Expanded Function Dental Auxiliary (EFDA)

As the first EFDA Program in the state of Ohio, we are exceptionally proud of our reputation as the leader in Expanded Function Dental Auxiliary education since 1976. Our new 21st-century state-of-the-art facility contains technology that allows our educators to provide EFDA students with an educational experience of the highest quality. Take a look at the new facility here.

If you are a Certified Dental Assistant or Registered Dental Hygienist with a strong desire to do more with your dental expertise, such as being able to provide more hands-on care to your patients, or if your employer has confidence in your ability to contribute more to the dental team, then our program will help you reach the next professional level.

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What is an EFDA?

The Case Western Reserve University School of Dental Medicine EFDA Program (Expanded Function Dental Auxiliary) is designed to train Certified Dental Assistants and Registered Dental Hygienists in the art of Restorative Dentistry.  An Ohio EFDA specializes in the placement of advanced remedial intra-oral procedures that involve the placement of preventative or restorative materials limited to sealants and metallic and non-metallic restorative materials (fillings). To review all of the tasks legally delegated by a dentist to an EFDA in Ohio, please refer to the Ohio State Dental Board website


The EFDA Program is a very rigorous and challenging course of the highest caliber. Students are expected to attend ALL lecture, laboratory and clinical sessions. Students must be very familiar with restorative procedures, be able to use both direct vision and indirect mirror vision to complete and evaluate restorations, and will have to perfect fine motor skills to enable the accurate and safe application of dental handpieces and instruments.

EFDA Students attend class one day per week from August through May, and can choose Wednesday or Friday as their class day. Class is in session from 8:30 a.m. to 4:30 p.m. and enrollment is limited to 40 students, with 20 students per class maximum.

Learning takes place in our state-of-the-art training center. Included in the tuition, each student has their own workstation, instruments, materials, textbooks, typodont, tooth preparations, overhead lamp, and life-like simulator to learn the clinical skills necessary to restore teeth with amalgam and composite fillings, and place sealants. The first semester consists of lecture and lab, and the second semester is spent in the lab/clinic.

Students begin the program learning instrumentation, tooth anatomy and morphology using wax, and then gradually advance through one, two, three, and complex surface restorations of amalgam and composite on the typodont. Rubber dam placement, retraction cord placement, and sealant placement are also learned.

Computer Requirements

Our program utilizes specialized examination software (Examplify from ExamSoft) for which the use of a laptop (or Surface Pro tablet) with minimum system requirements for Windows is necessary. See the requirements below or read the full list on the ExamSoft website for Windows and Mac:

  • Operating System: 32-bit and 64-bit Versions of Windows 10. (Alternate versions of Windows 10, such as Windows RT and Windows 10S, are NOT supported at this time and only genuine, US-English versions of Windows Operating Systems are supported.)
  • CPU Processor: 2.0 ghz Intel i3 processor or equivalent
  • RAM: 4GB or higher
  • Hard Drive: highest recommended for the operating system or 1GB of available space
  • Internet Connection: required for Download, Registration, Exam Download and Upload
  • Screen Resolution: 1024x768 or higher.

The EFDA Program also uses the University’s online learning management system (Canvas) to supplement in-class learning. Therefore, students must have access to a computer to complete weekly assignments outside of class hours, maintain university assigned email address, and to have access to the university Student Information System (billing, grades, etc.).

Clinical Requirements

An applicant's employer dentist must agree to allow the EFDA trainee to perform intra-oral procedures (restorations) in their office during the second semester of the program. Students must pass competency assessments during the first semester before providing care to patients. A preliminary agreement form to be signed by the employer is included in the application packet, and a contract is to be signed by the sponsoring dentist during the first semester.

The Ohio State Dental Board requires Ohio EFDA students to complete at least 80 hours of patient clinical experience. In the event an applicant does not have employer support or is not employed, there is limited availability to complete the hours at one of our affiliate clinics and will require the student to spend extra time in addition to their class day to complete the required hours. Clinical / patient experience affiliations include MetroHealth Hospital Dental Clinics in Cleveland, Ohio, or St. Elizabeth Hospital Dental Clinic in Youngstown, Ohio. Participation in either of these facilities is subject to facility availability, the needs of the student, and requires current immunizations, facility training, and drug testing.

Mock board exams are given at the end of the second semester, simulating the testing atmosphere and procedures of the actual state examination.

State Board Examination

After successful completion of the course, the student will be eligible to sit for the state board examination for EFDA administered by the Commission on Dental Testing in Ohio or the Commission on Dental Competency Assessments. Graduates of the CWRU EFDA Program will be permitted to use CWRU-loaned instruments for the examination, but must provide their own restorative materials. Successful examination results are necessary to register with the Ohio State Dental Board to then legally practice as an EFDA in Ohio.

According to various sections of the Ohio Law and Regulations for Certification and Licensure Boards, persons convicted of any felony or misdemeanor may not be able to take the certification examination, may be refused acceptance of placement by the clinical/practicum sites, or may have restrictions placed on their ability to practice. For more information, contact the Ohio State Dental Board.

Students enrolled in the EFDA Program are ineligible to enroll in any other programs in the university until completion of the EFDA Program.


  • Employed auxiliaries will be given priority consideration.
  • Must have at least 2 years chairside assisting experience in general dentistry (within the past 5 years) unless RDH (however, strongly recommended).
  • CDAs: Proof of current status as a Certified Dental Assistant (notarized copy of current certification document) from the Dental Assisting National Board (DANB) or State of Ohio Certification showing certification expiration date is required.
  • RDHs: Proof of current status as a Registered Dental Hygienist (license) is required.

Foreign Trained Dentists

  • Must submit transcripts from the dental school attended that have been evaluated (U.S. course equivalency) by Educational Course Evaluators
  • Must show proof of TOEFL Examination results (English proficiency must be demonstrated by taking the Test of English as a Foreign Language).
  • The minimum score to be considered for admission is 577 (paper-based) or 90 (internet-based), no exceptions.
  • Applicants are exempt from the TOEFL requirements if they show proof of:
    • Speaking English as their native language
    • A bachelor’s degree or higher at a US college or university or a foreign university where instruction was in English and is documented as such on the transcript.

Program Performance Requirements

All students admitted to the Expanded Function Dental Auxiliary Program must be able to meet the following requirements:

  • Students must be familiar with restorative procedures
  • Students must be able to use both direct vision and indirect mirror vision to complete and evaluate restorations, and will have to perfect fine motor skills to enable the accurate and safe application of dental handpieces and instruments.
  • Students must be familiar with basic dental terms and nomenclature.
  • Students must be able to function effectively under the time constraints of the program and display flexibility in the event of changing lab and clinical situations.
  • Students must be able to apply didactic learning (theory) to clinical situations.
  • Students must be able to hear and communicate effectively, follow directions, and act professionally in class and when delivering patient care.
  • Students must be able to read the printed words in EFDA textbooks and supplemental information, observe various dental instrument angulations and apply the concepts appropriately.
  • Students' eyesight must be able to visualize fine detail (either naturally or corrected), have depth perception, and have the ability to visualize three-dimensional objects.
  • Students must be physically free of the use of non-prescription drugs, illegal drugs, and alcohol.
  • Students must show acceptable progress and pre-clinical competency in the program by a prescribed time before they are allowed to provide care to patients

An EFDA must have use of both hands, dexterity in the fingers, and tactile sensitivity to manipulate dental instruments, materials, dental handpieces, and operate dental equipment. The use of feet is necessary to manipulate the rheostat for hand pieces, and other adjunct dental equipment. The body must be able to work from a dental operator stool in order to perform dental procedures. The ability to sit and stand for a duration of time is also necessary.  Other specific requirements include color discrimination (differentiation of various shades of color and gradations from black to white); manual dexterity/motor coordination (discern changes in surface textures by manipulating dental instruments, control exertion of hand/finger pressure); hand-eye coordination (transfer of visual input into motor output); physical communications (hear commands through operator’s face mask; visual acuity (identify the working ends of various dental instruments and implements at a two foot distance); form/spatial ability (view in three-dimensional relationships, distinguish subtle changes from one form or shape to another, discriminate intricate measurements); and language development (speak clearly so that patient can understand his/her dental condition).

Application Process

  • Completed Application (print and mail to address indicated on application, along with items listed below)
  • $40.00 application fee
  • 2 letters of recommendation
  • Official high school or college transcripts identified by seal of issuing institution (mailed directly to EFDA Program or sent with application in a SEALED envelope. NO unofficial copies accepted). If sending directly to us from the issuing institution, the address MUST be written EXACTLY as follows to ensure delivery:
    Case Western Reserve University
    School of Dental Medicine / EFDA Program
    Samson Pavilion Room 133A
    10900 Euclid Avenue
    Cleveland, OH 44106-7342
  • Letter from employer verifying at least 2 years assisting experience in general dentistry within the past 5 years
  • Notarized copy of current CDA certificate or RDH license (including expiration date)
  • Proof of HepBVac immunization (or titer if more than 10 years ago)
  • Proof of current TB test results (current year)
  • Entrance Examination -- Basic dental assisting knowledge (instruments, nomenclature, burs, materials, classification of caries, etc.); Spatial relations; Perceptual ability

Once a complete application is received, the applicant is eligible to sit for the entrance examination and will immediately receive (mailed) a letter of confirmation with instructions for the exam. Incomplete applications will NOT be considered.

Lectures and Labs

  • Nomenclature
  • Caries classification
  • Cavity preparations
  • Oral anatomy
  • Dental anatomy and morphology
  • Periodontium
  • Histology
  • Basics of occlusion
  • Ergonomics
  • Instrumentation
  • Pulp protection
  • Dental materials
  • Matrix and wedge techniques
  • Temporization
  • Amalgam placement and carving
  • Polishing amalgams
  • Composite placement
  • Composite finishing and polishing
  • Posterior composites
  • Retraction cord placement
  • Pit and fissure sealant placement
  • Rubber dam placement


  • Dr. Ronald Occhionero, DDS, Associate Dean for Administration
  • Shelly H. Feiwell, MEd, CDA, EFDA, Director
  • Karin Hein, CDA, EFDA, Instructor

    EFDA Program: 216.368.3252
    Email: sxf35@case.edu


2020-2021: $5,600

A $1000 non-refundable fee to reserve your seat in the class once accepted into the program is to be paid by June 22nd, 2020 and will be applied towards the tuition. The remainder of the tuition will be billed to you by the university starting in August 2020. Tuition is billed by semester. Failure to pay the fall semester tuition will prevent registration for the second semester. Please refer to the Student Accounts Office for information on payment plan options (cannot be used for tuition deposit), health fee and penalties. Tuition dates and deadlines can be found here. Fall and Spring Tuition Rates for the Expanded Function Dental Auxiliary Certificate can be found here.

The University charges all enrolled students a Health Fee. If you can provide proof of coverage in your own health care plan, then you may waive the fee. All students, regardless of Health Fee Waiver, have access to the University Health Service while enrolled in the EFDA Program.

All students accepted into the EFDA Program must complete a background check (through an agency used by the school), and will be provided information to do so immediately once the tuition deposit has been received. Background checks MUST be approved and completed before the first day of the program for admission. No exceptions.

The School of Dental Medicine has the right to cancel or change classes without notice.

This is a dental continuing education course, and therefore does not qualify for federal financial aid. However, you may apply for private educational funding. See a list of private loans (click on “undergraduate loans” to continue to private loan options).

Additional Expenses

  • Board Examination: approximately $750 paid to the testing agency (not a CWRU fee)
  • Loupes (magnification glasses, optional but highly recommended): approximately $1,500
  • Parking: $10 per day
  • Background Check (required by the School of Dental Medicine. Access to specific company used provided upon acceptance to the program): approximately $80
  • Uniform scrub pants and shoes

This program is not approved by the Pennsylvania State Dental Board.