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District of Columbia Dental Hygiene — Requirements & Free Practice

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Teacher's License in Dental Hygiene

Faculty license allowing a dental hygienist appointed to an accredited dental school in the District to teach and practice dental hygiene only at that institution (D.C. Official Code § 3-1205.08b; 17 DCMR Chapter 92).

Licensing authority: District of Columbia Board of Dentistry (DC Health)

Teacher's license in dental hygiene (17 DCMR §§ 9206 9208)

All of the following:

Adex History
The applicant must not have failed the ADEX clinical examination, or its successor, unless the applicant subsequently passed it (17 DCMR § 9206.1, § 9208.1); passing ADEX is not itself required.
Character
Good moral character, two letters of recommendation from clinical colleagues, criminal background check, lawful presence, no pending investigation or license not in good standing (17 DCMR §§ 9206.1, 9208.1).
Education And Practice
Dental hygiene program of at least two academic years at a CODA-accredited institution or substantially equivalent education, and active dental hygiene practice for the three years immediately preceding the application with at least 150 hours (17 DCMR § 9207.1).
Faculty Appointment
Appointment or promise of appointment as a full-time or part-time faculty member in a dental hygiene program at an accredited dental school located in the District, documented by the institution (17 DCMR § 9206.1; D.C. Official Code § 3-1205.08b(d)(5)).
Law Exam Waiver
The November 17, 2021 Board minutes record a temporary waiver of the DC Take Home Law Exam for dentists and dental hygienists "for both license types"; they do not say whether it extends to teacher's licenses. 17 DCMR § 9208.1(h) requires the applicant to pass the District of Columbia Dental Law Examination.
Scope
Teach and practice dental hygiene only at the named institution, under the direct supervision of a licensed dentist employed there (17 DCMR § 9210; D.C. Official Code § 3-1205.08b(f)).
Renewal of a teacher's license in dental hygiene
No examination is required for this applicant pathway.
Continuing Education
20 hours of continuing education in the two years before expiration including CPR, 2 hours infection control, 1 hour ethics, 2 hours LGBTQ cultural competency and at least 10% public health priority subjects (17 DCMR § 9211.6).
Term
Expires December 31 of each odd-numbered year or when the holder ceases to be a faculty member at the named institution (17 DCMR § 9202).

Official no-examination sources

Effective from 2021-04-09.

Dental Hygienist License

License to practice dental hygiene in the District of Columbia issued by the Board of Dentistry under D.C. Official Code Title 3, Chapter 12 and 17 DCMR Chapter 43.

Licensing authority: District of Columbia Board of Dentistry (DC Health) · Application information

Licensure by endorsement (17 DCMR § 4309)

All of the following:

  • National Board Dental Hygiene Examination

  • At least one of the following alternatives:

    • All of the following:

      • ADEX Dental Hygiene Computer Simulated Clinical Examination (CSCE OSCE) (practice unavailable)
      • ADEX Dental Hygiene Simulated Patient Treatment Clinical Examination (SPTCE) (assessment without a question bank)
  • District of Columbia Dental Law Examination (practice unavailable)
Application Items
2026 checklist items 1-13 plus official licensure verifications (item 14, endorsement applicants only).
Clinical Exam Alternatives
Instead of the NERB examination (the North East Regional Board examination in dental hygiene or its successor, reported as NERB (CDCA/WREB/ADEX/CITA) results), 17 DCMR § 4309.1(d)(2)-(3) accepts a regional board examination other than NERB, or a state dental examination the Board determines to be substantially equivalent; either alternative also requires active practice of dental hygiene in another U.S. state in good standing for the three years immediately preceding the application with at least 150 hours of active practice (§ 4309.3(f)). The rule names no particular examination for these alternatives, so they are applicant conditions, not exam leaves.
Competency Examination
The Board may, in its discretion, require a competency examination if the applicant's licensure in any state was ever denied, revoked, or suspended for incompetence or inability to practice safely (17 DCMR § 4309.4).
Current License
Currently licensed, in good standing, to practice dental hygiene in another U.S. state (17 DCMR § 4309.1(c)), with licensure verifications sent directly by every state in which the applicant holds or has ever held a health occupation license (§ 4309.2(c), § 4309.3(c)).
Education
Education requirements of 17 DCMR § 4302.1 or § 4303 (§ 4309.1(a)).
Law Exam Waiver
Board of Dentistry open-session minutes of November 17, 2021 (item OS-1117-05) record: "Temporary Waiver of DC Take Home Law Exam for Dentists and Dental Hygienists. This policy temporarily waives the DC law exam requirement for licensure for both license types while the Board finalizes the new Law Exam based on the updated regulations." 17 DCMR § 4305.1 still requires the examination of all applicants without exception; the rule outranks the Board's waiver policy, so the examination stays a leaf and the applicant should confirm with the Board whether the waiver is still applied.
Licensure by examination (17 DCMR § 4304)

All of the following:

  • National Board Dental Hygiene Examination

  • All of the following:

    • ADEX Dental Hygiene Computer Simulated Clinical Examination (CSCE OSCE) (practice unavailable)
    • ADEX Dental Hygiene Simulated Patient Treatment Clinical Examination (SPTCE) (assessment without a question bank)
  • District of Columbia Dental Law Examination (practice unavailable)
Adex Age
An applicant who completed the NERB examination ten or more years before the Board receives the application must retake it unless applying by endorsement (17 DCMR § 4304.4).
Adex Format
The ADEX examination may be patient-based or nonpatient-based (17 DCMR § 4304.1(b)(2)); the 2026 checklist asks for NERB (CDCA/WREB/ADEX/CITA) Dental Hygiene results.
Application Items
2026 checklist: online application and $245 fee, current CPR certificate for healthcare providers at the basic level, official transcript, three moral character references, criminal background check, screening-question explanations.
Education
Graduate of a dental hygiene program of at least two academic years at an institution recognized by the Commission on Dental Accreditation (D.C. Official Code § 3-1205.04(c); 17 DCMR § 4302.1), or a foreign-educated applicant accepted under 17 DCMR § 4303 (substantially equivalent education; National Board Dental Hygiene Examination passed; the Board may interview).
General Qualifications
At least 18 years of age, no conviction related to the occupation, no unresolved revocation or suspension elsewhere and no pending discipline in another state (D.C. Official Code § 3-1205.03(a)).
Law Exam Waiver
Board of Dentistry open-session minutes of November 17, 2021 (item OS-1117-05) record: "Temporary Waiver of DC Take Home Law Exam for Dentists and Dental Hygienists. This policy temporarily waives the DC law exam requirement for licensure for both license types while the Board finalizes the new Law Exam based on the updated regulations." 17 DCMR § 4305.1 still requires the examination of all applicants without exception; the rule outranks the Board's waiver policy, so the examination stays a leaf and the applicant should confirm with the Board whether the waiver is still applied.
Reactivation from inactive status
No examination is required for this applicant pathway.
Continuing Education
20 hours of approved continuing education in the two years before the application plus 8 hours for each additional inactive year beginning with the third year (17 DCMR § 4306.7).
Current Competency
Establish current competency to the satisfaction of the Board, which may include a re-entry plan; pay the fee and complete the criminal background check (D.C. Official Code § 3-1205.11(c)).

Official no-examination sources

Effective from 2021-04-09.

Reinstatement of an expired license
No examination is required for this applicant pathway.
Continuing Education
20 hours of approved continuing education in the two years before the application plus 8 hours for each additional expired year beginning with the third year (17 DCMR § 4306.9).
Fitness
Demonstrate fitness to resume practice, including competency and knowledge of District and federal laws; the Board may require additional education or training (17 DCMR § 4010.3-4010.5).
Time Limit
Apply within 5 years after expiration; after that the applicant must meet the requirements for a new license (D.C. Official Code § 3-1205.12(a)-(b)).

Official no-examination sources

Effective from 2021-04-09.

Renewal of a dental hygiene license
No examination is required for this applicant pathway.
Continuing Education
20 hours of approved continuing education in the two years before expiration, including current basic-level CPR certification, 2 hours infection control, 1 hour ethics, 2 hours LGBTQ cultural competency, and at least 10% in the Director's public health priority subjects (17 DCMR § 4306.5).
Late Renewal
Renewal within 60 days after expiration with a late fee (17 DCMR § 4005.5, § 4306.11).
Term
License expires December 31 of each odd-numbered year (17 DCMR § 4301.1).

Official no-examination sources

Effective from 2021-04-09.

District of Columbia Dental Law Examination

Examination outline
  • District of Columbia Health Occupations Revision Act of 1985 (D.C. Official Code Title 3, Chapter 12)
  • 17 DCMR Chapter 40, Health Occupations: General Rules
  • 17 DCMR Chapter 41, Health Occupations: Administrative Procedures
  • 17 DCMR Chapter 42, Dentistry
  • 17 DCMR Chapter 43, Dental Hygiene
  • 17 DCMR Chapter 92, Teaching Licenses for Dentistry and Dental Hygiene
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

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