Sealant Application ($400)

A dental assistant holding this expanded duty permit may place pit and fissure sealants.

Applications are located at the bottom of the page, but you must read the following information before enrolling. Failure to do so could potentially delay or void your enrollment.

Course Schedule (click Here)


  • Participant has a minimum of one-year active chair side experience as a dental assistant (waived if the assistant graduated from an Oklahoma CODA Accredited Dental Assisting Program).
  • Have current Dental Assisting Permit from the Oklahoma State Board of Dentistry showing they are certified in Coronal Polishing from the Oklahoma Board of Dentistry to enroll in this course.
    • PLEASE NOTE: A $15 credit card processing fee will be subtracted from all applications submitted without proof of Coronal Polishing certification if the applicant requests a refund in place of transferring to a later course.
  • Participants are required* to provide a patient and four (4) extracted molar or pre-molar teeth for this course.  Please refer to the Patient Requirements.
  • Participants are REQUIRED* to provide their own slow speed handpiece and attachments. The clinics do not have the handpieces needed for sealants available for loan. Please DO NOT enroll more employees than you have available handpieces.
    *Failure to bring these required items to the course will result in dismissal from the course and the participant will be required to enroll and pay for a later course.

Before Enrolling

  • Please use the "Mail-In Payment" link if your school is paying for this course or you work for a state, government, or tribal agency that does not allow you to pay electronically.
  • All other applications require online payment at the time of enrollment and must be submitted by credit/debit card or eCheck (i.e. entering the information from your check into the designated fields).  All major credit/debit cards are accepted.
  • Applications received without payment will be deleted and must be re-submitted with payment.
  • SPACE IS LIMITED. If the form says it is no longer taking submissions, then the course is FULL.

View the General FAQ and the Sealant FAQ for any questions.

Wait List form (Please note transfer fees and/or late fees will apply if a spot becomes available.)

Forms & Information

Enrollment Requirements
How to Upload Documents

Patient Requirements
Equipment Requirements

Employment Verification Form (MUST be signed by both the employing dentist and the applicant) The Employment Verification Form is NOT the application.

Application Links

View Course Schedule (click here) 2019 course dates will be available by November 1.

Mail in Payment (Click to view the application)

  • Designed for those who must pay by CHECK or DIRECT DEPOSIT (i.e. schools or state, government, or tribal agencies) but can be used by anyone who prefers to mail in their payment.
  • Spot in course is NOT reserved until payment is received.

Pay Online (Click to view the applications)

  • Requires online payment at the time of enrollment (credit/debit or eCheck)
  • Immediately reserves spot in course.

Tulsa course dates will be added by mid-January.  Please check back.