Candidate Handbook

DentalAnesthesia
AssistantNational
C ertification
E xamination

TABLE OF CONTENTS
Vision Statement......................................... 3

Rescheduling an Examination...................... 7

If You Pass the Examination....................... 11

Mission Statement...................................... 3

Missed Appointments.................................. 8

Verification of DAANCE Status.................... 11

Affiliation...................................................... 3

Substitution/Cancellation
and Refund Policies...................................... 8

If You Do Not Pass the
Examination/Retest Option........................ 12

DAANCE Program Overview........................ 3

Inclement Weather, Power
Failure or Emergency................................... 8

Appeals...................................................... 12

Introduction to the
DAANCE Program......................................... 3

Special Arrangements for
Candidates With Disabilities......................... 8

DAANCE Reading Resources List................. 12

Definition of theAnesthesia Assistant.................................... 4

Rules for Computerized Testing................ 8

DAANCE Examination
Content Outline....................................12-15

Statement of Nondiscrimination.............. 3

Eligibility Requirements............................... 4
About DAANCE............................................. 4
Educational Objectives................................. 4
Registration Information............................. 5
Fees and Payments...................................... 5
Self-study Component................................ 5
Topics Covered............................................. 5
About the Testing Agency............................ 6
Certification................................................. 6
Recertification............................................. 6
Preparation for the Examination.................. 6
About the Examination................................ 6
Pretesting.................................................... 6
The DAANCE Examination........................... 7

Taking the Examination............................... 8
Identification............................................... 9

Duplicate Score Report............................... 12

DAANCE Advisory Committee..................... 16

Security....................................................... 9

DAANCE Examination
Blueprint Matrix......................................... 16

Personal Belongings.................................... 9

Sample Questions...................................... 17

Examination Restrictions............................. 9Continuing Education Credit...................... 17

Misconduct................................................ 10

DAANCE Registration and Required
Documentation Checklist........................... 18

Copyrighted Examination
Questions................................................... 10
Practice Examination................................. 10
Timed Examination.................................... 10
Candidate Comments ................................ 10
Score Reports............................................. 10
Questions................................................... 11
General Information................................. 11

Examination Administration........................ 7

Scores Canceled by Advisory
Committee or PSI....................................... 11

Test Center Locations................................... 7

Disciplinary Policy...................................... 11

Scheduling the Final Examination............... 7

Pass/Fail Score Determination.................... 11

Registration Form...................................... 19
Request for Special Examination
Accommodations....................................... 20
Documentation of
Disability-related Needs............................. 21
Request for Duplicate DAANCE
Examination Score Report.......................... 22
Request to Change Mailingor Email Address Form............................... 23
DAANCE Substitution/
Cancellation/Reschedule Form................... 24
Request for Duplicate Certificate
and/or Pin Form......................................... 25

To help you prepare for the DAANCE, register for an AAOMS anesthesia assistants course at AAOMS.org/OMSStaff. Additional anesthesia
resource materials are available at AAOMSstore.com. These courses and materials, while not a comprehensive study program, are intended
to supplement your exam preparation.

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All questions and requests for information
about DAANCE Certification should bedirected to:

All questions and requests for information
about examination scheduling should bedirected to:

DAANCE
9700 W. Bryn Mawr Ave.
Rosemont, IL 60018-5701
Phone: 847-678-6200
Fax: 847-678-6286
Website: AAOMS.org/DAANCEPSI Candidate Services
18000 W. 105th St.
Olathe, KS 66061-7543
Phone: 833-333-4755
Fax: 913-895-4650
Email: ampExamServices@psionline.com
Website: Schedule.PSIexams.com© 2023. All rights reserved. No part of thispublication may be reproduced or transmitted
in any form or by any means, electronic ormechanical, including photocopy or recording,or any information and retrieval system,without permission in writing from the Dental
Anesthesia Assistant National Certification
Examination Advisory Committee (DAANCEAC).

IT IS YOUR RESPONSIBILITY TO READ AND UNDERSTAND
THE CONTENTS OF THIS HANDBOOK BEFORE APPLYING
FOR THE EXAMINATION.
This Handbook contains current information about
the certification examination developed by the Dental
Anesthesia Assistant National Certification Examination
Advisory Committee (DAANCEAC). It is essential you keep it
readily available for reference until you are notified of yourperformance on the examination. All previous versions of
this Handbook are null and void.
Direct all correspondence, address changes, requests for acurrent Candidate Handbook and information about thedevelopment and administration of the Dental Anesthesia
Assistant National Certification Examination (DAANCE)
certification program and recertification to:
DAANCE Advisory Committee
c/o PSI Candidate Services
18000 W. 105th St.
Olathe, KS 66061-7543, USA
833-333-4755
Fax: 913-895-4650
Email: ampExamServices@psionline.com
Schedule.PSIexams.com
After registering for the examination, candidates
may schedule an examination appointment online
at Schedule.PSIexams.com.

VISION STATEMENTThe Dental Anesthesia Assistant National Certification
Examination Advisory Committee raises the standard foranesthesia assistants by defining professional excellence
through the Dental Anesthesia Assistant National
Certification Examination.

MISSION STATEMENTThe Dental Anesthesia Assistant National Certification
Examination Advisory Committee, by providing the only
national anesthesia assistant certification, serves to educate,provide and promote the safe standards for supportive
dental anesthesia care.

AFFILIATIONThe DAANCEAC of the American Association of Oraland Maxillofacial Surgeons (AAOMS), the professionalorganization representing more than 10,000 oral andmaxillofacial surgeons in the United States, was formed in2007 to advance the profession of the anesthesia assistantthrough the development of a certification program. The
DAANCE Board/Committee establishes policies, procedures
and standards for certification and recertification in the fieldof anesthesia assistant quality. AAOMS supports its members’ability to practice their specialty through education, research
and advocacy. AAOMS members comply with rigorous
continuing education requirements and submit to periodic
office anesthesia evaluations.

STATEMENT OF NONDISCRIMINATIONThe DAANCEAC and PSI do not discriminate against
any individual or candidate with respect to age, sexual
preference, color, religion, creed, marital status, national
origin, race, language, medical conditions or disability.
All candidates are considered solely on the basis of their
independent ability to meet the eligibility criteria establishedby the DAANCEAC.

DAANCE PROGRAM OVERVIEWIntroduction
Control of the pain and anxiety of patients undergoing
dental and oral and maxillofacial surgery (OMS) proceduresis a primary focus of the dental profession. From the earlydays of anesthesia practice to the modern technology ofthe present, millions of anesthetic procedures have been
rendered safely by dentists trained in the administrationof general anesthesia, deep sedation, conscious sedation,
nitrous oxide analgesia and local anesthesia.
At the core of this experience are the dentist and his/her
office anesthesia team. In the course of prescribed training,
the contemporary oral and maxillofacial surgeon spends
major periods of time delivering the various forms ofanesthesia in the operating room as well as in a speciallyequipped operatory. In addition to this clinical experience,
the training program includes formal didactic material. Aftercompleting this intense educational experience, today’s
graduate of an approved oral and maxillofacial surgery
residency has the skills to provide safe and effective pain
and anxiety control in both the hospital and office settings.
Moreover, a growing number of other dental specialists
and general dentists are obtaining training in anesthesia
and sedation and using these treatment modalities in theirclinical practices.
To put these skills into practice, however, the correct setting
must be created. Organized oral and maxillofacial surgery,through its office anesthesia evaluation program and its
office emergency manual, has developed a system throughwhich anesthetic services are provided in a well-equipped
office by a practitioner knowledgeable in anesthetic practiceand emergency management. In the process of evaluating
the overall office environment, AAOMS recognized thata core educational experience could be tailored to theanesthesia assistant. DAANCE was developed to provide acontinuing education curriculum for professional allied staff.
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Although this program was initially developed by AAOMS,
there is clearly a need for the training of anesthesia assistantsin all dental practices where anesthesia and sedation areadministered.
The goals of this program are meant to provide a means forthe dental professional providing anesthesia and/or sedation
to help educate staff in the essentials of office-based
ambulatory anesthesia. With a better understanding of theseprinciples, it is anticipated that the office anesthesia assistantwill make a significant contribution to the patient care team.
This program is designed to assist not only the OMS office,but any dental office delivering outpatient anesthesia forother dental procedures. Doctors are encouraged to follow
up with their state dental board for an assistant’s full scopeof practice.

Definition of the Anesthesia Assistant
A Dental Anesthesia Assistant (DAA) possesses the expertiseto provide supportive anesthesia care in a safe and effective
manner. The DAA is knowledgeable in the perioperative andemergent care management of patients undergoing officebased outpatient anesthesia. The DAA is able to effectively
communicate pertinent information to patients and theirescorts as well as members of the healthcare team.

exam. The course is designed for oral and maxillofacial
surgery assistants or assistants employed by other dental
professionals with valid anesthesia permits.
The American Association of Oral and Maxillofacial Surgeons
is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association toassist dental professionals in identifying quality providers ofcontinuing dental education. ADA CERP does not approve orendorse individual courses or instructors, nor does it imply
acceptance of credit hours by boards of dentistry.
The American Association of Oral and Maxillofacial Surgeons
designates this activity for 36 continuing education credits.
Upon successful completion of the final examination, theassistant will receive proof of certification and a program
completion lapel pin.

Educational Objectives
Upon completion of this course, the dental anesthesia
assistant should be able to:
1. Describe the basic anatomy and physiologyof the cardiovascular and respiratory systems.
2. Describe the vascular anatomy of the forearm.
3. List the divisions of the central nervous system.

Eligibility Requirements
The following are the eligibility requirements forparticipation in the DAANCE program:•	You must be employed for at least six months by either anoral and maxillofacial surgeon who is a fellow or memberof AAOMS or by a dental professional who holds a valid
anesthesia permit.
•	Non-AAOMS offices must enclose a copy of theiranesthesia permit with each application submitted.
• You must provide a copy of a CURRENT CPR or BLS
certification with your registration form in order toreceive study materials.
• The CPR or BLS certification must be current throughyour examination date (a minimum of six months or yourregistration will not be approved, and you will not receive
your registration materials). Note: Once a new CPR card isreceived, your application will be processed and the study
package sent. If a new CPR card is not received within six
months of notification, you will be required to submit
a new application and fee to qualify for the examination.

About DAANCEDAANCE is a two-part continuing education program
comprised of approximately 36 hours of self-study
material and quizzes and a standardized, computer-based
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4.	Discuss the components of the medical history
and the review of systems.
5.	Compare and contrast the differences between generalanesthesia, deep sedation, conscious sedation, nitrous
oxide analgesia and local anesthesia.
6.	Discuss the drugs and techniques utilized by the oral andmaxillofacial surgery anesthesia team to achieve various
levels of anesthesia or sedation.
7.	Identify basic office emergencies and their treatment,
including cardiovascular, respiratory, allergic andconvulsive emergencies.
8.	Describe the essentials of monitoring blood pressure,pulse and oxygen saturation.
9.	Recognize normal electrocardiograph (ECG) waves andrecognize serious abnormal variations from the normal
rhythm.
10.	Recognize the essentials and importance of a complete
medical record.
The program is composed of two parts: 1. the self-study
component with quizzes and 2. the final exam. First, theassistant and the sponsoring surgeon should establish a
study schedule and a target date for the final examination.
For best availability, call to reserve this date as soon as you
have identified several preferred options. Working backwardfrom your final exam date, set up a schedule for completing
each module. Allow several weeks to complete each module.

Because individuals work at different paces, DAANCE allows
participants the opportunity to customize their studyschedules. Some modules may require additional study time.
Study should consist of reading the suggested material forthe module as listed in the course syllabus. The sponsoring
surgeon should be available to discuss questions about each
module during the weeks designated for studying them.
Establish a target date for completing and taking the quizfor that module. The sponsoring surgeon has the answer key
and should allow time for discussing the correct answers
with the assistant. Candidates are given six months fromtheir activation date to take the DAANCE test.

Registration Information
Each assistant enrolling in the program must complete a
registration form. You may photocopy the registration form.
Note: It is your responsibility to include the correct practice/office mailing address and email on the registration formin order to receive important communications about the
DAANCE program. If your mailing address or email addresschanges, please contact PSI (information below) with yourupdated information.
Mail registration forms to:
PSI Application Services
18000 W. 105th St.
Olathe, KS 66061-7543
Or fax registration forms to 913-895-4650.
Phone registrations are not accepted.
Direct questions to PSI at 833-333-4755.
Refer to the AAOMS DAANCE program.
Course materials will be mailed only to the sponsoring
doctor’s office address.
Please allow PSI three weeks to process the applicationand mail study materials.

Fees Payment
Tuition is $405 for AAOMS member-sponsored staff and $605
for other dentist-sponsored staff. Registration fee includes
the DAANCE study materials and examination fee. Approved
payment methods are credit card, personal check, company
check, cashier’s check or money order. Cash is not accepted.
Candidates who request testing in international locations
will be accommodated through web-based technology andgiven computerized examinations in a testing environment
similar to the conditions available through PSI’s national Test
Center Network. Please refer to Schedule.PSIexams.com fora current listing of international testing centers. Candidates
who desire to take an examination outside the United Statesshould submit a written request containing the desired
testing location along with the required additional $105
fee for Puerto Rico and international locations with theirapplication.

SELF-STUDY COMPONENTFor ultimate success with the program, it is best to
collaborate closely with your sponsoring doctor to prepare
for the DAANCE. However, while the self-study component
should be overseen by the sponsoring doctor, you shouldfamiliarize yourself with the course syllabus and study guidefor the specific modules to be covered on your own. You
and the sponsoring doctor should first establish a studyschedule and a target date for the final examination. For best
availability, it is suggested that you call to reserve this dateas soon as you have identified several preferred options.
Note: Candidates are given six months from their activation
date to take the examination. The activation date is thedate an application is made eligible. If you are not sure ofyour activation date and/or testing deadline date, call PSI
at 833-333-4755 to confirm. Working backward from yourfinal exam date, you and your sponsoring doctor will thenset up a schedule for completing the curriculum of each
module and corresponding quiz, allowing several weeks tocomplete each module. Because each individual may workat a different pace and some modules may require additional
study time, DAANCE offers you the opportunity to customize
your study schedules. Study should consist of reading thecontent of the module as well as the suggested additional
material for each module as listed in the course syllabus. The
sponsoring doctor should be available to discuss questions
regarding each module during the weeks that you designate
for studying that content. Then establish a target date tocomplete and take the quiz for each module. The sponsoring
doctor is provided the answer key for all quizzes and should
then grade the quizzes, allowing adequate time to review
the results and discuss the correct answers with you. Aftercompleting the quizzes and self-study portion of the
program, and once prepared to take the final examination,
you may then either schedule an examination appointment(if you have not done so already by calling PSI) or sit for yourscheduled examination.

Topics Covered
Assistants and sponsoring doctors will each receive
study materials that focus on the following five areas:• Basic sciences• Systemic diseases and evaluation/preparation of patients• Anesthetic drugs and techniques• Anesthesia equipment and monitoring• Office anesthesia emergencies
A suggested reading list is included in the DAANCE study
guide. Upon completion of each module, the assistant willtake a practice quiz, which the sponsoring doctor will score.
The doctor will receive an answer key with his/her study
guide. These quizzes are for reference and do not need to5

be submitted to AAOMS. When the assistant has completed
all study guide modules and practice quizzes, it is time toschedule the final examination.

About the Testing Agency
The DAANCEAC has contracted with PSI Services to assist
in the development, administration, scoring, score reporting
and analysis of the DAANCE. Contracting with PSI provides
a stable base from which the voluntary DAANCEAC operates
and serves as a conduit of information between certified
professionals, candidates and the DAANCE Board/Committee.
PSI carefully adheres to industry standards for developmentof practice-related, criterion-referenced examinations toassess competency.
PSI has 70 years of experience providing worldwide testing
solutions to corporations, federal and state government
agencies, professional associations, certifying bodies andleading academic institutions. PSI offers a comprehensive
solutions approach from test development to delivery toresults processing, including pre-hire employment selection,
managerial assessments, licensing and certification tests,
distance learning testing, license management services
and professional services.

Enrolled assistants should familiarize themselves withthe course syllabus and study guide for the specific module
to be covered. Requested reading source material is to bereviewed by the anesthesia assistant as part of the program
as well. Through close interaction between the sponsoring
doctor and the assistant, these academic materials should
be reviewed.
The assistant and sponsoring doctor should establish atimeline for moving through the curriculum and the quizzes
covering the module. The quizzes should be graded by thesponsoring doctor.
Every anesthesia assistant registered in DAANCE is required
to be certified in Basic Cardiac Life Support (BLS), Advanced
Cardiac Life Support (ACLS) or cardiopulmonary resuscitation(CPR). It is hoped this combined educational venture will
strengthen the anesthesia assistant’s knowledge and skills
and ultimately contribute to improved patient care.
Confirmation of a candidate’s eligibility will be valid
for a period of six months. If a candidate fails to schedule
an examination appointment within the six-month eligibility
period, he or she will forfeit fees and be required to reapply
and resubmit the full application fee to receive a new
window of eligibility.

Certification

About the Examination

To ensure the DAANCE examination meets existing
professional testing standards, the DAANCEAC follows theStandards for Educational and Psychological Testing (1999) as
published by the American Educational Research Association,
American Psychological Association and the National
Council on Measurement in Education. The standards aredesigned to establish criteria for appropriate development,
use and interpretation of tests. The examination is available
in computer-based format at PSI Test Centers in the UnitedStates.

The DAANCE examination consists of 115 multiple-choicequestions. Fifteen items will be included as pretest items,
which are unscored and will not affect a candidate’s score.
Candidates will have two hours to complete the exam. The
examination is administered in a computerized format that
does not require computer experience or typing skills. The
DAANCEAC uses the following percentage guidelines inselecting the three types of questions that appear on eachexamination: 37 percent recall, 47 percent application and
16 percent analysis. Recall questions test the candidate’sknowledge of specific facts and concepts. Applicationquestions require the candidate to interpret or apply
information to a situation. Analysis questions test thecandidate’s ability to evaluate, problem solve or integratea variety of information and/or judgment into a meaningfulwhole.

You must pass the examination to become certified. Yourcertification in Dental Anesthesia Assisting is effective on
the date you pass the examination. The credential is valid
from that date through a five-year period from the monthof your examination (for example, if you pass at some point
between July 1 to 31, 2023, your expiration would be July 31,2028). Upon successful completion of the final examination,
you will receive proof of certification and a program
completion lapel pin.

Recertification
DAANCE certification is valid for five years. To recertify,
assistants must retake the DAANCE examination every five
years and maintain current BLS and/or ACLS certifications.
Note: Online CPR certifications are not accepted.
6Preparation for the Examination

Pretesting
Pretesting items allows the DAANCEAC to collect meaningfulstatistics about new questions that may appear as scoreditems on future examinations. Pretesting is accomplishedby interspersing new untried questions throughout
the examination. These items are not scored as part ofthe candidate’s examination, and they do not affect anindividual’s pass/fail status. The pretest questions arescattered throughout the examination so candidates willanswer them with the same care they would items tobe scored as part of the final examination. The statistical
performance of the pretest items is later evaluated, anditems that perform well can then be included on a future
examination as scored items.

You must go online or call to schedule an examination
appointment at least two business days in advance.
Unscheduled candidates (walk-ins) will not be admitted
to the Test Center. If you do not attempt to take theexamination before your eligibility period expires, you will
forfeit your opportunity to test and must re-register andsubmit full payment in order to take the exam.

THE DAANCE EXAMINATION

When you call to schedule an appointment for examination,
you will be notified of the time to report to the Test Center.
An examination appointment confirmation email will be sent
to candidates who provide a valid email address.

Examination Administration
The final examination will be administered at testing sites
throughout the country. All questions about examination
dates or sites should be directed to:
PSI Candidate Services
18000 W. 105th St.
Olathe, KS 66061-7543, USA
833-333-4755
Fax: 913-895-4650
Email: ampExamServices@psionline.com
Schedule.PSIexams.com

Test Center Locations
The final examination will be administered by PSI. Specificaddress information will be provided when you schedule
an examination appointment. Detailed maps and directions
also are available at Schedule.PSIexams.com.

Scheduling the Final Examination
The examination will be administered exclusively in
a computerized format at established PSI Test Centers
nationwide. You do not need computer experience or typing
skills to take the examination. Easy-to-follow instructions
are displayed on screen, and time is allotted for practiceprior to starting the actual examination. Appointments must
be made at least two business days in advance. Results areavailable immediately after completion of the examination.
After completing the quizzes and self-study portion of the
program, you may schedule an examination appointment
at Schedule.PSIexams.com or by calling PSI toll-free at833-333-4755. The examinations are administered byappointment only Monday through Saturday. Appointment
starting times may vary by location. Individuals arescheduled on a first-come, first-served basis. For best
availability, you are encouraged to schedule examination
appointments well in advance of yourdesired date.

If you contacted PSI by
3 p.m. Central Time on...

Depending on availability,
your examination may bescheduled as early as:

Rescheduling an Examination
If for any reason you need to reschedule your examination,
you will be allowed a one-time rescheduling option withinyour six-month eligibility period at no charge.
You may reschedule one appointment for examination
at no charge online at Schedule.PSIexams.com or by calling
PSI at 833-333-4755 at least two business days prior to thescheduled testing session. A rescheduling fee of $95 will
be charged for any subsequent appointment changes within
the candidate’s eligibility period. Complete the DAANCE
Substitution/Cancellation/Reschedule Form in this brochureif necessary.
Requests for rescheduled/additional appointments must be
made on the Substitution/Cancellation/Reschedule Form(also included in this brochure) and mailed or faxed to:
PSI
18000 W. 105th St.
Olathe, KS 66061-7543
Fax: 913-895-4650

If your examinationis scheduled on...

You must contact PSI by 3 p.m.
Central Time to reschedule theexamination by the previous:

If you have not received your testing deadline date, contact
PSI to verify the date by which you must take your test. It isyour responsibility to obtain and remember your expiration
date.
7

Missed Appointments
You will forfeit your examination registration and all fees paid
to take the examination under the following circumstances(a new, complete application and examination fee are
required to reapply for examination):•	You wish to reschedule an examination but fail to contact
PSI at least two business days prior to the scheduled
testing session.
• You appear more than 15 minutes late for an examination.
•	You fail to report for an examination appointment anddo not reschedule within your eligibility period for $95.
•	You do not reapply within 30 days of a failed examination
to retake the examination for an $95 fee.

Substitution/Cancellation and Refund Policies
All substitutions and cancellations must be made using
the DAANCE Substitution/Cancellation/Reschedule Formprovided at the end of this candidate handbook or on the
AAOMS website at AAOMS.org. Phone cancellations andsubstitutions will not be accepted. Substitutions require
the Substitution/Cancellation/Reschedule Form (page 24)
accompanied by a completed DAANCE Registration Form
(page 19) and a valid CPR and/or BLS card for the newregistrant. Note: A candidate may be permitted to participate
in only one substitution per eligible record.
It is the responsibility of the sponsoring doctor to notify PSIof the substitution and to transfer previously provided course
material to the substitute registrant. New course material will
not be provided to the substitute registrant.
Cancellation requests must be received within 90 days ofthe candidate’s activation date. Requests received after 90
days of candidate’s activation will not be accepted and theexamination registration and all fees paid will be forfeited. If
a cancellation is made before 90 days, the sponsoring doctor
will receive a refund equal to 50 percent of the registration
fee. Substitutions must be made no later than 30 days before
the candidate’s expiration of eligibility.
Candidates have six months from their activation dateto take their examination. If unsure of the testing deadline
date, contact PSI at 833-333-4755.

Inclement Weather, Power Failure or Emergency
In the event of inclement weather or unforeseen
emergencies on the day of an examination, PSI will
determine whether circumstances warrant the cancellationand subsequent rescheduling of an examination. The
examination will usually not be rescheduled if the Test
Center personnel are able to open the Test Center.

8

You may visit Schedule.PSIexams.com prior to theexamination to determine if any Test Centers are closed.
Every attempt is made to administer the examination asscheduled; however, should an examination be canceled at a
Test Center, all scheduled candidates will receive notification
following the examination date regarding rescheduling or
reapplication procedures.
If power to a Test Center is temporarily interrupted duringadministration, your examination will be restarted. The
responses provided up to the point of interruption will
be intact, but for security reasons the questions will bescrambled.

Special Arrangements
for Candidates With Disabilities
PSI complies with the Americans with Disabilities Act
and strives to ensure that no individual with a disability
is deprived of the opportunity to take the DAANCE
examination solely by reason of that disability. PSI will
provide reasonable accommodations for candidates withdisabilities. Wheelchair access is available at almost all
established Test Centers. Candidates with visual, sensory or
physical disabilities that would prevent them from taking theexamination under standard conditions may request special
accommodations and arrangements. Verification of thedisability and a statement from an appropriate professional(education professional, doctor, psychologist, psychiatrist)of the specific type of assistance needed must be made inwriting and included with the completed registration form
and required documentation upon enrollment in DAANCE.
When you call to schedule your examination, please inform
PSI of your need for special accommodations. Please refer tothe Request for Special Examination Accommodations formon page 20.

RULES FOR COMPUTERIZED TESTINGTaking the Examination
Your examination will be given by computer at a PSI Test
Center. You do not need any computer experience ortyping skills to take your examination. On the day of yourexamination appointment, report to the Test Center no later
than your scheduled testing time. Look for signs indicating
PSI Test Center check-in. If you arrive more than 15 minutes
after the scheduled testing time, you will not be admitted
and you will forfeit your examination registration andall fees paid to take the examination. A new, complete
application and examination fee will be required toreapply for examination.

Identification• No calculators are permitted.

You must have proper identification to gain admission
to the Test Center.

• No guests, visitors or family members are allowedin the testing room or reception areas.

To gain admission to the Test Center, you must present
two forms of identification. The primary form must be
government-issued, current and include your name,signature and photograph. No form of temporary
identification will be accepted. You also will be required
to sign a roster for verification of identity.
• Examples of valid primary forms of identification are:driver’s license with photograph; state identification
card with photograph; passport; military identification
card with photograph.
• The secondary form of identification must display yourname and signature for signature verification (e.g., credit
card with signature, Social Security card with signature,
employment/student ID card with signature).
• If your name on your registration is different than it appears
on your identification, you must bring proof of your namechange (e.g., marriage license, divorce decree or court
order).
Candidates must have proper identification to gain
admission to the Test Center. Failure to provide appropriate
identification at the time of the examination is considered a
missed appointment. There will be no refund of examination
fees.
After your identification has been confirmed, you will bedirected to a testing carrel. At the testing carrel, you will
be prompted on-screen to enter your assigned candidate
ID number. Your photograph, taken before beginning theexamination, will remain on-screen throughout your testing
session. This photograph also will appear on your printed
score report.

Security
PSI administration and security standards are designed toensure all candidates are provided the same opportunity todemonstrate their abilities. The Test Center is continuously
monitored by audio and video surveillance equipment for
security purposes.
The following security procedures apply during theexamination:• Examinations are proprietary. No cameras, notes, taperecorders, pagers or cellular/smart phones are allowed in
the testing room. Possession of a cellular/smart phone orother electronic device is strictly prohibited and will resultin dismissal from the examination.

Personal Belongings
No personal items, valuables or weapons should be
brought to the Test Center. Only wallets and keys
are permitted. Coats must be left outside the testing room.
You will be provided a soft locker to store your wallet
and/or keys with you in the testing room. The proctor willlock the soft locker prior to you entering the testing room.
You will not have access to these items until after theexamination is completed. Please note the following items
will not be allowed in the testing room except securely
locked in the soft locker:• Watches• Hats• Wallets• KeysOnce you have placed everything in the soft locker, you will
be asked to pull out your pockets to ensure they are empty.
If all personal items will not fit in the soft locker, you will
not be able to test. The site will not store any personal
belongings.
If any personal items are observed or heard (e.g., cellular/
smart phones, alarms) in the testing room after theexamination is started, the administration will be forfeited.

Examination Restrictions• Pencils will be provided during check-in.
• You will be provided with one piece of scratch paper at atime to use during the examination, unless noted on thesign-in roster for a particular candidate. You must returnthe scratch paper to the proctor at the completion of
testing, or you will not receive your score report.
• No documents or notes of any kind may be removed
from the Test Center.
• No questions concerning the content of the examination
may be asked during the examination.
• Eating, drinking or smoking are not permitted in the Test
Center.
• You may take a break whenever you wish, but you will not
be allowed additional time to make up for time lost during
breaks.

9Misconduct
You may be dismissed, your scores will not be reported andexamination fees will not be refunded if you engage in anyof the following misconduct:• Create a disturbance, are abusive or otherwise
uncooperative.
• Display and/or use electronic communications equipment,such as pagers and cellular/smart phones.
• Talk or participate in conversation with other examination
candidates.
• Give or receive help or are suspected of doing so.
• Leave the Test Center during the administration.
• Attempt to record examination questions or make notes.
• Attempt to take the examination for someone else.
• Are observed with personal belongings.
• Are observed with notes, books or other aids without
it being noted on the roster.

Copyrighted Examination Questions
All examination questions are the copyrighted property of
AAOMS. It is forbidden under federal copyright law to copy,
reproduce, record, distribute or display these examinationquestions by any means, in whole or in part. Doing so may
subject you to severe civil and criminal penalties.

Practice Examination
Prior to attempting the examination, you will be given
the opportunity to practice taking an examination on acomputer. The time you use for this practice examination
is NOT counted as part of your examination time. When you
are comfortable with the computer testing process, you may
quit the practice session and begin the timed examination.

Timed Examination
Following the practice examination, you will begin theactual examination. Before beginning, instructions for taking
the examination are provided on-screen. The examination
contains 115 items (100 scored and 15 non-scored pretest
items). You will have two hours to complete the examination.
The computer monitors the time you spend on theexamination. The examination will terminate if you exceed
two hours. You may click on the Time box in the lowerright portion of the screen to monitor your time. A digitalclock indicates the time remaining for you to complete theexamination. The time feature also may be turned off during
the examination.
Only one item is presented at a time. The item number
appears in the lower-right portion of the screen. The entire
10

item appears on-screen (i.e., item and four options labeled A,
B, C and D). Indicate your choice by either entering the letterof the option you think is correct (A, B, C or D) or clicking
on the option using the mouse. Your answer appears in thelower-left portion of the screen in the box labeled Response.
To change your answer, enter a different option by typing A,
B, C or D or by clicking on the option using the mouse. You
may change your answer as many times as you wish.
To move to the next item, click on the forward arrow (>) in
the lower-right portion of the screen. This action will move
you forward through the examination item by item. If you
wish to review any item or items, click the backward arrow(<) or use the left arrow key to move backward through theexamination.
You may leave an item unanswered and return to it later.
Questions also may be bookmarked for later review byclicking in the blank square to the right of the Time button.
To advance to the next unanswered item on the exam, clickon the double arrows (>>). To identify all unanswered or
bookmarked items, repeatedly click on the double arrows(>>). When you have completed the examination, thenumber of examination items you answered is reported.
If you have not answered all items and you have timeremaining, return to the examination and answer those
items. Be sure to answer each item before ending theexamination. There is no penalty for guessing.

Candidate Comments
During the examination, you may add comments for any
question by clicking on the Comment button to the left of
the Time button. This opens a dialogue box where comments
may be entered. Comments will be reviewed, but individual
responses will not be provided.

Score Reports
After you finish the examination, you will be asked tocomplete a short evaluation of your testing experience. Then,
you will be instructed to report to the testing proctor toreceive your score report. Scores are reported in printed form
only, in person or by U.S. mail. Scores are not reported over
the telephone, by electronic mail or by facsimile.
Your score report will indicate “pass” or “fail.” Additional
details are provided in the form of raw scores by major
content category. A raw score is the number of items you
answered correctly. Your pass/fail status is determined byyour raw score.
To preserve the integrity of DAANCE, testing reports will
not provide examination questions and correct answers.
Testing reports are sent only to the sponsoring doctor. If thesponsoring doctor requires an additional report, he/she must
contact PSI directly and pay the appropriate fees directly
to PSI.

Questions

Pass/Fail Score Determination

All questions regarding registration, substitutions,cancellations and administration of the final
examination should be directed to:

The DAANCEAC is not able to release or discuss individualquestions with candidates following the examination. To
do so would require elimination of that question from theitem bank of pretested questions and deplete the numberof pretested questions required to develop future versionsof the examination.

PSI Candidate Services
18000 W. 105th St.
Olathe, KS 66061-7543
Phone: 833-333-4755
Fax: 913-895-4650

GENERAL INFORMATION
Scores Canceled by the Advisory Committee or PSI
The DAANCEAC and PSI are responsible for the integrityof the scores they report. On occasion, occurrences suchas computer malfunction or misconduct by a candidate
may cause a score to be suspect. The Advisory Committee
and PSI are committed to rectifying such discrepancies as
expeditiously as possible. The Advisory Committee may void
examination results if, upon investigation, violation of its
regulations is discovered.

Disciplinary Policy
The DAANCEAC shall undertake sanctions against applicants,
candidates or individuals already awarded the DAANCE
designation only in relation to failure to meet requirements
for initial certification or recertification. The DAANCE is avoluntary process, not required by law for employment in thefield. Monitoring and evaluating actual job performance isbeyond the scope of the Advisory Committee.
Applications may be refused, candidates may be barred fromfuture examinations, or candidates or individuals alreadycertified may be sanctioned – including revocation of the
DAANCE designation – for the following reasons:• Attesting to false information on the application or
on recertification documents or during a random
audit procedure.

The methodology used to set the minimum passing scoreis the Angoff method, applied during the performanceof a Passing Point Study by a panel of experts in the field.
The experts evaluated each question on the examination
to determine how many correct answers are necessary todemonstrate the knowledge and skills required to pass thisexamination portion. Your ability to pass the examination
depends on the knowledge and skill you display, not on theperformance of other candidates.
Passing scores may vary slightly for each version of theexamination. To ensure fairness to all candidates, a processof statistical equating is used. This involves selecting anappropriate mix of individual questions for each versionof the examination that meets the content distribution
requirements of the examination content blueprint. Because
each question has been pretested, a difficulty level can be
assigned. The process then considers the difficulty level ofeach question selected for each version of the examination,
attempting to match the difficulty level of each version
as closely as possible. To assure fairness, slight variations
in difficulty level are addressed by adjusting the passing
score up or down, depending on the overall difficulty levelstatistics for the group of scored questions that appear ona particular version of the examination.

If You Pass the Examination
Upon successful completion of the final examination, theassistant will receive proof of certification and a program
completion lapel pin. Your certificate and lapel pin will bemailed to registration address or sponsor address six to eightweeks after you pass the examination.

• Removing or attempting to remove examinationmaterials or information from the testing site.

Replacement certificates and replacement or extra DAANCE
pins can be obtained by completing the Request for
Duplicate Certificate or Pin Form in this Candidate Handbook.
DAANCE pins are available for $10, and Certificates areavailable for $20.

• Unauthorized possession and/or distribution of any
official testing or examination materials.

Verification of DAANCE Status•		Giving or receiving information to or from anothercandidate during the examination.

• Representing oneself falsely as a designated DAANCE
certified professional.

Information on the current certification status of anindividual will be provided to the public upon request.
Employers who request verification of a DAANCE-certified
professional must provide the individual’s name andcandidate ID number to assure correct identificationin the DAANCE database.
11

If You Do Not Pass the Examination/Retest Option

Duplicate Score Report

Individuals who do not pass the original examination will
receive retest registration information with their score
reports and will have 30 days to submit the necessary retest
registration form. Such individuals will be allowed one
retest for a fee of $95 and must submit the necessary retest
registration forms to PSI within 30 days of failing the exam.*
Candidates who wish to retake the examination in Puerto
Rico or outside the United States should submit a written
request containing the desired testing location along withthe required additional $105 fee with their application.
Once you complete the appropriate forms and submit themto PSI with the $95 retest fee (plus the additional $105 fee
for Puerto Rico and international locations, if applicable), a
new activation date will be assigned. You will then have anadditional six months from the new activation date to retakethe test.

You may purchase additional copies of your score report at
a cost of $25 per copy, payable by cashier’s check or moneyorder to PSI Services, Inc. Requests must be submitted to
PSI, in writing, within 90 days after the examination. The
request must include your name, candidate ID number,
mailing address, date of examination and your signature.
Use the form in the back of this Handbook to request aduplicate score report. Duplicate score reports will be mailed
approximately five business days after receipt of the request.
Score reports are only provided to sponsoring doctors.

*NOTE: It is the candidate’s responsibility to complete
and submit the reapplication form to PSI within 30 daysof the failed attempt. Candidates who fail to submit thereapplication form will not be allowed to retest at the $95
fee and will be expected to re-register for the program at
the full fee.
Names of candidates who do not pass the examination
are confidential and are not revealed under any
circumstances, except by legal compulsory process.

Appeals
Because the performance of each question on theexamination that is included in the final score has beenpretested, there are no appeal procedures to challenge
individual examination questions, answers or a failing score.
Actions by the Advisory Committee affecting eligibilityof a candidate to take the examination may be appealed.
Additionally, appeals may be considered for alleged
inappropriate examination administration procedures orenvironmental testing conditions severe enough to cause amajor disruption of the examination process and that could
have been avoided.
All appeals must be submitted in writing. Equivalency
eligibility appeals must be received within 30 days of
the initial Advisory Committee action. Appeals for alleged
inappropriate administration procedures or severe adverse
environmental testing conditions must be received within
60 days of the release of examination results.
The DAANCEAC chair will respond within 30 days of receiptof the appeal. If this decision is adverse, the candidate may
file a second-level appeal within 30 days. A three-member
panel of the DAANCE Advisory Committee will review thechair’s decision and respond with a final decision within
45 days of receipt.
12

DAANCE Reading Resources List
The following books are suggested reading materials thatwill enhance your educational experience. Several of theseresources are available through AAOMS Publications or atlarge public or medical/dental school libraries:
American Association of Oral and Maxillofacial Surgeons.
Dental Anesthesia Assistant National Certification Examination
Study Materials.
American Association of Oral and Maxillofacial Surgeons.
2018. Office Anesthesia Evaluation Manual, 9th edition.
(To order, phone: 800-366-6725; online: AAOMSstore.com)
American Heart Association. 2020. Advanced
Cardiovascular Life Support (ACLS) Provider Manual.
Item #20-1106. (To order, contact Worldpoint ECC;
phone: 888-322-8350; online: worldpoint.com)

DAANCE Examination Content Outline
The content validity of DAANCE is based on analysis of theresults of a survey of the tasks of the Dental Anesthesia
Assistant (DAA). The results and subsequent analysis were
sufficiently detailed to provide a professionally sound andlegally defensible basis for the development of a certification
examination. Each question on the examination is linked
directly to one of the five tasks listed below. In other words,
each question is designed to test if the candidate possesses
the knowledge necessary to perform the task and/or has theability to apply it to a job situation.
Each of the tasks was rated as significant to practice by DAAs
who responded to the survey. After the survey data wereanalyzed, the results were reviewed and decision rules were
established. These rules were used to determine which tasks
were appropriate for assessment and, therefore, for inclusionin the content domain and final test. Thus, the examination
content is valid for DAAs and examinations constructed tomeet these specifications will have substantial evidence ofvalidity and job-relatedness.

The following tasks are those that form the DAANCE content
outline and to which the examination questions are linked:

		 3. Cardiovascular

I. Apply Knowledge of Basic Sciences (15 items)

		 5. Endocrine		 4. Respiratory		 6. Renal and hepatic
A. Cardiovascular anatomy and physiology
1. The myocardium, chambers, vessels and valves		 2. The heart as a pump and the conduction system
		 3. Vasculature of importance in OMS
			a. Vasculature of the head and neck			b. Vasculature of the arm

B. Pulmonary anatomy and physiology

		 7. Musculoskeletal (malignant hyperthermia)
F. Review social/family history/dependence
G. Perform physical assessment
H. Document breathing pattern
I. Survey skin – color, bruising, etc.
J. Document height and weight
K. Assess that the patient is alert and oriented

		 1. The upper and lower airway

L. Record vital signs

		 2. Physiology of respiration and lung volumes

M. Document ASA classification

		 3. Control of respiration
C. The nervous system
		 1. Central and peripheral		 2. Cranial and spinal nerves		 3. Sympathetic nervous system
D. Pharmacology

III. Assist in Administration of Anesthetic Drugs(18 items)
A. Prepare anesthetics
		 1. Local anesthetics
			a. Esters and amides

			b. Vasoconstrictors

		 1. Mechanisms and sites of action

		 2. Intravenous sedation anesthetics

		 2. Absorption and metabolism

			a. Benzodiazepines		 3. Mathematics of anesthetic drugs

			b. Narcotics

		 4. Levels of sedation and anesthesia			c. Narcotic agonist – antagonists

		 5. Anesthetic approaches		 3. Oral sedation anesthetics – benzodiazepines

			a. Intravenous

		 4. Intravenous general anesthetics

			b. Inhalation

			a. Propofol			b. Ketamine			c. Barbiturates

II. Evaluate and Prepare Patient (20 items)
A. Verify that chart is for the patient		 5. Adjunctive agents			a. Topical local anesthetics

			b. Drug reversal agents

C. Collect history of present illness			c. Anticholinergics

D. Review past medical/dental history (PMH)			d. Antihistamines, ataractics and related agents			e. Antiemetics

			f. Steroids			g. Muscle relaxants

B. Elicit chief complaint (CC)E. Perform review of systems
		 1. Nervous system
		 2. Head, eyes, ears, nose, throat (HEENT)

13

B. Assist in administration of anesthetics
		 1. Local anesthetics
			a. Esters and amides

			b. Vasoconstrictors

		 2. Intravenous sedation anesthetics
			a. Benzodiazepines

			b. Narcotics

			c. Narcotic agonist – antagonists

		 3. Oral sedation anesthetics – benzodiazepines
		 4. Intravenous general anesthetics
			a. Propofol			b. Ketamine			c. Barbiturates

		 5. Adjunctive agents

B. Prepare anesthesia equipment
and perform patient monitoring		 1. Maintain anesthesia equipment
			a. Perform equipment check			

b. Check emergency airway equipment

			c. Check daily anesthetic gases, etc.

			d. Ensure gases are turned on/off each day

		 2. Confirm NPO and pre-medication status
		 3. Prepare patient – seat, drape, etc.
		 4. Place monitors, record data and report to surgeon			a. Pulse oximeter			

b. Blood pressure			c. EKG		 5. Document anesthesia record
			a. Monitor data, events with times

			b. Dosages of medications

			a. Topical local anesthetics

			b. Drug reversal agents			c. Anticholinergics

		 6. Check position of patient			d. Antihistamines, ataractics and related agents

		 7. Observe air exchange (breathing)			e. Antiemetics

		 8. Monitor status of IV line			f. Steroids			g. Muscle relaxants

		 9. Review and record data from monitors
during procedureIV. Prepare Anesthesia Equipment andPerform Patient Monitoring (22 items)
A. Monitor Airway Maintenance			a. Blood pressure			b. Pulse/O2 stat			c. EKG

			

d. End tidal CO2 if available		 1. Identify routine airway equipment

		 10. Complete postoperative monitoring		 2. Apply nasal canula or nasal hood/mask

		 11. Determine discharge criteria are met

		 3. Airway maintenance		 12. Complete postoperative record keeping			a. Routine head tilt, chin lift or jaw thrust			b. Assist with airway adjuncts as necessary

		13. Record any controlled substances dispensed
or prescribed			(1) Nasopharyngeal airway

			(2) Oropharyngeal airway

			(3) LMA			(4) Endotracheal intubation

V. Assist with Emergency Treatment and Protocols(25 items)
A. Respiratory emergencies
		 1. Airway obstruction
		 2. Laryngospasm
		 3. Bronchospasm
		 4. Emesis and aspiration
		 5. Hyperventilation
		 6. Respiratory depression and apnea

14

B. Cardiovascular emergencies

C. Endocrine disorders		 1. Significant hypertension

		 1. Hypoglycemia and insulin shock		 2. Significant hypotension

		 2. Acute adrenal insufficiency

		 3. Acute coronary syndrome – angina
		 4. Acute coronary syndrome – myocardial
infarction (MI)		 5. Symptomatic bradycardia
		 6. Supraventricular tachycardia

D. Immune system
		 1. Mild allergic reactions
		 2. Severe allergic reactions and anaphylaxis
E. Nervous system emergencies

		 7. Premature ventricular contractions

		 1. Syncope

		

8. Ventricular tachycardia

		 2. Seizures		

9. Ventricular fibrillation

		 10. Asystole/PEA
		 11. Cerebrovascular accident (stroke)		

12. Venipuncture complications

15

Dental Anesthesia Assistant National Certification Examination
Advisory Committee Roster
Stanley Smith, DDS
Chair
New Rochelle, N.Y.
Jen Brady
Bend, Ore.
Judy Bull
Marlton, N.J.

Stephanie J. Drew, DMD
Atlanta, Ga.

David Todd, DMD, MD
Lakewood, N.Y.

Virginia W. Fulmer
Chapel Hill, N.C.

Thomas Trowbridge, DDS, MD
Lowell, Mass.

Bradford Porter, DDS
Marlton, N.J.

daanceinquiries@aaoms.org

DAANCE Examination Blueprint Matrix

16# of questions in each of thethree cognitive levels on the exam

Sample Questions
The following five questions have been removed from active use in the DAANCE item pool that is established, maintained andowned by the AAOMS DAANCE Advisory Committee. The purpose of releasing these questions is to provide information that
could assist prospective candidates in preparing for the examination and to further their understanding of the examination
process.
Following each question is the correct response (key). Additional information about the DAANCE examination and certification
program is available from a variety of other sources. These sources include, but are not limited to, other sections in this Handbook,
AAOMS.org and Schedule.PSIexams.com.
1. T he valve that covers the airway
to prevent food from entering thetrachea is the

3. T he most significant adverse
reaction to meperidine(Demerol) is

5. D epressed respirations secondary toadministration of narcotics may beeffectively reversed with

A. esophagus
B. uvula
C. epiglottis
D. carina

A. dysphoria
B. hypoglycemia
C. postural hypotension
D. respiratory depression

A. diphenhydramine (Benadryl)
B. meperidine (Demerol)
C. fentanyl (Sublimaze)
D. naloxone (Narcan)

Key: C

Key: D

Key: D

2. Cigarette smokers have an
increased risk for which of
the following diseases?

4. P ulse oximetry readings provide
a measurement of

A. renal disease
B. emphysema
C. hypertension
D. diabetes mellitus
Key: BA. arterial blood pressure
B. hemoglobin saturation
C. the absorption of blue lightby arterioles
D. the number of red corpuscles
per milliliter
Key: B

Continuing Education Credit
The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying
quality providers of continuing dental education. ADA CERP does not approve or endorse individual
courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
The American Association of Oral and Maxillofacial Surgeons designates this activity for 36 continuing
education credits.

17

DAANCE Registration and Required Documentation Checklist
q Registration Form is fully completed.
q Registration Form is signed by registrant. (Electronic signatures are not accepted.)
q Registration Form is signed by surgeon. (Electronic signatures are not accepted.)q Copy of valid CPR, BLS and/or ACLS card is included with the Registration Form.
		 CPR, BLS and/or ACLS certification must be current through your examination date		 (a minimum of six months).
Additional documentation required for non-AAOMS member sponsoring dental
professionals:
q

18

Copy of valid anesthesia permit is included with Registration Form.

Registration Form
Please remember to include a copy of your CPR, BLS and/or ACLS certification
with your registration form to receive the study materials. Your CPR, BLS or ACLS
certification must be current through your examination date (a minimum of six months).
Allow PSI three weeks to process your application and mail your study materials. For inquiries,
please call PSI at 833-333-4755.
Assistant Information (as it should appear on the certificate):

Fees and Payment
Tuition includes the DAANCE Study
Materials and Examination Fee.
Additional suggested reading: AOMS Office Anesthesia
A
Evaluation Manual, 9th edition
Copyright 2018
This additional reading
must be ordered separately.
Substitution/Cancellation
and Refund Policies
All substitutions and cancellations must
be made using the DAANCE Substitutions
and Cancellations Form provided in the
DAANCE Candidate Handbook or on the
AAOMS website at AAOMS.org/DAANCE.
Substitutions require the Substitution/
Cancellation Form accompanied by acompleted DAANCE Registration Formand a valid CPR, BLS and/or ACLS cardfor the new registrant.
Candidates may reschedule ONE
appointment for examination at nocharge by calling PSI at 833-333-4755
at least two business days prior to thescheduled testing session. A rescheduling
fee of $95 will be charged for any
subsequent appointment changes
within the candidate’s eligibility period.
It is the responsibility of the sponsoring
doctor to notify PSI of the substitution
and to transfer previously provided course
material to the substitute registrant. New
course material will not be provided to thesubstitute registrant.
If a cancellation is made before 90 days,
the sponsoring doctor will receive a refund
equal to 50 percent of the registration
fee. Substitutions must be made 30 days
before the candidate’s expiration ofeligibility.
Candidates have six months from theiractivation date to take their examination.
If unsure of the testing deadline date,contact PSI at 833-333-4755.
Email communications will be sent toregistrants. To ensure messages are notoverlooked, registrants are encouraged tocheck their email spam or junk folders formessages from PSI.

†Candidates who wish to take an

examination in Puerto Rico or outside
the United States should submit awritten request containing the desired
testing location along with the required
additional $105 fee with their application.

Please print or type
Mr./Ms. First Name

Middle Initial Last Name

Degree(s)/Credentials (e.g., RN, RDA, CDH, etc.)

Registrant Email Address			

Registrant Phone Number(Note: Correspondence about the course and examination will be sent to the email address you
provide here. Any changes to this email address should be provided to PSI using the change
address/email form.)
Have you previously passed in the DAANCE program? q Yes q No
Provide your current practice address information below. Do not provide your homeaddress. It is your responsibility to contact PSI should this information change.
Sponsoring Doctor
Practice Address

Practice Name
Suite #

Email		

City

State

ZIP

Daytime Telephone Number

I certify that the assistant named above will have completed course materials and quizzes
prior to sitting for the Dental Anesthesia Assistant National Certification Examination. I further
certify that the participant named above possesses a valid CPR, BLS and/or ACLS card and will
maintain current CPR, BLS and/or ACLS certification through the date of the examination.
Participant’s Signature

Date

Sponsoring Doctor’s Signature

Date

A copy of the participant’s current CPR, BLS and/or ACLS card is enclosed q Y q N
Please indicate the status of your sponsoring surgeon:		

Tuitionq AAOMS Member / OMS Sponsor$405

q Other Dental Professional*$605

Specify Specialty______________________________*Non-AAOMS member/sponsoring dental professional must enclose a copy of their valid anesthesia
permit.
q Puerto Rico or International Location†

			 $105
Total Tuition: $_____________PAYMENT BY CREDIT CARD
When paying by credit card, complete the information below and return it with completed
registration form. Fax to: 913-895-4650 Mail to: PSI, 18000 W. 105th St., Olathe, KS 66061
Credit Card: q MasterCard q Visa q Discover q American Express
Name of Cardholder

Credit Card Number

Security Code

Cardholder Signature

Expiration Date

Credit Card Billing Address

City

State

ZIP

PAYMENT BY CHECKPayment in the form of personal check, company check, cashier’s check or money order must
be made in U.S. currency and payable to PSI Services, Inc. Mail with completed form to:
PSI Candidate Services, 18000 W. 105th St., Olathe, KS 66061

detach here "Registration Form

Dental Anesthesia AssistantNational Certification Exam19

If you have a disability covered by the Americans with Disabilities Act, please complete this form andprovide the Documentation of Disability-related Needs on the next page so your accommodations fortesting can be processed efficiently. The information you provide and any documentation regarding yourdisability and your need for accommodation in testing will be treated with strict confidentiality. Please
return this form with your examination application and fee to PSI within 45 days of the desired testing date.
Candidate Information:
Name (Last, First, Middle Initial, Maiden Name) ________________________________________________Name of Practice/Facility/Company __________________________________________________________
Title ____________________________________________________________________________________
Mailing Address __________________________________________________________________________
City ______________________________________________________ State _________ ZIP ____________
Daytime Phone Number ___________________________________________________________________
Email ___________________________________________________________________________________
Special Accommodations:
I request special accommodations for the Dental Anesthesia Assistant National Certification Examination (DAANCE).
Please provide (check all that apply):q Readerq Extended testing time (time-and-a-half )q Reduced distraction environmentq Other special accommodations (please specify) ______________________________________________________________________________________________________________________________________________________________________________________________________________________________
Comments ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Signed ___________________________________________________________ Date __________________
Return this form with your examination application and fee to:detach here "PSI
18000 W. 105th St.
Olathe, KS 66061-7543

20

If you have questions, call Candidate Services at 833-333-4755.

Request for Special Examination Accommodations

Request for Special Examination Accommodations

Please have this section completed by an appropriate professional (education professional, physician,psychologist, psychiatrist) to ensure that PSI is able to provide the required examination accommodations.
Professional Documentation:
I have known ____________________________________________ since ____ / ____ / ____
in my capacity as a ________________________________________________________ (Title).
The candidate discussed with me the nature of the examination to be administered. It is my opinion that,
because of this candidate’s disability described below, he/she should be accommodated by providing thespecial arrangements listed on the Request for Special Examination Accommodations form.
Description of Disability___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Signed ______________________________________________________________________________________
Title _____________________________________________________________ Date ______________________
Printed Name ________________________________________________________________________________
Address _____________________________________________________________________________________
Phone Number ________________________________ License # (if applicable) __________________________
Return this form with your examination application and fee to:
PSI
18000 W. 105th St.
Olathe, KS 66061-7543
If you have questions, call Candidate Services at 833-333-4755.

detach here "Documentation of Disability-Related Needs

Documentation of Disability-related Needs

21

(Duplicate score reports available to sponsoring doctors only.)
Directions:	
You may use this form to ask the testing agency, PSI, to send a duplicate copy of your score report.
Score reports are only provided to sponsoring doctors. This request must be postmarked no later
than 90 days after the examination administration. Proper fees and information must be included
with the request. Please print or type all information in the form below. Be sure to provide all
information and include the correct fee, or the request will be returned.
Fees:	$25 per copy. Please enclose a cashier’s check or money order payable to PSI Services, Inc. Do notsend cash. Write your test identification number on the face of your payment.
Mail to:	PSI Services, Inc. 		
18000 W. 105th St.
Olathe, KS 66061-7543, USA		

Amount enclosed $_______________
Examination Date ________________

Print your current name and address:
Name________________________________________________________ Credentials ________________________
Candidate/DAANCE ID____________________________________________________________________________
Sponsoring Doctor _________________________________ Practice Name _________________________________
Practice Address _________________________________________________________________________________
City ______________________________ State/Prov. ______________ ZIP/Postal Code _______________________Country ________________________________________________________________________________________
Work Telephone ____________________________ Other Telephone (i.e., mobile) ____________________________
Email __________________________________________________________________________________________
If the above information was different at the time you were tested, please write the original information
below:
Name__________________________________________________________________________________________
Candidate/DAANCE ID_____________________________________________________________________________
Sponsoring Doctor _________________________________ Practice Name _________________________________
Practice Address _________________________________________________________________________________
City ______________________________ State/Prov. ______________ ZIP/Postal Code _______________________Country ________________________________________________________________________________________
Work Telephone ____________________________ Other Telephone (i.e., mobile) ____________________________

detach here "Email__________________________________________________________________________________________

22

I hereby request PSI to send a duplicate copy of my score report to the first address shown above.
_______________________________________________________________________________________________
Candidate signature 				DateRequest for Duplicate DAANCE Examination Score Report

Request for Duplicate DAANCE Examination Score Report(All address and email changes must be submitted in writing, either by mail or facsimile, including
an authorization signature and candidate ID number.)
You may use this form to request that DAANCEAC enter a change of practice address, including email address, into
the database once you have registered for the examination. To protect your confidential record and ensure that no
unauthorized person is able to alter your record, all address changes are required to be submitted in writing andincluded with your authorizing signature. Do not use your home address.
DAANCEAC will forward your address change to the testing agency PSI. If you have questions, contact DAANCEAC
at 847-678-6200 or toll-free 800-822-6637.
Mail or fax your request to: DAANCE Advisory Committee
AAOMS
9700 W. Bryn Mawr Ave.
Rosemont, IL 60018
Fax: 847-678-6286
Print your NEW name and practice address
Name __________________________________________________________________________________________
Candidate/DAANCE ID ____________________________________________________________________________
Sponsoring Doctor _________________________________ Practice Name _________________________________
Practice Address _________________________________________________________________________________
City ______________________________ State/Prov. ______________ ZIP/Postal Code _______________________Country ________________________________________________________________________________________
Work Telephone ____________________________ Other Telephone (i.e., mobile) ____________________________
Email __________________________________________________________________________________________
Print your OLD information as it appeared on your application form
Name __________________________________________________________________________________________
Sponsoring Doctor _________________________________ Practice Name _________________________________
Practice Address _________________________________________________________________________________
City ______________________________ State/Prov. ______________ ZIP/Postal Code _______________________Country ________________________________________________________________________________________
Work Telephone ____________________________ Other Telephone (i.e., mobile) ____________________________
Email __________________________________________________________________________________________
Examination Date_____________________________________ Test Site____________________________________
I hereby authorize DAANCEAC and PSI to change my address in the examination database as shown above.
_______________________________________________________________________________________________
Candidate signature 				Datedetach here "Request to Change Mailing or Email Address

Request to Change Mailing or Email Address

23Submit completed form to PSI:
• Mail: PSI, 18000 W. 105th St., Olathe, KS 66061-7543• Fax: 913-895-4650
Request for (check one):q Substitution

q Cancellationq Rescheduling•	To make a substitution, you must submit a completed Substitution/Cancellation Form accompanied by acompleted DAANCE Registration Form (page 19) and a valid CPR, BLS or ACLS card for the new registrant.
•	Substitutions must be made a minimum of 30 days before the candidate’s expiration of eligibility.*
Note: A candidate may be permitted to participate in only one substitution per eligible record.
• Cancellations will not be accepted after 90 days of candidate’s activation.
•	If a cancellation is made before 90 days, the sponsoring doctor will receive a refund equal to 50 percentof the registration fee.
•	Rescheduled appointment dates must be before the candidate’s expiration of eligibility. Note that
rescheduling does not extend eligibility.* An $95 rescheduling fee may apply.
•	New course material will not be provided to the substitute registrant.
REQUEST FOR SUBSTITUTION/CANCELLATION OR RESCHEDULING
Name _______________________________________________________________________________________
Candidate/DAANCE ID _________________________________________________________________________
Registrant (Substitute) to be enrolled:
Name _______________________________________________________________________________________
Candidate/DAANCE ID _________________________________________________________________________
Sponsoring Doctor
Sponsoring Doctor Name _______________________________________________________________________
Address _____________________________________________________________________________________
City __________________________________________________ State ___________ ZIP __________________
Phone ________________________________________________ Fax __________________________________
Email _______________________________________________________________________________________
Signature of person requesting substitution or cancellation______________________________________________________________________ Date _________________
Please note: You will receive written confirmation regarding your request within 10 business days.
If you do not receive written confirmation within that time period, please contact PSI at 833-333-4755.
REQUEST TO RESCHEDULE TEST APPOINTMENT
Candidates may reschedule ONE appointment within the eligibility period at no charge; a rescheduling feeof $95 is required for any subsequent appointment change within the eligibility period. PLEASE NOTE: If thisis your first request to reschedule your test appointment, you do not need to complete this form, but PSI must
be contacted at least two business days in advance of your appointment date.
It is your responsibility to complete and submit this form according to the AAOMS Candidate
Handbook Policies.
detach here "Payment type:24

q Check for $95 payable to PSI Services, Inc. enclosed

q Credit Card (MasterCard or Visa)

Credit Card #_______________________________________ Security Code __________ Expiration Date __________Name of Cardholder: __________________________________________________________________________*Failure to comply will result in a candidate’s registration being forfeited.

DAANCE Substitution/Cancellation Form

DAANCE Substitution/Cancellation/Reschedule FormTo order a replacement certificate: Please complete this form and send it to the address listed below
with a $20 check payable to AAOMS.
Note: If you need a certificate from the current year,
please call PSI at 833-333-4755 for a replacement copy.
To order a replacement pin: Please complete this form and send it to the address listed below witha $10 check payable to AAOMS.
DAANCE
9700 W. Bryn Mawr Ave.
Rosemont, IL 60018-5701
Voice: 847-678-6200
Fax: 847-678-6286

Your name as it should appear on the certificate

Your name at the time you took your exam (if different)

Sponsoring doctor’s name at the time you took your exam

Year and month you took the exam (if you don’t remember, please write the approximate year)

Mailing address (please indicate if this is your home or work address)

Contact phone number or email address

The information on this form is confidential and may be legally privileged. It is intended solely for the addressee.
If you are not the intended recipient, any disclosure, copying, distribution or any action taken or omitted to betaken in reliance on it is prohibited and may be unlawful.
detach here "Request for Duplicate Certificate and/or Pin Form

Request for Duplicate Certificate and/or Pin Form

25

American Association of Oral and Maxillofacial Surgeons
9700 W. Bryn Mawr Ave.
Rosemont, IL 60018-5701
800-822-6637 • 847-678-6200 • fax: 847-678-6286
AAOMS.org