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Colorado Dental Hygiene — Requirements & Free Practice

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Dental Hygienist License

Colorado license to practice dental hygiene issued by the Colorado Dental Board under C.R.S. 12-220-405 to 12-220-407.

Licensing authority: Colorado Dental Board (Colorado Department of Regulatory Agencies, Division of Professions and Occupations) · Application information

Licensure by endorsement (Occupational Credential Portability Program)

All of the following:

Applicant Category
Licensure by endorsement through the Occupational Credential Portability Program for an applicant who holds an active dental hygiene license in good standing in another state or United States territory (C.R.S. 12-220-407 and 12-20-202(3); Rule 1.6(G)(1)). C.R.S. 12-20-202(3)(b)(I) also covers a holder of a military occupational specialty.
Clinical Competency
Demonstrate current clinical competency by one of: at least 300 hours per year of active clinical dental hygiene practice in the U.S., its territories or Canada for one of the three preceding years; at least 300 hours annually of teaching with patient care in an accredited program for one of the three preceding years; a senior officer's report for military practice; passing a Board-approved regional or state clinical examination within one year of the application; or a Board pre-approved evaluation within one year (Rule 1.6(G)(5)). The Board may also apply other measures (Rule 1.6(G)(5)(f)).
Clinical Examination All Parts
Board Policy 1.A: all parts of a clinical examination must be successfully completed; no part is optional for Colorado licensure.
Dhlosce Basis
The Dental Hygiene Licensure Objective Structured Clinical Examination is mounted because Board Policy 1.A accepts 'all OSCE's'. C.R.S. 12-220-406(1)(b) describes the clinical examination as one administered by a regional testing agency composed of at least four states, an examination of another state, or a methodology adopted by the Board by rule; Rule 1.6(F)(1)(c) names only the first two.
Disclosures
Disclose acts that would be grounds for discipline, prior or pending disciplinary actions in any jurisdiction, and malpractice actions with ten years of carrier coverage history (C.R.S. 12-220-405(1)(a); Rule 1.6(F)(2)(b)-(d)).
Discontinued Examinations Omitted
Board Policy 1.A still names SRTA and WREB. SRTA has merged with CRDTS (crdts.org/srta) and the Western Regional Examining Board is now part of CDCA-WREB-CITA (wreb.org); neither is mounted as a separate alternative.
Education
Graduation from a dental hygiene school accredited by the Commission on Dental Accreditation (CODA) with a program of at least two academic years or the equivalent (C.R.S. 12-220-405(1)(b); Rule 1.6(F)(1)(a)). Foreign-trained applicants must complete a CODA-approved program or, by reciprocal agreement, a CDAC-accredited program (Rule 1.6(A)(10)).
Examinations Via Rule
Rule 1.6(G)(2) requires endorsement applicants to meet Rule 1.6(F)(1), which includes the Joint Commission examination and the clinical examination, and C.R.S. 12-20-202(3)(b)(I)(C) requires compliance with any applicable requirement, including passing an exam, of Article 220. The Board's DH Initial Application Preview lists for 'Dental Hygienist by Endorsement' only: 'Possess an Active Dental Hygienist license in another state or jurisdiction.' plus program completion and clinical competency, without the examination items; the rule controls.
Jurisprudence Education
Attest to at least one hour of jurisprudence education covering the Colorado Dental Practice Act and related regulations before applying for initial licensure (Rule 1.6(F)(2)(e)); this is an education requirement, not an examination.
Other Clinical Examinations
C.R.S. 12-220-406(1)(b) and Rule 1.6(F)(1)(c) also accept an examination of another state (Board Policy 1.A names the examination developed and administered by Delaware); another state's own examination is not mounted as a leaf. Board Policy 1.A accepts all U.S. dental hygiene clinical examinations, on manikins or patients, that provide adequate assurance of competency; examinations beyond the mounted alternatives are accepted on that basis.
Other License Disclosure
Disclose every dental hygiene or other health care license previously or currently held, with dates and status (Rule 1.6(G)(4)).
Professional Liability Insurance
Obtain before practicing professional liability insurance of at least $50,000 per claim and $300,000 aggregate per calendar year, or be covered by a Rule 1.5 exemption (Rule 1.6(F)(2)(a)).
Substantial Equivalence
An applicant is not entitled to endorsement if the Board shows the applicant lacks substantially equivalent education, experience or credentials or committed an act that is grounds for discipline (C.R.S. 12-20-202(3)(c)).
Initial licensure by examination

All of the following:

Applicant Category
Original licensure by examination for a graduate of an accredited dental hygiene program (C.R.S. 12-220-405 and 12-220-406; Rule 1.6(F)).
Clinical Competency
Demonstrate current clinical competency by one of: graduation from an accredited dental hygiene program within the 12 months before the application; at least 300 hours per year of active clinical dental hygiene practice for one of the three preceding years; teaching dental hygiene or dentistry in an accredited program for one of the five preceding years; service as a licensed dental hygienist in the military for one of the five preceding years; passing a Board-approved regional or state clinical examination within one year of the application; or a Board pre-approved evaluation within one year (Rule 1.6(F)(3); C.R.S. 12-220-405(3)). The Board may apply additional measures in its discretion (Rule 1.6(F)(3)(g)-(h)).
Clinical Examination All Parts
Board Policy 1.A: all parts of a clinical examination must be successfully completed; no part is optional for Colorado licensure.
Dhlosce Basis
The Dental Hygiene Licensure Objective Structured Clinical Examination is mounted because Board Policy 1.A accepts 'all OSCE's'. C.R.S. 12-220-406(1)(b) describes the clinical examination as one administered by a regional testing agency composed of at least four states, an examination of another state, or a methodology adopted by the Board by rule; Rule 1.6(F)(1)(c) names only the first two.
Disclosures
Disclose acts that would be grounds for discipline, prior or pending disciplinary actions in any jurisdiction, and malpractice actions with ten years of carrier coverage history (C.R.S. 12-220-405(1)(a); Rule 1.6(F)(2)(b)-(d)).
Discontinued Examinations Omitted
Board Policy 1.A still names SRTA and WREB. SRTA has merged with CRDTS (crdts.org/srta) and the Western Regional Examining Board is now part of CDCA-WREB-CITA (wreb.org); neither is mounted as a separate alternative.
Education
Graduation from a dental hygiene school accredited by the Commission on Dental Accreditation (CODA) with a program of at least two academic years or the equivalent (C.R.S. 12-220-405(1)(b); Rule 1.6(F)(1)(a)). Foreign-trained applicants must complete a CODA-approved program or, by reciprocal agreement, a CDAC-accredited program (Rule 1.6(A)(10)).
Examination Timing
The national examination and clinical examination results must be on file with the Board; examination results are kept for at least one year (C.R.S. 12-220-406(2)).
Jurisprudence Education
Attest to at least one hour of jurisprudence education covering the Colorado Dental Practice Act and related regulations before applying for initial licensure (Rule 1.6(F)(2)(e)); this is an education requirement, not an examination.
Other Clinical Examinations
C.R.S. 12-220-406(1)(b) and Rule 1.6(F)(1)(c) also accept an examination of another state (Board Policy 1.A names the examination developed and administered by Delaware); another state's own examination is not mounted as a leaf. Board Policy 1.A accepts all U.S. dental hygiene clinical examinations, on manikins or patients, that provide adequate assurance of competency; examinations beyond the mounted alternatives are accepted on that basis.
Professional Liability Insurance
Obtain before practicing professional liability insurance of at least $50,000 per claim and $300,000 aggregate per calendar year, or be covered by a Rule 1.5 exemption (Rule 1.6(F)(2)(a)).
Licensure of a military spouse, gold star military spouse or military dependent licensed in another state
No examination is required for this applicant pathway.
Applicant Category
A military spouse, gold star military spouse, military dependent, or spouse or dependent of another qualified servicemember relocated to Colorado who holds an active dental hygiene license in good standing in another state or U.S. territory (C.R.S. 12-20-202(3)(f)).
Exclusions
Not available if issuance would violate an existing compact or reciprocity agreement or the Board shows the out-of-state license is not in good standing (C.R.S. 12-20-202(3)(f)(III)).
Proof
Satisfactory proof, under penalty of perjury, of the active out-of-state license in good standing.
Validity
The license is valid for six years and may be renewed; Rule 1.6(A)(19)(b) calls it military spouse temporary licensure. The application fee is waived (C.R.S. 12-20-202(3)(f)(IV)).

Official no-examination sources

Effective from 2026-06-30.

Reinstatement of an expired license or reactivation of an inactive or retired license to active status

At least one of the following alternatives:

Applicant Category
A Colorado dental hygienist whose license expired (after the sixty-day grace period of C.R.S. 12-20-202(1)(e)) or is in inactive or retired status and who seeks active status (Rule 1.6(I); C.R.S. 12-220-408(1), 12-220-409(5), 12-220-410(5)).
Continuing Education
A license expired or inactive for less than two years requires proof of the thirty hours of continuing education for the previous renewal period (Rule 1.6(H)(3)).
Dhlosce Basis
The Dental Hygiene Licensure Objective Structured Clinical Examination is mounted because Board Policy 1.A accepts 'all OSCE's' as Board-approved clinical examinations.
Disclosures
Disclose disciplinary and malpractice matters since the last renewal (Rule 1.6(I)(1)(b)-(d)).
Discontinued Examinations Omitted
Board Policy 1.A still names SRTA and WREB. SRTA has merged with CRDTS (crdts.org/srta) and the Western Regional Examining Board is now part of CDCA-WREB-CITA (wreb.org); neither is mounted as a separate alternative.
Military And Hardship
The Board shall reinstate the expired license of qualifying active military personnel and veterans (C.R.S. 12-20-202(2)(b)) and may waive reinstatement requirements for demonstrated hardship (C.R.S. 12-20-202(2)(c)(III)).
Other Clinical Examinations
C.R.S. 12-220-406(1)(b) and Rule 1.6(F)(1)(c) also accept an examination of another state (Board Policy 1.A names the examination developed and administered by Delaware); another state's own examination is not mounted as a leaf. Board Policy 1.A accepts all U.S. dental hygiene clinical examinations, on manikins or patients, that provide adequate assurance of competency; examinations beyond the mounted alternatives are accepted on that basis.
Other Competency Options
Instead of an examination the Board may accept, case by case, 300 hours of practice in a twelve-month period, postgraduate training, residency or internship, research and teaching in an accredited program, military or public health practice with a senior officer's report, or a Board pre-approved evaluation (Rule 1.6(I)(2)(a)-(e)); C.R.S. 12-20-202(2)(c)(II) also lists an out-of-state license in good standing with active practice, restricted-license practice, remedial courses and continuing education.
Professional Liability Insurance
Obtain professional liability insurance under C.R.S. 12-220-307 or be covered by a Rule 1.5 exemption (Rule 1.6(I)(1)(a)).
When Examination Applies
A clinical examination is one way to show continued clinical competency, required only when the license has been expired, retired or inactive for two or more years (Rule 1.6(I)(2)) and, per the Board's guide, when the applicant has not practiced at least 300 hours in a twelve-month period within the five preceding years. The examination must have been passed within one year of the date the application is received (Rule 1.6(I)(2)(d)). An applicant whose license lapsed less than two years ago sits no examination.
Biennial renewal of an active license
No examination is required for this applicant pathway.
Applicant Category
A dental hygienist holding an active Colorado license.
Continuing Education
Thirty hours of Board-approved continuing education per two-year period, including two hours of infection control on the CDC guidelines; at least sixteen hours clinical or science based and at least half live and interactive; current Basic Life Support certification (Rule 1.6(H)).
Renewal Cycle
Licenses are renewed every two years with the renewal fee (Rule 1.6(A)(6)); a sixty-day grace period with a delinquency fee follows expiration (C.R.S. 12-20-202(1)(e)).

Official no-examination sources

Effective from 2026-06-30.

ADEX Dental Hygiene Computer Simulated Clinical Examination (CSCE OSCE)

Provider
American Board of Dental Examiners; Prometric delivery
Format
Computer-based clinically based questions
Exam questions
Up to 120 items; pilot questions do not affect the final score
Passing score
Minimum scaled score 75; results reported as Pass/Fail
Examination outline
  • Medical/Dental Assessment (12%)
  • Intra and Extra Oral Assessment and Charting (27%)
    • Intra and Extra Oral Examination
    • Dental and Periodontal Charting and Assessment
    • Soft Tissue, Bone, and Tooth Abnormalities
  • Radiology/Imaging (15%)
  • Dental Hygiene Care Planning (13%)
  • Patient Care (19%)
    • Periodontal Procedures
    • Infection Control
    • Medical Emergency Management
  • Dental Specialties and Pharmacology (14%)
    • Dental Specialties
    • Applied Pharmacology
Examination sources

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

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

Dental Hygiene Licensure Objective Structured Clinical Examination

Examination outline
  • Assessment, Interpretation, Evaluation, and Reevaluation (45%)
    • The extraoral and intraoral examination conducted by a dental hygienist, including hard and soft tissue evaluation (including the periodontal examination), interpretation of medical, dental, and psychosocial history and the patient’s oral health condition (e.g., via radiographic imaging), and reevaluation after treatment; findings are interpreted within scope of practice and used to inform the dental hygiene diagnosis.
    • Medical, Dental, and Psychosocial History — measured throughout the examination in every representation of a patient
    • Soft Tissue Evaluation (15% of this topic area)
    • Hard Tissue Evaluation (15% of this topic area)
    • Periodontal Assessment (35% of this topic area)
    • Hard and Soft Deposits (20% of this topic area)
    • Radiographic Technique (15% of this topic area) — effective use of radiographic equipment to obtain diagnostic-quality radiographs, including recognizing factors affecting diagnostic quality and adjustments to improve quality; excludes interpretation of radiographic images to establish the dental hygiene diagnosis, which is covered in other specification areas
  • Dental Hygiene Care Planning and Evidence Based Treatment (55%)
    • Use information acquired during Assessment, Interpretation, Evaluation, and Reevaluation to formulate appropriate dental hygiene care plans incorporating patient considerations, risk factors, and anticipated outcomes; inform dental hygiene treatment (including instrumentation) and follow-up; manage patient anxiety through pain control and medical emergencies during treatment, all within the dental hygienist’s scope of practice.
    • Infection Control (10% of this topic area)
    • Dental Hygiene Care Planning (25% of this topic area)
    • Pain Control (15% of this topic area)
    • Nonsurgical Periodontal Therapy and Adjunctive Therapy (40% of this topic area)
    • Medical Emergencies (10% of this topic area)
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