United States · Licensing exam

Dental hygiene clinical board exams beside the NBDHE

A clinical board exam is a separate step from the National Board Dental Hygiene Examination (NBDHE), which is written. The Joint Commission on National Dental Examinations (JCNDE) says most licensing jurisdictions have three basic requirements: education, a written exam and a clinical exam. Which dental hygiene clinical board exam counts is up to the board where you’ll work. So check its rules before you register for one.

  • 3States the JCNDE lists for the DHLOSCE
  • $575DHLOSCE fee in the 2027 proposal
  • $1,150ADEX hygiene exam, before other fees

Which dental hygiene clinical board exam do you need?

Your state board. The JCNDE’s guide says acceptance of its exams is completely at each jurisdiction’s discretion, and the clinical agencies say the same about theirs: the onus is on you to check.

Two maps help. The American Dental Hygienists’ Association (ADHA) keeps licensure maps with each state’s rules and board links. The American Board of Dental Examiners (ADEX) shows which jurisdictions accept its exams. Confirm with the board as well, because it has the final word.

The ADEX dental hygiene exam, and what became of WREB and NERB

WREB’s site says the Western Regional Examining Board is part of CDCA-WREB-CITA, and sends you to ADEX. The American Dental Association (ADA) lists CDCA-WREB-CITA as the former Commission for Dental Competency Assessments (CDCA), WREB and The Council of Interstate Testing Agencies (CITA), and CDCA’s site says it’s the American Board of Dental Examiners. ADEX’s score reports cover past NERB, CDCA, WREB, CITA and ADEX attempts, so ask ADEX for an old result.

ADEX describes its dental hygiene exam in two parts:

  • The Simulated Patient Treatment Clinical Examination (SPTCE), on a manikin: finding and removing calculus, measuring pocket depths and managing tissue.
  • The Computer Simulated Clinical Examination (CSCE), an Objective Structured Clinical Examination (OSCE) on diagnosis and treatment planning, using photographs, radiographs and other clinical images.

Only students or graduates of programs accredited by the Commission on Dental Accreditation (CODA) or the Commission on Dental Accreditation of Canada may take it. Others apply to the state board where they want to practice. ADEX sets its own fees: $1,150 for both parts, including one complimentary retake of the first clinical exam, plus a $150 typodont fee and a facility fee that varies by site.

CRDTS dental hygiene exams

Central Regional Dental Testing Service (CRDTS) says its dental and dental hygiene exams are accepted in over 40 states. It offers a simulated patient option for dental hygiene, with a written Oral Assessment OSCE given on site. It also says it’s the candidate’s job to know whether a state accepts CRDTS, and links each state board from its map. For fees and dates, see CRDTS’s own site.

The DHLOSCE from the JCNDE

The Dental Hygiene Licensure Objective Structured Clinical Examination (DHLOSCE) launched in 2025. It tests clinical judgment and skills in a problem-solving context, at Prometric test centers rather than Pearson VUE. The JCNDE says it isn’t a regional exam.

The JCNDE’s DHLOSCE page lists three states that accept it toward their clinical exam requirement: Arizona, Kentucky and Oregon. It asks you to check each state board’s site for the details. At its June 24, 2026 meeting, the JCNDE proposed keeping the DHLOSCE fee at $575 for 2027, the same as in 2026, and extended its discount incentives into 2027.

Talks on hygiene licensure exams

On October 5, 2026, the ADA said it, the JCNDE and ADEX had begun discussions on dental hygiene licensure assessment. It described them as exploring closer alignment in exam content, evaluation methods and the candidate experience, and it didn’t announce any change to the exams.

Sources: ADEX · CRDTS · WREB and 7 more. Checked November 2026.

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