EFDA Curriculum

EFDA students in simulation lab pre-COVID

Program Expectations

Course Schedule

Students are expected to attend all lecture, laboratory and clinical sessions. In the program, students attend class one day per week during the August through May year, selecting a Wednesday or Friday session. Classes are held 8:30 a.m. to 4:30 p.m. 

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.


To offer students the advantage of continuing to work while attending classes just one day per week, the curriculum is intensive in nature. Students can expect to invest time studying and completing assignments outside the classroom (related to lectures) each week with an average of 10 hours per week. 

Course Materials and Resources

Included in tuition costs, 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. 


EFDA 111. Tooth Morphology for the EFDA. 1 Unit.
Instructional laboratory sessions provide experience with viewing models of teeth as well as reproducing teeth in wax. Mastery of terminology and basic facts of dental anatomy and tooth positions of permanent and primary teeth. Introduction of proper instrumentation begins.

EFDA 113. Dental Materials for the EFDA. 1 Unit.
Instructional laboratory sessions cover the physical and chemical properties and uses and manipulation of materials used in protection of the pulp and intracoronal temporization. Composition, properties and manipulation of dental amalgam, composite and pit and fissure sealant materials are also introduced. Isolation techniques, silver diamine placement and rubber dam placement.

EFDA 115. Restorative Dentistry for the EFDA I. 3 Units.
Skill development in the placement and carving of Class I, II, V and complex amalgam restorations on the typodont. Skill development in the placement and finishing and polishing of Class I, II, III, IV, and V composite restoration and amalgam restoration finishing and polishing on the typodont. Continued skill development in instrumentation, body positioning and ergonomics. Skill development in the use of low and high speed handpieces for rotary instrument use in finishing and polishing restorations. Skill development in self-evaluation using specific criteria. Pit and fissure sealant applications. **Student must show/pass competency of skills acquired to be able to progress in Clinical Practicum for the EFDA**. Review of OSDB practice act / jurisprudence for the EFDA.

EFDA 116. Restorative Dentistry for the EFDA II. 2 Units.
Students begin preparation for the state board examination by demonstrating successful completion of amalgam and composite restorations with increasingly difficult grading evaluation, mastery of self-evaluation skills, decreasing restoration placement time and by completing 2 mock board examinations. Students must pass a final clinical and didactic examination to pass the course. Emphasis on reveiwing Ohio EFDA Registration protocol.

EFDA 120. Clinical Practicum for the EFDA. 2 Units.
Students fulfill the Ohio State Dental Board requirement of having minimum of 80 hours of clinical experience on patients in their place of employment or CWRU approved dental clinics and will include a variety of restorative experiences on many patients. Students will restore patients' teeth under the direct supervision of a licensed dentist and a clinical supervisor in their place of employment or clinics affiliated with CWRU. Emphasis is placed on restoring metallic, non-metallic, and composite restorations.

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
  • Gingival retraction methods
  • Pit and fissure sealants
  • Rubber dam
  • Concepts in Pedodontic care
  • Silver Diamine Fluoride

Clinical Requirements

An applicant's dental employer 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 being permitted to provide care to patients. A preliminary agreement form to be signed by the employer is included in the application process 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. This option 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, needs of the student, and requires current immunizations, facility training and drug testing.

Students participate in mock board exams simulating the testing atmosphere and procedures of the actual state examination at the end of the second semester.

State Board Examination

After successful completion of the program, students are 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.

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

Program Standards

All students admitted to the Expanded Function Dental Auxiliary Program must meet the requirements listed below for admission, retention, promotion and graduation.

I. Program Performance Requirements

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

  • Familiarity with restorative procedures
  • Ability 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.
  • Familiarity with basic dental terms and nomenclature.
  • Ability to function effectively under the time constraints of the program and display flexibility in the event of changing lab and clinical situations.
  • Ability to apply didactic learning (theory) to clinical situations.
  • Ability to hear and communicate effectively, follow directions, act professionally in class and when delivering patient care.
  • Ability to read the printed words in EFDA textbooks and supplemental information, observe various dental instrument angulations and apply the concepts appropriately.
  • Eyesight must be able to visualize fine detail (either naturally or corrected), have depth perception, and have the ability to visualize three-dimensional objects.
  • Be physically free of the use of non-prescription drugs, illegal drugs and alcohol.
  • Show acceptable progress and pre-clinical competency in the program by a prescribed time before they are permitted to provide care to patients.
  • Expected to possess the ability to measure, calculate, reason, analyze, synthesize, and problem solve.
II. Behavioral and Social Attribute Requirements
  • Exhibit the emotional stability required for full utilization of their intellectual abilities, which includes—but is not limited to—the exercise of good judgment, organizational skills and the prompt completion of responsibilities associated with the program.
  • Exhibit integrity, honesty, professionalism, compassion and display a spirit of cooperation and teamwork.
  • Understand the legal and ethical aspects of the practice of dentistry as an EFDA and function within the law and ethical standards of the dental profession.
  • Accept responsibility for learning.
  • Contribute to collaborative, constructive learning environments, accept constructive feedback from others and take personal responsibility for making appropriate positive changes.
  • Candidates must understand that—as students—they must refrain from actions that detract from the professional atmosphere or orderly appearance of the School of Dental Medicine or University, including personal appearance or other actions. This expectation would also apply when attending any school-sponsored or related activities.
III. Motor Function Requirements

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 handpieces, 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).

IV. Technology Requirements

The EFDA program uses the university's online learning management system (Canvas). Therefore, students must have access to a computer to complete weekly assignments outside of class hours, maintain university assigned email addresses, and to have access to the university Student Information System (billing, grades, etc.).

When choosing a device, the following are recommended minimum specifications to consider, particularly for remote learning:

  • Operating System: Mac OS High Sierra or Catalina or Windows 10 or newer preferred.
  • Chrome OS or Linux not recommended.
  • Processor: Intel 15 or AMD equivalent or better
  • RAM: 8GB or higher
  • Hard Drive: 256 GB or larger
  • Wireless Card: Wireless N or better
  • Camera: Built-in or external, 720p or greater
  • Microphone: built-in or external

Other Considerations:

  • Sufficient ports to support any additional peripherals needed, such as an external webcam or headset
  • Any necessary adapters to ensure functioning of peripherals with the connections available on your device
  • Headset with microphone

When learning remotely, students will need to use their mobile device to login to Canvas and Zoom for preclinical activities, in addition to logging in with a desktop device (as explained in the Program Format document).

Phone or tablet needs the capability to take photos, record videos, install applications, and connect to the internet.

  • An ethernet (wired connection) is the most reliable
  • High speed internet is needed for synchronous sessions and secure testing
  • Preferred: Bandwidth of 10 megabits per second (Mbps) down and 2 Mbps up (or higher)

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