Professionalism

Reviewed By:  Cynthia Fong, RDH, MS

Date: June 23, 2019

“Unraveling the Dental Hygiene Clinical Examination Process.”

Cynthia Fong, RDH, MS

When seeking a dental hygiene license, either an initial or an addition license, the decision made by the individual regarding which clinical examination taken can have a significant impact on the portability of their license in the future. This information will help dental hygienists not only understand the various clinical examinations available to the profession but will also enable them to be informed consumers regarding their dental hygiene license.

To apply for initial licensure in dental hygiene form an individual state, the majority of dental hygiene students must meet three basic requirements: 1) successfully graduate from dental hygiene program accredited by the Commission on Dental Accreditation; 2) take the American Dental Association (ADA) National Board Dental Hygiene Examination (NBDHE); and 3) take a clinical examination. If a current dental hygiene licensee wants to pursue another license in a different jurisdiction, the individual may obtain it through options such as credentialing, reciprocity or re-taking a written and/or clinical examination.

The first two requirements, graduating from an accredited dental hygiene program and taking the ADA NBDHE do not involve any decision making on the part of the individual. To clarify, the ADA NBDHE is a computer based examination taken at a testing center (e.g. Pearson VUE). It tests the candidate’s knowledge in basic biomedical and dental hygiene sciences and his/her ability to apply the information to problem based patient cases.

However, a choice is required when taking the clinical examination. A clinical examination may consist of one or two parts depending upon the testing agency administering the examination. A one part examination required the candidate to utilize professional judgment and demonstrate his/her clinical skills on a live patient. If applicable, the second of a two part examination is computer based. It provides the candidate with clinical and radiographic images to which the candidates uses to answer test items that are patient case based. A candidate has the ability to take any of the clinical examinations currently offered by five testing agencies in the United States. Ease of access is a major factor of many candidates taking a clinical examination offered in their state of residency. However their decision may have a profound impact on the mobility of their license in the future.

There are five testing agencies in the United States that offer a clinical examination in dental hygiene. The agencies are the North East Regional Board of Dental Examiners (NERB), now doing business as the Commission on Dental Competency Assessments (CDCA), the Council of Interstate Testing Agencies (CITA); the Central Regional Dental Testing Service (CRDTS); the Southern Regional Testing Agency (SRTA) and the Western Regional Examining Board (WREB). Each state regulatory board decides which testing agency or agencies, along with its clinical examination, of which it accepts, in part, for its licensing requirements.

Historically, each testing agency was responsible for developing its own clinical examination and subsequently administering it within regions of the United States. In early 2000, the state boards began to discuss the need for a single uniform clinical examination, which would eliminate the need to take subsequent examinations when a licensee seeks licensure in another state. The discussion was also stimulated by the fact that society, in general, has become more mobile. Consequently, the American Board of Dental Examiners, Inc. (ADEX) was created (https://adexexams.org).

The sole purpose of ADEX is to develop a single clinical examination in both dental and dental hygiene with the testing agencies continuing to administer the examination. ADEX is supported by its member licensing jurisdictions. At this time, two testing agencies administer the ADEX clinical examination, CDCA and CITA. If a dental hygiene candidate successfully passes the ADEX examination, then the candidate has fulfilled the clinical examination portion of licensure, with is accepted by forty -two licensing jurisdictions. The three other testing agencies (CRDTS, SRTA and WREB) do not administer the ADEX examination. Although the ADEX clinical examination is accepted by more jurisdictions than the other testing agency’s clinical examinations there are some overlap of jurisdictions. (NOTE: Changes may occur in regards to the clinical examination acceptance by a licensing jurisdiction, it is strongly advised for the candidate to contact the licensing jurisdiction for specific requirements).

In conclusion, the type of dental hygiene clinical examination taken by a candidate can have an impact on the individual’s portability of their license in the future. Dental hygienists should understand the boundaries that each of the testing agencies have in regard to the acceptance of their clinical examination and then make the decision that best meets their current and future needs.

Testing Agency Administrator

Type of Clinical Examination Administered

Number of Jurisdictions Accepting the Dental Hygiene Clinical Examination for Licensure

Contact information

CDCA

Commission on Dental Competency Assessment (formerly NERB)

ADEX

42. Alabama, Arizona, Arkansas, Colorado, Connecticut, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, Wisconsin, Wyoming.

https://cdcaexams.org

1304 Concourse Drive, Suite 100

Linthicum, MD 21090

301-563-3300

301-563-3307 fax

CITA

Council of Interstate Testing Agencies

ADEX

42. Alabama, Arizona, Arkansas, Colorado, Connecticut, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, Wisconsin, Wyoming.

https://citaexam.com

1518 Elm Street, Suite A

Sanford, NC 27330

866-678-9795

919-460-7750

919-460-7715 fax

 CRDTS 

Central Regional Dental Testing Service

Independent

42. Alabama, Arkansas, Arizona, California, Colorado, Connecticut, Georgia, Hawaii, Idaho, Iowa, Illinois, Indiana, Louisiana, Kansas, Kentucky, Maine, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming.

http://crdts.org

1725 SW Gage Blvd.

Topeka, KS 66604

785-273-0380

785-273-5015 fax

SRTA

Southern Regional Testing Agency

Independent

29. Alabama, Arkansas, Colorado, Connecticut, Hawaii, Illinois, Indiana, Kansas, Kentucky, Maine, Massachusetts, Missouri, Montana, New Hampshire, New Mexico, Mississippi, Nebraska, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, Wyoming.

https://srta.org

4698 Honeygrove Rd, Suite 2

Virginia Beach, VA 23455

757-318-9082

757-318-9085 fax

WREB

Western Regional Examining Board

Independent

37. Alaska, Arizona, Arkansas, California, Connecticut, Colorado, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Ohio, Oklahoma, Oregon, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, Wyoming.

https://wreb.org

23460 N. 19th Avenue, Suite 210

Phoenix, AZ 85027

623-209-5400

602-371-8131 fax

Keeping Up with Licensing News

 

CDCA had its annual business meeting in January 2018. Changes to the clinical examination and business agenda items were discussed.

June 2019, SB 824 was signed into law by OR’s Governor; paving the way for “non-live patient licensing exams.”

 

In June 2018, the ADHA released a statement supporting the elimination of a patient based, single encounter, clinical examination. Read the statement here.

 

Alabama has preceptorship for Dental Hygienists. Its called the Dental Hygiene Program and is one year with no formal college education. The individual does not have to take NBDHE or a clinical examination. Alabama also has traditional degree programs. Much has been written about the preceptor program. Is it NOT supported by ADHA or any other professional organization.

 

Deleware is the only remaining state that develops and administers its own clinical examination and does not accept anyone else’s examination for licensure eligibility.

 

Arkansas, Colorado, Connecticut, Hawaii, Illinois, Indiana, Kansas, Kentucky, Maine, Massachusetts  Missouri, Montana, Ohio, Oregon, Pennsylvania, Tennessee, Texas, Utah, Virginia, Wisconsin and Wyoming accept all of the testing agencies clinical examinations!