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California Dental Hygiene — Requirements & Free Practice

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Registered Dental Hygienist (RDH)

Ordinary California dental hygiene license issued by the Dental Hygiene Board of California under BPC 1917 and 1917.1.

Licensing authority: Dental Hygiene Board of California · Application information

Initial licensure as a graduate of a California accredited dental hygiene program within three years (BPC 1917(b)(2))

All of the following:

Application And Background
Completed application and fees (BPC 1917(e)); FBI and California DOJ criminal background clearance before issuance (Board applicants page).
Basic Life Support
Current, valid basic life support certification from a course consistent with 16 CCR 1016, 1016.2 or 1017 (BPC 1917(g)).
California Graduation
Graduation from a California accredited dental hygiene college approved by the Board within the preceding three years (BPC 1917(b)(2)); the Board page states this applies from January 1, 2024 and that applicants applying more than 3 years after graduation must instead submit a passing score on a Board-approved clinical examination.
Education
Completion of a dental hygiene educational program approved by the Board, accredited by the Commission on Dental Accreditation, and conducted by a degree-granting postsecondary institution (BPC 1917(a)).
Probationary License
The Board may, in its sole discretion, issue a probationary license to an applicant who has satisfied all licensure requirements and may require terms such as a professional competency examination (BPC 1932).
Radiation Safety
Proof of completion of an ADA-approved radiation safety course (Licensure by Clinical Exam checklist).
Sln Instruction
Satisfactory completion of Board-approved instruction in gingival soft-tissue curettage, nitrous oxide-oxygen analgesia, and local anesthesia (BPC 1917(f)); out-of-state graduates may apply for an equivalency review of out-of-state SLN education.
Initial licensure by clinical examination (BPC 1917(b)(1))

All of the following:

  • National Board Dental Hygiene Examination
  • California Registered Dental Hygienist Laws and Ethics Examination (practice unavailable)

  • At least one of the following alternatives:

    • ADEX Dental Hygiene Simulated Patient Treatment Clinical Examination (SPTCE) (assessment without a question bank)
    • CRDTS Dental Hygiene Patient-Based Exam (assessment without a question bank)
    • CRDTS Dental Hygiene Simulated Patient Exam (practice unavailable)
Application And Background
Completed application and fees (BPC 1917(e)); FBI and California DOJ criminal background clearance before issuance (Board applicants page).
Basic Life Support
Current, valid basic life support certification from a course consistent with 16 CCR 1016, 1016.2 or 1017 (BPC 1917(g)).
Clinical Exam Timing
The clinical examination must have been completed within the preceding three years (BPC 1917(b)); the application form states the exam must be taken within 3 years from the date of application.
Crdts Format
Board sources name the "Central Regional Dental Testing Service (CRDTS) clinical examination" without restricting its format; both CRDTS dental hygiene formats are mounted as alternatives.
Education
Completion of a dental hygiene educational program approved by the Board, accredited by the Commission on Dental Accreditation, and conducted by a degree-granting postsecondary institution (BPC 1917(a)).
Other Approved Clinical Exam
BPC 1917(b)(1) also accepts "any other clinical or dental hygiene examination approved by the dental hygiene board"; examinations beyond those the Board names (ADEX, CRDTS) are at the Board's approval.
Probationary License
The Board may, in its sole discretion, issue a probationary license to an applicant who has satisfied all licensure requirements and may require terms such as a professional competency examination (BPC 1932).
Radiation Safety
Proof of completion of an ADA-approved radiation safety course (Licensure by Clinical Exam checklist).
Remediation
An examinee who fails the clinical examination three times, or once through gross trauma to a patient, must complete Board-approved remedial education before re-examination (BPC 1917.3).
Sln Instruction
Satisfactory completion of Board-approved instruction in gingival soft-tissue curettage, nitrous oxide-oxygen analgesia, and local anesthesia (BPC 1917(f)); out-of-state graduates may apply for an equivalency review of out-of-state SLN education.
Wreb Scores
The statute names the dental hygiene examination given by the Western Regional Examining Board; WREB merged into CDCA-WREB-CITA in 2021-2022 and its successor now provides the ADEX examination, so the WREB examination is not a current alternative. The RDH application still accepts a WREB pass dated within 3 years as prior evidence.
Restoration of an inactive RDH license to active status (BPC 1940(b))
No examination is required for this applicant pathway.
Continuing Education
Evidence of the required hours of approved continuing education within the two years preceding the application (BPC 1940(b)).

Official no-examination sources

Effective from 2020-01-01.

Licensure by credential for dental hygienists licensed in another state (BPC 1917.1)

All of the following:

Additional Board Examination
BPC 1917.1(a)(4) also requires "any examination that may be required by the dental hygiene board"; no such examination is identified.
Clinical Exam Failures
Must not have failed the state clinical examination, the WREB examination, or any other Board-approved clinical examination more than once or once within five years before application (BPC 1917.1(a)(8)).
Clinical Practice
Clinical practice as an RDH, or full-time faculty in an accredited dental hygiene program, for at least 750 hours per year for at least five years immediately preceding application; three years plus a filed pending contract with a qualifying clinic may satisfy it (BPC 1917.1(a)(3)).
Continuing Education
At least 25 units of continuing education in the preceding two years, including Board-mandated coursework (BPC 1917.1(a)(9)).
Discipline
Proof of no disciplinary action in any state, or Board review of any such action (BPC 1917.1(a)(5)).
Education
Graduation from a CODA-accredited school of dental hygiene (BPC 1917.1(a)(6)); Board-approved SLN training (BPC 1917.1(a)(10)).
Foreign Education
The Board page states dental hygiene education and licensure in another country is not recognized or accepted in California.
Out Of State License
Current RDH license issued by another state that is not revoked, suspended, or otherwise restricted (BPC 1917.1(a)(2)).
Prior Clinical Examination
Proof of satisfactory completion of "a state clinical examination, regional clinical licensure examination, or any other clinical dental hygiene examination approved by the dental hygiene board" (BPC 1917.1(a)(7)); the checklist asks for "Original proof of passing a State or Regional Examination". No particular examination is named.
Petition for reinstatement of a revoked or surrendered RDH license (BPC 1957)
No examination is required for this applicant pathway.
Board Terms
The Board or administrative law judge may impose necessary terms and conditions in reinstating the license (BPC 1957(f)); no examination is named.
Waiting Period
At least three years after revocation for unprofessional conduct or surrender, or one year after revocation for mental or physical illness (BPC 1957(a)).

Official no-examination sources

Effective from 2025-01-01.

Renewal of an expired RDH license within five years of expiration (BPC 1936)
No examination is required for this applicant pathway.
Fees
All accrued renewal and delinquency fees (BPC 1936).
Timing
Within five years after expiration; a license not renewed within five years cannot be renewed, restored, reinstated or reissued and the holder must apply as a new applicant (BPC 1939).

Official no-examination sources

Effective from 2020-01-01.

Reactivation of a retired RDH license to active status (16 CCR 1119(e))
No examination is required for this applicant pathway.
Requirements
Form DHBC RLC-02, $160 fee, proof of current continuing education under 16 CCR 1016 and 1017, and fingerprint compliance under 16 CCR 1132 (16 CCR 1119(e)).

Official no-examination sources

Effective from 2025-01-01.

ADEX Dental Hygiene Simulated Patient Treatment Clinical Examination (SPTCE)

This assessment does not have a question bank.

Provider
American Board of Dental Examiners
Format
Simulated patient treatment on maxillary and mandibular typodonts
Passing score
75 or greater; results reported as Pass/Fail for this part
Examination sources

California Registered Dental Hygienist Laws and Ethics Examination

Provider
PSI Services LLC
Format
Computer-based multiple-choice written examination
Exam questions
60 questions (50 scored, 10 unscored pretest)
Time limit
90 minutes
Passing score
Minimum score of 75% (16 CCR 1121(c))
Exam fee
$32.07 PSI examination fee
Examination outline
  • Consent, Confidentiality, and Patient Privacy (35%)
    • Informed Consent Rights Regarding Treatment Decisions (20%)
    • Disclose all relevant treatment options to assist patients in making informed treatment decisions.
    • Respect patient autonomy in making decisions about their care.
    • Obtain informed consent to authorize dental hygiene treatment.
    • Comply with requirements to provide oral care to minor patients.
    • Knowledge of required disclosures that facilitate patient ability to make educated treatment decisions.
    • Knowledge of laws about patient right to make treatment decisions.
    • Knowledge of methods for ensuring patients understand risks, benefits, and alternatives to treatment.
    • Knowledge of requirements regarding informed consent for treatment.
    • Knowledge of requirements for treating minor patients.
    • Knowledge of requirements regarding consent to treat and refuse treatment of minors.
    • Knowledge of requirements regarding access to information related to treatment of minors.
    • Patient Privacy and Protected Health Information (9%)
    • Maintain patient confidentiality to protect their inherent right to privacy in treatment.
    • Comply with requirements regarding requests for records to protect patient rights.
    • Comply with the provisions of the Health Information Portability and Accountability Act (HIPAA) to protect sensitive patient information.
    • Comply with laws regarding telehealth to deliver dental hygiene services using information and communication technologies.
    • Knowledge of requirements regarding the release of confidential patient information.
    • Knowledge of requirements regarding patient right to access treatment records.
    • Knowledge of requirements regarding the release of records to other individuals, professionals, or third parties.
    • Knowledge of requirements of the Health Information Portability and Accountability Act (HIPAA).
    • Knowledge of requirements regarding geographic limitations in providing telehealth.
    • Knowledge of requirements regarding standards of care and delivery of telehealth.
    • Limits to Confidentiality and Mandated Reporting (6%)
    • Report known or suspected child abuse or neglect to protect the health and safety of minors.
    • Report known or suspected abuse, neglect, or exploitation of dependent adults to protect vulnerable populations.
    • Report known or suspected abuse, neglect, or exploitation of older adults to protect vulnerable populations.
    • Knowledge of signs of child abuse and neglect.
    • Knowledge of laws regarding mandated reporting of child abuse and neglect.
    • Knowledge of procedures for filing mandated reports with protective authorities.
    • Knowledge of signs of abuse, neglect, and exploitation of dependent adults.
    • Knowledge of laws regarding mandated reporting of abuse, neglect, and exploitation of dependent adults.
    • Knowledge of signs of abuse, neglect, and exploitation of older adults.
    • Knowledge of laws regarding mandated reporting of abuse, neglect, and exploitation of older adults.
  • Standards for Professional Dental Hygiene Practice (35%)
    • Scope of Practice, Professional Conduct, and Adherence to License Requirements (20%)
    • Adhere to requirements regarding scope of practice to respect professional boundaries.
    • Maintain professional conduct within and outside work hours to uphold professional integrity.
    • Comply with license requirements to keep dental hygiene license current and valid.
    • Knowledge of legal requirements regarding RDH scope of practice.
    • Knowledge of requirements regarding professional conduct.
    • Knowledge of the relationship between personal and professional actions and public trust.
    • Knowledge of the principles of universality.
    • Knowledge of the principles of ethical behaviors that prevent harm to patients and society.
    • Knowledge of requirements regarding maintenance, renewal, and restoration of a California dental hygiene license.
    • Knowledge of requirements for responding to and fulfilling penalties under disciplinary actions.
    • Knowledge of requirements regarding continuing education to maintaining dental hygiene license.
    • Professional Practices (15%)
    • Maintain patient records according to requirements for documentation, storage, and disposal.
    • Adhere to requirements regarding billing and payments of dental hygiene treatments to protect patients from financial harm or exploitation.
    • Comply with requirements regarding advertising to inform public of dental hygiene qualifications and services provided.
    • Knowledge of requirements regarding documentation of treatments provided.
    • Knowledge of requirements regarding the storage and disposal of treatment records.
    • Knowledge of protocols for documenting in patient dental records.
    • Knowledge of requirements regarding disclosures and notification of fees and fee changes.
    • Knowledge of requirements regarding the collection of fees and surcharges.
    • Knowledge of laws regarding advertisement and dissemination of information pertaining to professional qualifications and services.
  • Obligation to the Patient and Professional Role (30%)
    • Obligation to the Patient (20%)
    • Practice within scope of competence to provide treatment consistent with level of training and experience.
    • Maintain competence in providing dental hygiene services that are culturally sensitive and respect patient diversity.
    • Provide services in a manner that protects all patients to minimize harm to patients and others.
    • Maintain standard of care to align with patient oral health care needs.
    • Promote well-being of patients to protect their best interest and welfare.
    • Manage safety concerns and crisis situations that arise during treatment to protect patients and others.
    • Refer patients to other providers to address situations that require additional treatment or expertise.
    • Knowledge of ethical standards about the use of techniques or approaches within level of competence.
    • Knowledge of ethical standards about remaining current on professional developments.
    • Knowledge of methods regarding cultural sensitivity in working with diverse patients.
    • Knowledge of the principles of complementarity.
    • Knowledge of standards that prohibit discrimination in professional services and conduct.
    • Knowledge of the principles of non-maleficence.
    • Knowledge of methods for preventing harm to patients.
    • Knowledge of standards about providing services in the best interest of patients.
    • Knowledge of standards about excessive treatment and limiting patient care.
    • Knowledge of standards about acting in the best interest of patients.
    • Knowledge of methods for enhancing the well-being of patients.
    • Knowledge of procedures regarding the management of safety needs.
    • Knowledge of methods for addressing patient safety needs.
    • Knowledge of ethical standards about referrals for services to meet patient oral health care needs.
    • Obligations within Professional Role (10%)
    • Manage conflict of interest situations to prevent harm to patients or impairment to decision-making.
    • Maintain professionalism while providing oral health services to patients.
    • Adhere to standards regarding practicing while impaired to prevent harm to patients.
    • Collaborate with other professionals to meet patient oral health care needs.
    • Address unethical or incompetent conduct of colleagues to protect the wellbeing and best interest of patients.
    • Knowledge of ethical standards about conflict-of-interest situations.
    • Knowledge of methods for managing conflict of interest situations.
    • Knowledge of the relationship between personal values and professional objectivity.
    • Knowledge of methods for managing the impact of personal values on treatment.
    • Knowledge of methods for maintaining objectivity in providing services to patients.
    • Knowledge of methods for managing the impact of personal issues on professional performance or judgement.
    • Knowledge of standards about practicing when impaired.
    • Knowledge of standards about practicing under the influence of alcohol or other substances.
    • Knowledge of standards about participating with other professionals in providing patient care.
    • Knowledge of requirements regarding protecting patient rights during consultation and collaboration with other professionals.
    • Knowledge of signs of colleague impairments that jeopardize professional judgment.
    • Knowledge of types of colleague behaviors that require intervention or action.
    • Knowledge of ethical standards about addressing unethical or incompetent conduct of colleagues.
Examination sources

CRDTS Dental Hygiene Patient-Based Exam

This assessment does not have a question bank.

Examination sources

CRDTS Dental Hygiene Simulated Patient Exam

Examination outline
  • Extra/Intra Oral Assessment OSCE — 16 scorable items, 1 point each, 16 maximum points
    • Identify gross head and neck anatomy, variations of normal anatomy, palpation techniques used to examine head and neck extraoral and intraoral structures, and atypical or abnormal findings, whether pathologic or non-pathologic
    • Extraoral — Head, Face, and Neck: asymmetry, infected piercings, swellings, lesions
    • Extraoral — Lymph Nodes, TMJ: description of location, restricted opening
    • Intraoral — Oral Mucosa/Lips and Supporting Structures: lesions, chemical/physical irritations, tattoos, swellings, hematomas, nodules
    • Intraoral — Alveolar Ridge: lesions, chemical/physical irritations, exostosis, torus/tori, tattoos, swellings, hematomas, nodules
    • Intraoral — Palate and Oral Pharynx (tonsils and tonsillar pillars): torus, lesions, chemical/physical irritation, other significant findings
    • Intraoral — Tongue: hairy tongue, fissured tongue, loss of papilla, geographic tongue, glossitis, nodules, lesions
    • Intraoral — Floor of the Mouth: ankyloglossia, hematomas, lesions, tattoos, other significant findings
  • Calculus Detection — 12 scorable surfaces, 1 point each, 12 maximum points
    • Explore 12 random assigned surfaces on the maxillary arch and accurately record presence (Y/Yes) or absence (N/No) of calculus on each surface
    • The maxillary arch is for calculus detection only, not scaling; deposits detected on a line angle are marked on the closest interproximal surface
  • Scaling/Subgingival Calculus Removal — 12 scorable surfaces, 5 points each, 60 maximum points
    • Candidate selects the right or left mandibular quadrant during the initial online application; examiners evaluate 12 surfaces in the selected quadrant
    • Because evaluated surfaces are unknown, explore all subgingival surfaces in the selected quadrant and remove subgingival calculus so no deposits are detectable with an 11/12 explorer; detectable subgingival calculus is a scaling error
    • Supragingival deposit/stain removal is not part of this examination, so rubber cup polishing is not needed or required
  • Periodontal Probing — 12 scorable measurements, 1 point each, 12 maximum points
    • On two randomly assigned teeth in the selected treatment quadrant, chart simulated gingival sulcus/pocket depths within ±1 mm to the nearest mm on six aspects of each tooth: MF, F-midpoint, DF, ML, L-midpoint, and DL
    • Record periodontal measurements after scaling; direct facial and lingual readings are at tooth midpoint with probe parallel to root surface and long axis; interproximal readings place the shank against the contact point and tip slightly into the col; if no contact, place at proximal midpoint and record the same facial and lingual measurement; use light pressure to position the tip to sulcus depth
Examination sources

National Board Dental Hygiene Examination

Examination outline
  • Discipline-Based Component — Scientific Basis for Dental Hygiene Practice (61 items)
    • Anatomic Sciences
    • Anatomic Sciences — Anatomy
    • Anatomic Sciences — Anatomy — Head and neck anatomy
    • Anatomic Sciences — Anatomy — Dental anatomy
    • Anatomic Sciences — Anatomy — Dental anatomy — General anatomy
    • Anatomic Sciences — Anatomy — Dental anatomy — Root anatomy
    • Anatomic Sciences — Anatomy — Histology and Embryology
    • Anatomic Sciences — Physiology
    • Anatomic Sciences — Biochemistry and Nutrition
    • Anatomic Sciences — Microbiology and Immunology
    • Anatomic Sciences — Pathology
    • Anatomic Sciences — Pathology — General
    • Anatomic Sciences — Pathology — Oral
    • Anatomic Sciences — Pharmacology
  • Discipline-Based Component — Provision of Clinical Dental Hygiene Services (115 items)
    • Assessing Patient Characteristics
    • Assessing Patient Characteristics — Medical and dental history
    • Assessing Patient Characteristics — Head and neck examination
    • Assessing Patient Characteristics — Periodontal evaluation
    • Assessing Patient Characteristics — Oral evaluation
    • Assessing Patient Characteristics — General
    • Obtaining and Interpreting Radiographs
    • Obtaining and Interpreting Radiographs — Principles of radiophysics and radiobiology
    • Obtaining and Interpreting Radiographs — Principles of radiologic health
    • Obtaining and Interpreting Radiographs — Technique
    • Obtaining and Interpreting Radiographs — Recognition of normalities and abnormalities
    • Obtaining and Interpreting Radiographs — General
    • Planning and Managing Dental Hygiene Care
    • Planning and Managing Dental Hygiene Care — Infection control (application)
    • Planning and Managing Dental Hygiene Care — Recognition of emergency situations and provision of appropriate care
    • Planning and Managing Dental Hygiene Care — Individualized patient education
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Planning of individualized instruction
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Provision of instruction for prevention and management of oral diseases
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Provision of instruction for prevention and management of oral diseases — Dental caries
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Provision of instruction for prevention and management of oral diseases — Periodontal disease
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Provision of instruction for prevention and management of oral diseases — Oral conditions
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Anxiety and pain control
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Recognition and management of compromised patients
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Dental hygiene treatment strategies
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Dental hygiene treatment strategies — Diagnosis
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Dental hygiene treatment strategies — Treatment plan
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Dental hygiene treatment strategies — Case presentation
    • Planning and Managing Dental Hygiene Care — Individualized patient education — General
    • Performing Periodontal Procedures
    • Performing Periodontal Procedures — Etiology and pathogenesis of periodontal diseases
    • Performing Periodontal Procedures — Prescribed therapy
    • Performing Periodontal Procedures — Prescribed therapy — Periodontal debridement
    • Performing Periodontal Procedures — Prescribed therapy — Surgical support services
    • Performing Periodontal Procedures — Prescribed therapy — Chemotherapeutic agents
    • Performing Periodontal Procedures — Prescribed therapy — General
    • Performing Periodontal Procedures — Reassessment and maintenance (e.g., implant care)
    • Using Preventive Agents
    • Using Preventive Agents — Fluorides - systemic and topical
    • Using Preventive Agents — Fluorides - systemic and topical — Mechanisms of action
    • Using Preventive Agents — Fluorides - systemic and topical — Toxicology
    • Using Preventive Agents — Fluorides - systemic and topical — Methods of administration
    • Using Preventive Agents — Fluorides - systemic and topical — Methods of administration — Water fluoridation
    • Using Preventive Agents — Fluorides - systemic and topical — Methods of administration — Self-administered
    • Using Preventive Agents — Pit and fissure sealants
    • Using Preventive Agents — Other preventive agents
    • Providing Supportive Treatment Services
    • Providing Supportive Treatment Services — Properties and manipulation of materials
    • Providing Supportive Treatment Services — Polishing natural and restored teeth
    • Providing Supportive Treatment Services — Making of impressions and preparation of study casts
    • Providing Supportive Treatment Services — Other supportive services (e.g., tooth desensitization)
    • Providing Supportive Treatment Services — General
    • Professional Responsibility
    • Professional Responsibility — Ethical principles, including informed consent
    • Professional Responsibility — Regulatory compliance
    • Professional Responsibility — Patient and professional communication
    • Professional Responsibility — General
  • Discipline-Based Component — Community Health/Research Principles (24 items)
    • Promoting Health and Preventing Disease Within Groups
    • Participating in Community Programs
    • Participating in Community Programs — Assessing populations and defining objectives
    • Participating in Community Programs — Designing, implementing, and evaluating programs
    • Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results
  • Case-Based Component (150 items involving 12 to 15 dental hygiene patient cases)
    • Cases present information dealing with adult and child patients and may involve geriatric, adult-periodontal, pediatric, special needs, medically compromised, and other patient types; a medically compromised patient is one whose health status may require modification of standard treatment or special consideration.
    • Patient information is presented by means of patient histories, dental charts, radiographs, and clinical photographs.
    • Assessing patient characteristics
    • Obtaining and interpreting radiographs
    • Planning and managing dental hygiene care
    • Performing periodontal procedures
    • Using preventive agents
    • Providing supportive treatment service
    • Professional responsibility
Examination sources