Now that it’s time to get your dental hygiene license, you have to do special things to make sure it’s issued properly, stays up to date, and is renewed every year. Depending on which state you live in or plan to practice (some dental hygienists are licensed in more than one state) there will be certain steps you have to take.
Your most important go-to is your State Dental Board. Each state maintains different sets of rules and licensing protocols; some are the same, some not so much. But for the most part, getting a dental hygiene license follows a similar path that starts with written and clinical boards, CPR classes, plenty of paperwork, and then a final printed document with your state seal on it.
Maintaining a current dental hygiene license allows you to practice anywhere in your respective state. If you plan on moving out of state, you’ll need to have a current license to apply for a license in that area. Once you’re licensed, it’s extremely important to keep everything up to date.
The rigorous process of getting a dental hygiene license protects patients, the public, and the dental industry. Without a license, you cannot practice dental hygiene. In fact, a copy of your license should be hung on the wall at the practice where you’re working. That way patients know the person cleaning their teeth is legally authorized to do so.
Since becoming a dental hygienist is no easy feat, the application for licensure includes submitting test scores, college paperwork, and other supporting documents to prove you’ve met all credential requirements.
Being that hygienists physically render services to patients, it’s vital that their job role is monitored by state regulatory agencies. Otherwise you might see non-hygienists trying to provide services (malpractice) and harm patients. The annual fees charged by your state help to ensure that standards are met, and regulations are enacted to protect dental professionals and their patients. It's also a good idea never to practice without dental malpractice insurance!
What needs to happen before you can apply for a dental hygiene license?
Most schools have higher grade requirements for pass/fail than traditional college courses. You can receive your training from either a 2 or 4-year school; either is fine. Courses typically begin once a year, with one annual graduating class from each hygiene program. Credentialed schools are listed on the American Dental Hygiene Association’s website. Be sure to select a college that is accredited to ensure that you can apply for appropriate state and national board exams. It does not matter which type of hygiene program you attend (associate or bachelor) as long as it is accredited.
Register for the written National Board Dental Hygiene Examination (NBDHE). You must score at least a 75 (99 is the highest) to pass. This 350-question, multiple-choice examination is usually offered at an accredited dental hygiene school on specific dates during your final semester. You may prefer to sit for the test at your own campus or register for a different date at another school (as long as it is one of the approved testing facilities.) Sometimes the exam is at an off-site testing center instead of your college. Generally, the NBDHE takes up most of the day, with a planned lunch break between different sections of the test.
Register for your state or regional clinical dental hygiene examination. This testing process is a hands-on practical where patient care is rendered, screenings are completed, and accuracy is carefully measured by existing dental professionals. In most cases, patients will need to fit a certain category to qualify for board requirements. (Yes, you will need to find your own patient.) State/regional clinical exams are taken toward the end of your final semester in dental hygiene school. But they may be scheduled as early as the beginning of your last semester or after college graduation.
Check for any miscellaneous tests, certifications, or requirements with your state (i.e. CPR + BLS, jurisprudence exams, nitrous oxide sedation certification, etc.) You will not need any continuing education courses to apply for your initial dental hygiene license, being that you will be straight out of college.
All dental hygienists – regardless of which state you live in – must take and pass the National Board Dental Hygiene Examination (NBDHE) in order to achieve licensure. . The NBDHE is the only nation-wide exam that’s required by all 50 U.S. states. In order to take the test, you’ll have to obtain a “DENTPIN” from the ADA to prove you’re qualified to sit for the exam and then move on to the remainder of the application process. The DENTPIN allows you to log in to register for the actual exam. You will need to select a testing date and register in time to ensure that there is a spot available to take your exam. Depending on the testing center that you select, you may be able to choose from various dates to take your test.
NBDHE tests cover practically everything you learn in an accredited dental hygiene school. The questions are divided into discipline-based knowledge and case-based applications.
The 200 discipline-based questions cover three specific areas, including scientific basis for general hygiene practice, the provision of clinical hygiene services, and community health/research principles. The remaining 150 case-based questions are divided up between 12-15 different case scenarios including patient information (ranging from medically compromised and periodontal involvement to pediatric and special needs). Case-base questions require that hygienists pull from provided information such as radiographs, intraoral images, dental charting, and case descriptions to create care plans, utilize preventative strategies, and assess needs of the respective patient.
The NBDHE is a lengthy exam, with 350 multiple-choice questions. You are given 9 hours to complete the exam, with scheduled breaks for lunch and between sections. You can take time to use the restroom or get up and stretch your legs. Depending on the format that you’re taking the test in (such as a computerized testing center), you may have the option to skip the breaks if you choose.
Discipline-based questions make up the first portion of the exam, with 3.5 hours allotted for testing. Optional breaks are built into the questions, as well as a half-hour lunch break. Then, you return for an additional 4 hours to complete the case-based portion of the exam and additional optional breaks.
Although you have up to 9 hours to complete the exam, you may not need that long. Depending on how comfortable you are with the subject, it’s possible to only take 6-8 hours total.
The NBDHE has an approximate passing rate of 92%, with around 8,000 dental hygiene students taking the exam each year. That means somewhere just over 600 students will have to re-take the test after their first try.
You must score at least a grade of 75 in order to pass the board. If for any reason you do not pass, you must wait at least 90 days before retesting. You have up to five attempts and five years to pass the exam. Fortunately, there are board prep options, study books, and mock exams that can help you prepare for and be successful at passing on your first attempt. There are also hygiene re-entry programs that exist, which allow students or existing hygienists to brush up on subject areas they want to improve on.
In addition to the written exam, you’ll need to complete a clinical state/regional exam, where you assess and treat a patient. This exam is also several hours long but held in a clinical setting, similar to what you would experience while still in school. Existing practitioners will score you on your accuracy and clinical competency.
