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United States · Licensing exam

National board dental hygiene exam: how the NBDHE works

The National Board Dental Hygiene Examination (NBDHE) is the written exam that every US licensing jurisdiction recognizes for dental hygienists. You answer 350 multiple-choice questions at a Pearson VUE test center. The first 200 stand on their own, and the other 150 are built on patient cases. The result is pass or fail. The national board dental hygiene exam belongs to the Joint Commission on National Dental Examinations (JCNDE), an agency of the American Dental Association (ADA). Passing it doesn’t license you, though. That’s up to the state board where you want to work.

  • 350NBDHE questions, all multiple choice
  • $600Exam fee in the 2026 Candidate Guide
  • 9 hoursTotal time, with the optional breaks
Where to studyHow the test works

Updated November 2026 · Written from the NBDHE 2026 Candidate Guide

Key facts

At a glance

Run by
The JCNDE, with the ADA’s Department of Testing Services, and Pearson VUE delivering it
Format
350 multiple-choice questions: 200 discipline-based and 150 on patient cases
Where
Pearson VUE test centers in the US and Canada, but not Quebec
Fee
$600 in the 2026 Candidate Guide, plus $435 if your program isn’t accredited by the Commission on Dental Accreditation (CODA)
Result
Pass or fail, based on a scale score of 75 or higher
Accepted by
All 50 states, DC, Puerto Rico, Guam and the US Virgin Islands

How it works

How the national board dental hygiene exam runs

NBDHE scale score
49 to 74: fail75 to 99: pass
75 is a scale score, not 75% of the questions right. If you pass, your report says “pass” and nothing more.
  1. You take it on computer at a Pearson VUE test center, one question at a time.
  2. It comes in two sessions: 200 discipline-based questions, then 150 questions on patient cases. The Candidate Guide page has the timings.
  3. You read your pass or fail result by signing in with your Dental Personal Identification Number (DENTPIN).

Topics

What the NBDHE covers

The first seven come from the discipline-based component, with its large clinical services area split into five. The last is the case-based component. They follow the updated test specifications, which the JCNDE scheduled to start on November 1, 2026.

01

Scientific basis for dental hygiene practice

The biomedical science behind hygiene care, from anatomy to pharmacology. It’s 56 of the 200 discipline-based questions in the updated specifications.

Key points (3)
  • The updated specifications give this area 56 items, down from 61.
  • Local anesthesia is listed under pharmacology in the updated specifications.
  • All National Board Examinations number permanent teeth 1 to 32 and primary teeth A to T, the Universal/National system.
02

Patient assessment and dental radiography

Taking histories, examining the patient and producing and reading radiographs.

Key points (3)
  • Occlusal evaluation joins patient assessment in the updated specifications.
  • The JCNDE says the word “film” isn’t used for radiographs on the exam, so there are no darkroom or chemical processing questions.
  • Emerging technologies appear as a radiography topic in the updated specifications.
03

Dental hygiene care planning

Planning safe, individual care, from infection control to case presentation.

Key points (3)
  • Questions reflect the American Heart Association’s 2021 statement on antibiotic prophylaxis.
  • Blood pressure questions follow the American Heart Association’s 2017 hypertension guidelines.
  • Anesthesia questions use the American Society of Anesthesiologists’ physical status classes, amended in October 2025 with the core I to VI definitions unchanged.
04

Periodontal disease management

Why periodontal disease starts and how hygienists treat and maintain it.

Key points (3)
  • Questions reflect the American Academy of Periodontology’s 2017 classification system.
  • Smoking may appear as cigarettes per day or as pack-years, with one pack counted as 20 cigarettes.
  • Pack-years are packs smoked per day multiplied by years of smoking.
05

Preventive agents and supportive treatment

Fluorides, sealants and the materials and chairside services that support care.

Key points (3)
  • Fluoride questions cover mechanisms of action, toxicology and methods of administration.
  • Polishing natural and restored teeth is a listed supportive service.
  • Making impressions and preparing study casts are listed supportive services too.
06

Professional responsibility

Ethics, the law and clear communication in practice.

Key points (3)
  • Documentation and risk management appears for the first time in the updated specifications.
  • The Candidate Guide points to the American Dental Hygienists’ Association’s Code of Ethics for Dental Hygienists.
  • Professional responsibility is tested in the case-based component as well.
07

Research principles and community health

Reading research and running programs for groups. It’s 20 items in the updated specifications, down from 24.

Key points (3)
  • These questions come as testlets: a short case or problem with a set of questions on it.
  • The Candidate Guide says the testlet format is used for this section’s questions.
  • The updated name puts research principles before community health.
08

Case-based items

The second session: 150 questions on 12 to 15 patient cases, adults and children.

Key points (3)
  • Cases can involve geriatric, adult-periodontal, pediatric, special needs and medically compromised patients.
  • A medically compromised patient is one whose health may call for changes to standard treatment.
  • If an area of the patient box is empty, treat that information as unknown or not available.

Test day

What to bring to the Pearson VUE test center

  • A primary ID: original, unexpired and government issued, with your photo, name and signature, such as a driver’s license, passport or passport card.
  • A secondary ID: original and unexpired, with your name and signature, such as a debit card, credit card or library card.
  • Physical cards only. Staff won’t accept digital or paper copies, and every ID except a passport must be in English.

Before you go

  1. Check that your application and DENTPIN record match your IDs exactly. If they don’t, you can’t test, and you lose your testing and application fee.
  2. Ask for any name or date of birth correction at least two weeks before your test, with Update Detail in your DENTPIN account.
  3. Leave what you can at home. Phones, food, drinks, wallets, keys, jackets and watches go in a locker, and you can’t reach them during an unscheduled break.
  4. Expect a biometric check, such as a photo, fingerprint or palm vein scan, and an inspection of glasses and hair accessories. Jewelry is out, except wedding and engagement rings.
  5. You don’t need paper or a pen. The center gives you a laminated notebook or note board and a marker, and the timer is on screen.
  6. Don’t arrive more than 30 minutes late. If you’re refused admission, you lose the full testing fee.
Pearson VUE: schedule your NBDHEBook after the JCNDE’s eligibility email reaches you. First-time test takers create a Pearson VUE web account first.

Study options

Where to study

The JCNDE posts free sample questions and sells official practice tests through Pearson VUE. It doesn’t endorse any review course or text, so other companies’ prep is listed as theirs, with prices from their own sites.

OptionPriceFree to useLinks
Official
JCNDE NBDHE sample questionsThe exam owner’s PDF of sample questionsWritten by NBDHE test constructors to show the question types and formats. The Technical Report says some released items may be outdated.
FreeThe Candidate Guide says they’re available at no charge
JCNDE: Sample questions (PDF) ↗JCNDE: Prepare for the NBDHE ↗
JCNDE NBDHE practice testThe JCNDE’s timed practice modules, sold through Pearson VUEA full form has 180 items in 240 minutes, and you have 30 days to finish. Results are raw scores, and the JCNDE says they haven’t been correlated with NBDHE scores.
$100 for a full form, or $20 to $75 a moduleNot free
Pearson VUE: JCNDE NBDHE practice test ↗
JCNDE Candidate Guide and reference textsThe rules, the test specifications and the source booksThe guide is updated each year. The reference texts list shows the books question writers used.
No charge listedPosted as PDFs on the JCNDE’s site
JCNDE: 2026 Candidate Guide (PDF) ↗JCNDE: Reference texts (PDF) ↗
Pearson VUE NBDHE tutorialA walk-through of the test softwareIt needs a Windows PC and won’t run on a Mac. A 15-minute version is offered at the test center too.
No price shownPearson VUE posts it as a download
Pearson VUE: NBDHE tutorial ↗
Board reviews
StudentRDHOnline NBDHE board review, with a book in its VIP PackageIt shows the VIP price as reduced from $1,113 and lists six months of access with unlimited extensions. It says it includes 5,000+ practice questions and full mock boards. Its pass rate claims are its own.
$397 On-Demand, $497 VIP, $97 case studiesIt offers free mini-reviews by email
StudentRDH: NBDHE review options ↗StudentRDH: Case Studies Package ↗
AndyRDH Board ReviewsAndyRDH’s Dental Hygiene Academy: a three-day seminar, in person or streamed, plus online coursesIts Premium packages carry a money-back guarantee, with terms on its site. Some packages include three simulated mock NBDHE exams.
$199.99 to $499.99 for 2027 packagesA 14-day free trial
AndyRDH: Board review packages ↗
Books
Dentin NBDHE ebooksDentin’s study guide and drill book, as ebooksDentin lists the drill book as 1,001+ High Speed Drills for the NBDHE.
$135 NBDHE ebook, $125 High Speed Drills ebookNot free
Dentin: NBDHE ↗

Prices and ratings checked November 2026.

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FAQ

Common questions

Is the national board dental hygiene exam the same as the dental hygiene boards?

It’s the national, written part. The NBDHE is meant to meet all or part of a board’s written exam requirement. Each state board decides what else you need for a license, such as a clinical exam, and how it uses your result.

Can I take the NBDHE online at home?

The JCNDE lists test centers only. It says all candidates take the NBDHE at a testing center operated by Pearson VUE.

Can dental students take the NBDHE?

Yes. The 2026 guide says a dental student is eligible if they meet the eligibility rules for the dentists’ exam, the Integrated National Board Dental Examination (INBDE). A student at an accredited dental school can also qualify with a letter from the dean saying they’ve completed the equivalent of a CODA-accredited hygiene program.

Is the NBDHE changing in 2026 or 2027?

In steps. The JCNDE scheduled updated test specifications to start on November 1, 2026. Its April 2026 report planned a new way of calculating scores and an updated passing standard to go with them, also in 2026. The pass mark stays a scale score of 75 either way. For 2027 the JCNDE proposed keeping the $600 fee, with final fees set in its 2027 Candidate Guide. Multi-stage adaptive testing, which would shorten the exam, comes no sooner than 2028.

Can I retake the NBDHE after I pass?

Only if a state board or another regulatory agency requires it. Otherwise a pass is final, and you can’t sit the exam again to raise your score.

Sources: JCNDE · Pearson VUE and 5 more. Checked November 2026.

Rules and fees can change, so check the official site before your test.

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