bonding.
  • Place, adjust, and finish direct provisional restorations.
  • Fabricate, adjust, cement, and remove indirect provisional restorations, including placement of stainless steel crowns when used as a provisional restoration.
  • Place post-extraction dressings after inspection of the surgical site by the supervising licensed dentist.
  • Place periodontal dressings.
  • All other duties as specified by the California Dental Association (see link below)

Source: California Dental Assistant Association

Projected Growth

Employment prospects for dental assistants are expected to be excellent with an expected growth rate of 36 percent through 2018, far surpassing the rate of most other occupations. Preference for entry-level jobs will be given to those who have graduated from an accredited dental assisting program.

Education Requirements for Dental Assistants

California has no formal education requirements to become an entry-level dental assistant. High School students interested in pursuing this career should take courses in biology, chemistry, and office management. For those wishing to pursue further education, the California Dental Assistant Association offers a training program in the field which has been approved by the Commission on Dental Accreditation. The program includes classroom instruction, laboratory work, and instruction in dental assisting skills and theory. The program takes approximately one year to complete and graduates will be awarded a diploma. Entry to the program requires a H.S. Diploma or equivalent.

View a list of schools in California offering programs in dental assisting.

Many dental assistants are trained on-the-job.  In these situations, the supervising dentist or senior dental assistant teach needed skills, terminology, patient care, and how to perform daily office tasks.

Licensure and Certification of Dental Assistants

Dental Assistants may become registered through the California Dental Assistant Association. For further information regarding registration requirements an application instructions visit, http://www.dbc.ca.gov/applicants/rda/becomelicensed_rda.shtml.

Promotional Opportunities

While not required, registration allows dental assistants to pursue career advancement opportunities as an office manager, dental assisting instructor, dental products sales representative, or claims adjuster with insurance companies. Other dental assistants return to school to become dental hygienists.

Career Overview Dental Hygienists

Dental hygienists must be registered to work in California. They provide a diverse range of responsibilities, primarily becoming involved in preventative oral healthcare. They share some of the job duties as dental assistants, such as creating molds and taking X-rays but also perform the following tasks:

  • Gathers information regarding patients’ oral and medical history.
  • Uses hand tools and rotating instruments to remove calcifications, tartar stains and plaque (hard and soft deposits) from surface of patient teeth.
  • Counsels patients with regard to good nutrition and its affect on oral health
  • Records patient current dental condition in chart for review by dentist.
  • Applies fluorides and decay preventatives.
  • California permits registered dental hygienists to administer local anesthetics, oxygen, and nitrous oxide.
  • Removes sutures and dressings
  • Performs such periodontal therapy as root planning (deep cleaning to remove infected root structures)
  • All other duties as defined the California Association of Dental Hygienists. Visit, http://www.leginfo.ca.gov/cgi-bin/displaycode?section=bpc&group=01001-02000&file=1900-1966.6 for a comprehensive list of job duties permitted to be performed by registered dental hygienists in California.

Projected Growth

Employment prospects for dental hygienists are bright with a growth rate anticipated to be about 36 percent through 2018 which represents a much faster rate than is the case with most other occupations. This demand will arise from the increased need for dental services due to population growth, aging of the population, and a growing awareness of the importance of preventative dental care.

Education Requirements for Dental Hygienists

Graduation from an accredited dental hygiene program is required for entry level employment in California. High school students should take courses in biology, mathematics, and chemistry. Specific entry requirements differ from one school to another.  Coursework will include a combination of laboratory, clinical and classroom instruction in such subjects as anatomy and physiology, microbiology, pharmacology, nutrition, radiology, periodontology (study of gum disease), dental equipment, as well as behavioral science.

Most programs award an associate’s degree, although some also offer a certificate, diploma, or bachelor’s degree. As per the Dental Hygiene Committee of California, a minimum of an associate’s degree is typically required for practice in a private dental office in California. A bachelor or master’s degree will be required for teaching and advanced clinical practice in public health programs.

View a list of schools in California offering programs in dental hygiene.

Licensure of Dental Hygienists

Dental hygienists must be licensed in the State in which they work. California requires all applicants to have graduated from an accredited program and pass a written and clinical examination. The American Dental Association’s (ADA) Joint Commission on National Dental Examinations administers the written examination, which is accepted by all States and the District of Columbia. For additional information regarding application procedures and test construction visit http://www.ada.org/2662.aspx

State or regionally-based testing agencies administer the clinical examination. There are different requirements to become a licensed Dental Hygienist in California  depending on whether applicants have graduated from a dental hygiene program in-state or out-of-state.

For graduates of in-state programs visit http://www.dhcc.ca.gov/applicants/becomelicensed_rdh_calgrad.shtml to obtain licensure details: application instructions, examination details, etc.

Out-of-state applicants may visit http://www.dhcc.ca.gov/applicants/becomelicensed_rdh_outofstate.shtml to obtain licensure information.

Promotional Opportunities

Most advancement opportunities are available outside the dental office, and typically require a bachelor’s or master’s degree in dental hygiene or related field. Some dental hygienists may choose to pursue programs in teaching, careers in public health, or work in a corporate health setting.

Salary Difference between Dental Assistant and Dental Hygienists

Median Entry-level Salaries of Dental Hygienists and Dental Assistants in select cities (figures as per Salary.com May 2011).

City Dental Hygienist Dental Assistant
Fresno $56,535-$60,794 $30,534-$32,794
Los Angeles $61,952-$66,618 $33,459-$35.936
Sacramento $60,146-$64,677 $32,484-$34,889
San Diego $59,695-$64,191 $32,240-$34,627
San Francisco $67,707-$72,807 $36,568-$39,274