Missouri dental teams ask the same question again and again: how does an assistant become an EFDA? This post summarizes what the Missouri Dental Association (MDA) publishes about the path. It uses MDA pages opened on October 26, 2026. Fees, dates and rules change, so confirm each step with the MDA and the Missouri Dental Board. This is general information, not legal advice.
What is an EFDA in Missouri?
An expanded function dental assistant, or EFDA, is a dental assistant who has finished extra training to perform added tasks. A dentist must delegate those tasks. The MDA says it has developed and delivered expanded functions training since 1998. It also says five EFDA certifications now exist within its framework (MDA EFDA site, October 2026).
Which tasks fall under each certification is a question for the Missouri Dental Board. This post does not list them. The Board sets the legal scope of practice.
What are the steps to become an EFDA in Missouri?
The MDA pathway chart shows four steps: meet the course prerequisite, register, finish the course, and get a Board permit. The chart is a one-page PDF on the MDA EFDA site.
| Step | What the MDA chart says |
|---|---|
| 1. Meet the prerequisite | Pass the Missouri Dental Assisting Skills (MDAS) exam. The chart also lists the CDA or COA credential, or an active RDH license, as routes. |
| 2. Register | Present the MDAS, CDA, COA or RDH credential when you register for an MDA EFDA course. |
| 3. Complete the course | Finish MDA online coursework, attend in-person clinical training and pass all competency testing. |
| 4. Apply for the permit | Apply online to the Missouri Dental Board. The chart lists a $10 fee, proof of eligibility, the course certificate and current BLS. Permits renew every 5 years. |
The chart ties the CDA and COA routes to some restrictions, including one note about the orthodontic EFDA course. Read the PDF for the exact wording before you plan around those routes.
The chart also says an assistant may take the MDAS exam with on-the-job training only. The Dental Assisting National Board (DANB) gives the MDAS, CDA and COA exams.
When can a dentist delegate expanded functions?
Only after the assistant holds the permit. The MDA chart states that the permit is “required before delegation by supervising dentist in your practice.” Finishing a course alone is not enough.
Delegation and supervision rules come from the Board’s statutes and rules. A practice owner who plans to delegate should read those rules or ask the Board.
Does Missouri accept EFDA credentials from other states?
No. The MDA chart is direct on this point. It says Missouri does not recognize out-of-state EFDA training, permits or credentials as substitutes for its course prerequisites. A Registered Dental Assistant from another state is not exempt from the Missouri requirements.
This matters for hiring. A new hire who held an EFDA-type credential elsewhere cannot perform Missouri expanded functions until the Missouri steps are done.
How can a team or study club plan around EFDA courses?
The main limit is seats. The MDA says courses cap at 16 students, or 8 for Restorative II, and often fill before the suggested deadline. It lists the MDA Clinical Training Center in Jefferson City as the course location.
A study club can use these as discussion questions. They are planning prompts, not advice.
| Question | Why it matters |
|---|---|
| Which assistants meet a course prerequisite today? | The MDAS exam, CDA, COA or RDH license comes first. |
| Who covers the schedule on course days? | Training time takes an assistant away from the chair. |
| When will the permit be filed? | Delegation waits for the Board permit. |
| Who tracks the 5-year permit renewal? | A lapsed permit stops delegation. |
| How does this fit the wider workforce shortage? | Teams look at training as one response to hiring gaps. |
Leaders who want the wider hiring picture can read the guide on hiring and keeping a dental team. The guide on dental leadership covers team development more broadly. A related Missouri topic is the Oral Preventive Assistant pilot.
What other MDA courses sit beside the EFDA courses?
The MDA EFDA site lists two related offerings. Both can matter when a team plans training in order.
| Course | What the MDA site says |
|---|---|
| Basic Skills Review | In-person exam preparation for the EFDA course prerequisite; the next date was not set when the page was opened |
| Nitrous Oxide Monitoring | A certification course to administer and monitor nitrous oxide |
| EFDA courses | Offered on various dates at the MDA Clinical Training Center in Jefferson City |
The site also says member dentists get preferred pricing for EFDA training. Prices and dates were not copied here because they change often. Check the MDA EFDA site for the current schedule.
What should readers verify before acting?
Check three things on the day you plan: the current course dates on the MDA EFDA site, the current permit form and fee at the Missouri Dental Board, and the Board rules for the task you want to delegate. The MDA is a professional association. The Board is the licensing agency.
The MDA also frames the Periodontal EFDA role as a separate certification track. The post on the Oral Preventive Assistant pilot explains where that proposal stands.
Next step
To go deeper on building and developing a dental team, read the guide on hiring and keeping a dental team. Contact Dr. Copeland about study club topics. Dr. Jon Copeland, DDS, is a general dentist in Wildwood, Missouri, and a past president of the Missouri Dental Association.
Frequently asked questions
Does Missouri accept EFDA training from another state?
Not as a substitute. The MDA pathway chart says Missouri does not recognize out-of-state EFDA training, permits or credentials in place of its course prerequisites. An assistant who worked as an EFDA elsewhere must still complete the required Missouri courses and get the matching permit before a dentist delegates.
Who issues the Missouri EFDA permit?
The Missouri Dental Board issues it. The MDA chart says the permit is required before a supervising dentist delegates expanded functions. Check the Board for current forms, fees and renewal rules before you apply.
How many students can attend an MDA EFDA course?
The MDA says capacity is limited to 16 students for all courses, except Restorative II, which is limited to 8. It also says EFDA courses often fill before the suggested deadline, so teams should check dates early.
Terms on this page
Sources
- Missouri Dental Association (MDA EFDA): Expanded Functions Dental Assistant Program, opened October 26, 2026
- Missouri Dental Association (MDA EFDA): Pathway to Becoming A Missouri EFDA (PDF), opened October 26, 2026
- Missouri Dental Association (MDA EFDA): Periodontal EFDA (OPA), opened October 26, 2026
Written by Copeland Consulting Services and checked against the sources above on October 26, 2026. Rules, data and guidance change, so check the linked page before you act on it.