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Hawaii Dental Hygiene — Requirements & Free Practice

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Dental Hygienist License

Hawaii license to practice dental hygiene under HRS chapter 447 and HAR chapter 16-79.

Licensing authority: Hawaii Board of Dentistry, Department of Commerce and Consumer Affairs, Professional and Vocational Licensing Division · Application information

Licensure by examination

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)
    • CRDTS Dental Hygiene Patient-Based Exam (assessment without a question bank)
    • CRDTS Dental Hygiene Simulated Patient Exam (practice unavailable)
Age
At least eighteen years of age (HRS § 447-1(a)(1); HAR § 16-79-9(b)(1)).
Background Check
The Board may require an additional background check from an approved independent background check service at the applicant's cost (HAR § 16-79-11.5(c)).
Education
Graduate of a dental hygiene school accredited by the ADA Commission on Dental Accreditation requiring at least a two-year course (HRS § 447-1(a)(2); HAR § 16-79-9(b)(5)).
Local Anesthesia Certification
Certified in the administration of intra-oral infiltration local anesthesia and intra-oral block anesthesia by an accredited dental hygiene school or a Board-approved certification program (HRS § 447-1(a)(3), (e); HAR § 16-79-9(b)(6)).
National Clinical Examination Clause
HRS § 447-1(c) and HAR § 16-79-9(b)(3): once a national clinical dental hygiene examination becomes available, the applicant must pass it and the state and regional examinations are no longer accepted, except for applicants who passed a state or regional examination after February 1, 2005 but before it became available. No Hawaii official source consulted identifies any examination as that national clinical examination.
Out Of State Licensees
Applicants licensed as a dental hygienist in another state also submit official verification of licensure and licensure status and an NPDB self-query report (HAR § 16-79-11.5(b); Form DT-05).
Prior Regional Exam Scores
HRS § 447-1(b) accepts a regional clinical examination given after February 1, 2005 by WREB, CRDTS, SRTA or NERB (CDCA). Scores from examinations those agencies no longer offer (the former WREB, NERB/CDCA and SRTA dental hygiene examinations; SRTA examinations ended after the 2025 season and CDCA-WREB-CITA delivered only ADEX examinations) are prior evidence the applicant may present; the Board voted on January 25, 2021 to accept the manikin-based regional dental hygiene examination from these agencies, and all sections must be passed in their entirety (Form DT-05).
State Examination Slot
HRS § 447-1(b) also names "the State's examination"; no current official source identifies a currently offered Hawaii state dental hygiene examination, so this slot is recorded only as a condition.
Work Authorization
United States citizen, United States national, permanent resident, or alien authorized to work in the United States (HAR § 16-79-9(b)(4); HRS § 436B-10 as cited on Form DT-05).
Restoration of a forfeited license more than two and not more than five years after expiration

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)
    • CRDTS Dental Hygiene Patient-Based Exam (assessment without a question bank)
    • CRDTS Dental Hygiene Simulated Patient Exam (practice unavailable)
Continuing Education
Evidence of twenty hours of continuing education each biennium (HAR § 16-79-3.1(b)(3)).
Examination Discretion
Only if the person cannot meet the above requirements, the Board may require the person to reapply as a new applicant and take and pass the licensure examination (HAR § 16-79-3.1(b)(5)); the examinations are mounted for that case, and reapplication follows the licensure-by-examination requirements of HAR § 16-79-9(b).
Forfeited License
The dental hygiene license was forfeited and more than two years, but not more than five years, have passed since expiration (HAR § 16-79-3.1(b), (c)).
National Clinical Examination Clause
HRS § 447-1(c) and HAR § 16-79-9(b)(3): once a national clinical dental hygiene examination becomes available, the applicant must pass it and the state and regional examinations are no longer accepted, except for applicants who passed a state or regional examination after February 1, 2005 but before it became available. No Hawaii official source consulted identifies any examination as that national clinical examination.
Npdb And Background
NPDB self-query; the Board may require an independent background check (HAR § 16-79-3.1(b)(4)).
Practice Evidence
At least three years of dental hygiene practice preceding the written application, with active clinical practice of not less than 1,000 hours per year for the three years immediately prior and certification from the licensing authority of the other jurisdiction (HAR § 16-79-3.1(b)(2)).
Prior Regional Exam Scores
HRS § 447-1(b) accepts a regional clinical examination given after February 1, 2005 by WREB, CRDTS, SRTA or NERB (CDCA). Scores from examinations those agencies no longer offer (the former WREB, NERB/CDCA and SRTA dental hygiene examinations; SRTA examinations ended after the 2025 season and CDCA-WREB-CITA delivered only ADEX examinations) are prior evidence the applicant may present; the Board voted on January 25, 2021 to accept the manikin-based regional dental hygiene examination from these agencies, and all sections must be passed in their entirety (Form DT-05).
State Examination Slot
HRS § 447-1(b) also names "the State's examination"; no current official source identifies a currently offered Hawaii state dental hygiene examination, so this slot is recorded only as a condition.
Reapplication after a license forfeited for more than five years

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)
    • CRDTS Dental Hygiene Patient-Based Exam (assessment without a question bank)
    • CRDTS Dental Hygiene Simulated Patient Exam (practice unavailable)
Forfeited License
The license has not been restored for more than five years from the date of expiration; the person must reapply as a new applicant (HAR § 16-79-3.1(c)).
National Clinical Examination Clause
HRS § 447-1(c) and HAR § 16-79-9(b)(3): once a national clinical dental hygiene examination becomes available, the applicant must pass it and the state and regional examinations are no longer accepted, except for applicants who passed a state or regional examination after February 1, 2005 but before it became available. No Hawaii official source consulted identifies any examination as that national clinical examination.
New Applicant Requirements
The requirements of licensure by examination apply, including the age, education, local anesthesia certification and work authorization conditions of HAR § 16-79-9(b).
Npdb And Background
NPDB self-query report and a report from a Board-approved independent background check service at the applicant's cost (HAR § 16-79-3.1(c)).
Prior Regional Exam Scores
HRS § 447-1(b) accepts a regional clinical examination given after February 1, 2005 by WREB, CRDTS, SRTA or NERB (CDCA). Scores from examinations those agencies no longer offer (the former WREB, NERB/CDCA and SRTA dental hygiene examinations; SRTA examinations ended after the 2025 season and CDCA-WREB-CITA delivered only ADEX examinations) are prior evidence the applicant may present; the Board voted on January 25, 2021 to accept the manikin-based regional dental hygiene examination from these agencies, and all sections must be passed in their entirety (Form DT-05).
State Examination Slot
HRS § 447-1(b) also names "the State's examination"; no current official source identifies a currently offered Hawaii state dental hygiene examination, so this slot is recorded only as a condition.

Community Service License - Dental Hygienist

Community service license under HRS § 447-1.5 limited to employment with an eligible health center, outreach program or training program.

Licensing authority: Hawaii Board of Dentistry, Department of Commerce and Consumer Affairs, Professional and Vocational Licensing Division · Application information

Community service license for employment with an eligible organization
National Board Dental Hygiene Examination
Disclosure
Disclosure of all previous and pending malpractice or misconduct actions (HRS § 447-1.5(a)(3)).
Education
Diploma or certificate of graduation from a dental hygiene college accredited by, or with a reciprocal agreement with, the ADA Commission on Dental Accreditation (HRS § 447-1.5(a)(1)(A)).
Eligible Employer
Employment by a federally qualified health center, Native Hawaiian health center, community health center, rural health clinic, mobile dental outreach program, or CODA-accredited post-secondary dental auxiliary training program (HRS § 447-1.5(a)).
Nbdhe Timing
The National Board Dental Hygiene Examination must have been passed within five years of the date of request (HRS § 447-1.5(a)(1)(B)(i)).
Out Of State License
Active, unrestricted dental hygiene license from another state (HRS § 447-1.5(a)(2)).
Practice Alternative
Instead of the National Board examination, the applicant may show active clinical dental hygiene practice of not less than 1,000 hours per year for the three years immediately prior to the request (HRS § 447-1.5(a)(1)(B)(ii); Form DT-20).
Prior Failure
No community service license for a person who failed the license examination administered under chapter 447 after July 2, 2004 (HRS § 447-1.5(a); Form DT-20).
Quality Assurance
Active participation in a formal and ongoing clinical quality assurance program (HRS § 447-1.5(b)).
Community service license for commissioned officers of the uniformed federal services
No examination is required for this applicant pathway.
Duty Assignment
Documentation of official duty assignment to a qualifying community service dental hygiene license site; license term follows the federal duty assignment (HRS § 447-1.5(e)(2)).
Officer Status
Commissioned officer of the U.S. Army, Navy, Air Force, Public Health Service or Department of Veterans Affairs practicing in a federally qualified health center or Native Hawaiian health systems center (HRS § 447-1.5(e)).
Out Of State License
Copy of an active, unrestricted dental hygiene license from another state (HRS § 447-1.5(e)(1)).

Official no-examination sources

Effective from 2026-09-22.

Temporary License - Dental Hygienist

Temporary license under HRS § 447-2 limited to employment with the State, a county, or a qualifying charitable or educational employer.

Licensing authority: Hawaii Board of Dentistry, Department of Commerce and Consumer Affairs, Professional and Vocational Licensing Division · Application information

Temporary license for employment with a qualifying public or charitable employer
National Board Dental Hygiene Examination
Education
Graduate of a CODA-accredited dental hygiene college recognized and approved by the Board (Form DT-09a).
Employment
Employment by the State, a county, or a legally incorporated eleemosynary dispensary or infirmary, private school, or welfare center, shown by a letter of employment and employer documentation (HRS § 447-2; Form DT-09a).
Exam Restriction
No temporary license if any regional clinical examination has been failed (Form DT-09a).
License Verification
Verification of every dental hygiene license held now or previously (Form DT-09a).
Qualified To Be Examined
Issued without the licensure examination to a person qualified to be examined under HRS § 447-1(a) (HRS § 447-2), which includes having passed the National Board Dental Hygiene Examination (HRS § 447-1(a)(4)). Form DT-09a does not list the National Board examination among its submittals; the statute is followed here.
Validity
Valid until the earliest of leaving the employment, the 365th day after issuance, the date the person takes the licensure examination, or revocation (HRS § 447-2).

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

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