The following article was provided by the Washington State Dental Quality Assurance Commission (DQAC) for the Winter 2020 issue of the WSDA News.

Most of you have probably heard the term EFDA. What does that mean? EFDA stands for expanded function dental auxiliary. Now, what does that really mean?

First, a little about what it takes to be an EFDA. EFDAs must:

• Complete an educational program (only a few are in the state of Washington).
• Pass a written examination from the Dental Assisting National Board (DANB).
• Pass a clinical restorative examination given by a regional board, such as the ones offered by the Western Regional Examining Board (WREB) and the Central Regional Dental Testing Service (CRDTS), as hygienists do and similar to what dentists do. 

After appropriate training and successful completion of a clinical restorative examination, EFDAs are issued a license that allows them to place direct restorations such as amalgams, composites and glass ionomers, and take final impressions. They may not place, adjust, or “polish” indirect restorations. They may do many other things, including what all registered dental assistants can do, in addition to their restorative functions. Because of their additional training, some EFDAs are highly involved within office crown milling.

The original idea behind the EFDA program was to relieve the dentist of the need to place the restorations after preparing them, allowing the dentist to prepare teeth on other patients. This would allow an office to see more patients, lowering the “dentist cost” with the hope of allowing offices to see more low-income patients (or patients with limited access to care) without lowering the quality of care delivered and without imposing a financial burden upon the office. For example, public health clinics or federally qualified health centers could hire fewer dentists and more EFDAs to provide more care for fewer dollars. 

Is an EFDA a good thing for your office? It all depends. More and more offices are seeing the benefit to using EFDAs to place restorations. The practice owner needs to see how much time is spent placing restorations and work out the math. Are you busy enough that you feel under stress trying to see all the patients who need your care? Would there be a place in your practice to see patients with limited access to care if you use an EFDA? Would your practice function better for you, perhaps giving you more free time or less stress, if you had another staff member to lighten your load? If any of these are true, maybe there should be an EFDA in your future.