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Herzing University

Phyllis Neal

The Dental Assistant: Then and Now

The role of dental assistants has evolved over the years. See what this profession looks like today.

In 1885, Dr. Charles Edmund Kells, noted dentist and dental X-ray pioneer, asked his wife to assist him in his dental practice. She was helpful, to the extent that she even allowed her hands to be radiographed over and over as he perfected his techniques.

As his practice grew, Dr. Kells required additional help and hired a teenager named Malvina Cuerina to become his official assistant. Malvina is commonly recognized as the first dental assistant and stayed active in the dental community, being honored in her 80’s for her contribution to the profession.

The first dental assistants were called “Ladies in Waiting.” These assistants mostly helped mix materials and cleaned up the examining rooms. The biggest benefit of having a Lady in Waiting employed in the dental office was that it allowed women to obtain dental treatment without needing an escort for the appointment.

Times changed, duties developed and grew, and the Ladies and Waiting became today’s dental assistants. Dental assistants are now an essential part of every dental practice. A dental assistant’s duties are different than a dental hygienist. Tasks completed by dental assistants include:

  • Taking impressions of patients teeth
  • Sitting chairside to assist in 4- and 6-handed dentistry
  • Exposing radiographs; commonly called X-rays
  • Taking a patient’s vital signs
  • Teaching oral hygiene techniques
  • Managing the front office

Dental assistants are employed in private practices, clinics, hospital settings, schools, detention facilities, the military, insurance companies, dental supply houses, dental labs, and coroner offices. Depending on the state in which they are employed, dental assistants can enhance their skill levels with additional certification in orthodontics, coronal polishing, nitrous oxide-oxygen monitoring, and the application of dental sealants.

Due to the additional duties, the dental assisting profession requires more formalized training before working in the dental field. State rules vary from being trained on the job in an office to applying for licensure after graduation from an accredited institution. Most states also require that dental assistants have formalized training in dental X-ray production and safety with licensure upon completion.

CODA, the Commission on Dental Accreditation, sets the standards for all dental education in the U.S. Dental assistants graduating from an accredited institution can confidently state that they have the knowledge and skill needed to perform entry-level procedures in any general practice office. When looking for dental assisting schools, it’s important to look for a CODA-accredited program, like the one at Herzing University.

Dental assisting has come a long way from Dr. Kells and his Ladies in Waiting. The field has a strong history and with innovations in and the need for proper dental care, it promises to have a bright future.

Phyllis Neal is a registered dental hygienist, a certified dental assistant, a faculty member at Herzing University in the dental assisting program, the Department Chair of the Akron campus program and the Systems Division Chair of Dental Care within Herzing University. She has over 30 years of experience in the dental field, including over 20 years as a clinician in dental hygiene. She has an Associate’s degree in Applied Science in Dental Hygiene from Cuyahoga Community College, a Bachelor’s Degree in Technical Education, and Master’s Degree in Technical Education for Postsecondary Learners from the University of Akron.

Learn More About Becoming a Dental Assistant


* Bureau of Labor Statistics (BLS), U.S. Department of Labor, Occupational Employment and Wage Statistics 2023 / Occupational Outlook Handbook 2022. BLS estimates do not represent entry-level wages and/or salaries. Multiple factors, including prior experience, age, geography market in which you want to work and degree field, will affect career outcomes and earnings. Herzing neither represents that its graduates will earn the average salaries calculated by BLS for a particular job nor guarantees that graduation from its program will result in a job, promotion, salary increase or other career growth.

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