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Michigan Dental Hygiene — Requirements & Free Practice

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Registered Dental Hygienist

License to engage in the practice of dental hygiene in Michigan.

Licensing authority: Michigan Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing (Michigan Board of Dentistry) · Application information

Licensure by endorsement

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)
Disclosure
Disclose each license, registration or certification held elsewhere and satisfy MCL 333.16174(2) (R 338.11259(2)(e) and (f)).
Education
Graduation from a dental hygiene educational program meeting the standards in R 338.11303, with official transcripts (R 338.11259(2)(a)).
Identity And Character
Criminal background check (fingerprints), good moral character, social security number, verification of every license held elsewhere with no pending discipline or sanctions in force (MCL 333.16174; licensing guide).
License Elsewhere
Holds a dental hygienist license in another state that is active and in good standing for at least 1 year before filing the application (R 338.11259(2)(d)).
Life Support
Current BLS or ACLS certification for healthcare providers with a hands-on component, earned within the 2-year period before receiving the license. (R 338.11259(2)(g))
Nbdhe Exemption
The NBDHE requirement is waived for persons who graduated from an accredited school before 1962 (R 338.11259(2)(b)).
Practice Three Years Exam State
An applicant licensed and practicing as a dental hygienist for at least 3 years immediately preceding the application in a state that required a regional or state board examination meets subrule (2)(a), (b) and (c), including both examination requirements (R 338.11259(3)); the licensing guide asks for certification of the passing regional or state examination scores.
Practice Three Years Non Exam State
An applicant licensed and practicing for at least 3 years in a state that does not require a regional examination meets subrule (2)(a) and (b), and may petition the board for a determination that the credentials are substantially equivalent instead of taking an examination (R 338.11259(4)).
Prior Regional Or State Exam
An applicant who passed a regional or state board examination may petition the board for a determination that it is substantially equivalent to all parts of the ADEX examination (R 338.11259(2)(c), R 338.11257(5) and (6)); converted score of 75 or higher on each component.
Training Requirements
One-time human trafficking identification training meeting R 338.11271, English language proficiency under R 338.7002b, and at least 2 hours of implicit bias training within the 5 years before issuance (licensing guide).
Licensure by endorsement canada

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)
Board Guide National Board Scores
The licensing guide (Revision Date 1/26/2026, p. 4) also asks Canadian applicants to "Arrange for the official report of your National Board scores to be sent directly to this office from the Joint Commission on National Dental Examinations"; R 338.11259(5), which lists all requirements of this route, does not include the NBDHE.
Disclosure
Disclose each license, registration or certification held elsewhere and satisfy MCL 333.16174(2) (R 338.11259(5)(f) and (g)).
Education
Graduation from a CDAC-accredited dental hygiene program with all training completed in Canada, or from a dental hygiene educational program meeting the standards in R 338.11303 (R 338.11259(5)(c)).
Examination Options
This pathway uses R 338.11259(5)(b)(ii): all parts, written and clinical, of the ADEX examination. The alternative under (b)(i) is recorded as a separate Canadian-written-exam pathway.
Identity And Character
Criminal background check (fingerprints), good moral character, social security number, verification of every license held elsewhere with no pending discipline or sanctions in force (MCL 333.16174; licensing guide).
License Elsewhere
Holds a Canadian dental hygienist license that is active and in good standing for at least 1 year before filing the application, and has never been licensed as a dental hygienist in Michigan (R 338.11259(5)).
Life Support
Current BLS or ACLS certification for healthcare providers with a hands-on component, earned within the 2-year period before receiving the license. (R 338.11259(5)(h))
Training Requirements
One-time human trafficking identification training meeting R 338.11271, English language proficiency under R 338.7002b, and at least 2 hours of implicit bias training within the 5 years before issuance (licensing guide).
Licensure by endorsement canada canadian written exam
ADEX Dental Hygiene Simulated Patient Treatment Clinical Examination (SPTCE) (assessment without a question bank)
Board Guide National Board Scores
The licensing guide (Revision Date 1/26/2026, p. 4) also asks Canadian applicants to "Arrange for the official report of your National Board scores to be sent directly to this office from the Joint Commission on National Dental Examinations"; R 338.11259(5), which lists all requirements of this route, does not include the NBDHE.
Disclosure
Disclose each license, registration or certification held elsewhere and satisfy MCL 333.16174(2) (R 338.11259(5)(f) and (g)).
Education
Graduation from a CDAC-accredited dental hygiene program with all training completed in Canada, or from a dental hygiene educational program meeting the standards in R 338.11303 (R 338.11259(5)(c)).
Examination Options
This pathway uses R 338.11259(5)(b)(i): the applicant has passed the National Dental Hygiene Canadian Exam written examination and the ADEX clinical examination. The Canadian written examination is a prior qualification condition; the current US examination requirement is SPTCE. The alternative under (b)(ii) is recorded as the separate all-parts ADEX pathway.
Identity And Character
Criminal background check (fingerprints), good moral character, social security number, verification of every license held elsewhere with no pending discipline or sanctions in force (MCL 333.16174; licensing guide).
License Elsewhere
Holds a Canadian dental hygienist license that is active and in good standing for at least 1 year before filing the application, and has never been licensed as a dental hygienist in Michigan (R 338.11259(5)).
Life Support
Current BLS or ACLS certification for healthcare providers with a hands-on component, earned within the 2-year period before receiving the license. (R 338.11259(5)(h))
Training Requirements
One-time human trafficking identification training meeting R 338.11271, English language proficiency under R 338.7002b, and at least 2 hours of implicit bias training within the 5 years before issuance (licensing guide).
Licensure by examination

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)
Adex Administration
All parts, written and clinical, of the ADEX examination conducted by CDCA-WREB-CITA, a successor organization, or another regional testing agency; a converted score of 75 or greater on each component (R 338.11221(c), R 338.11223(2)). The licensing guide states that non-ADEX examinations are not accepted.
Education
Graduation from a dental hygiene educational program meeting the standards in R 338.11303 (CODA-accredited); official transcripts sent directly to the department (R 338.11221(a)).
Identity And Character
Criminal background check (fingerprints), good moral character, social security number, verification of every license held elsewhere with no pending discipline or sanctions in force (MCL 333.16174; licensing guide).
Life Support
Current BLS or ACLS certification for healthcare providers with a hands-on component, earned within the 2-year period before receiving the license. (R 338.11221(d))
Nbdhe Exemption
The NBDHE requirement does not apply to an applicant who graduated from a dental hygiene program before 1962 (R 338.11221(b)).
Training Requirements
One-time human trafficking identification training meeting R 338.11271, English language proficiency under R 338.7002b, and at least 2 hours of implicit bias training within the 5 years before issuance (licensing guide).
Relicensure lapsed 3 to 5 years

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)
Alternative License
Instead of the ADEX examination, the applicant may provide documentation of holding or having held a valid and unrestricted license in another state or in Canada within 3 years immediately preceding the application (R 338.11267(1)(i)(ii)).
Application
Relicensure application and fee; good moral character under 1974 PA 381 (R 338.11267(1)(a) and (b)).
Continuing Education
36 hours of board-approved continuing education earned within the 3-year period preceding the application, including 2 hours in pain and symptom management, 1 hour in dental ethics and jurisprudence and 1 hour in infection control (R 338.11267(1)(e)).
Examination Window
The ADEX hygiene clinical and written examination must have been passed within the 2-year period immediately preceding the application for relicensure (R 338.11267(1)(i)(i)).
Lapse
Michigan RDH license lapsed more than 3 years but less than 5 years; fingerprints required (R 338.11267(1)(c)).
Life Support
Current BLS or ACLS certification with a hands-on component earned within the 2-year period before receiving the license (R 338.11267(1)(d)).
Training
One-time human trafficking training (R 338.11271), English language requirement (R 338.7002b) and implicit bias training (R 338.7004); disclosure of licenses held elsewhere (R 338.11267(1)(f) to (h)).
Relicensure lapsed 5 or more years

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)
Alternative License
An applicant who holds or held a valid and unrestricted license in another state or in Canada within the 3 years immediately preceding the application and meets subdivisions (a) to (h) is relicensed without the examination requirements (R 338.11267(1)(j)).
Application
Relicensure application and fee; good moral character under 1974 PA 381 (R 338.11267(1)(a) and (b)).
Continuing Education
36 hours of board-approved continuing education earned within the 3-year period preceding the application, including 2 hours in pain and symptom management, 1 hour in dental ethics and jurisprudence and 1 hour in infection control (R 338.11267(1)(e)).
Education
Proof of graduation from a dental hygiene educational program meeting the standards in R 338.11303 (R 338.11267(1)(j)(ii)).
Examination Window
The ADEX hygiene clinical and written examination must have been passed within the 2-year period immediately preceding the application for relicensure (R 338.11267(1)(j)(iv)).
Lapse
Michigan RDH license lapsed 5 years or more; fingerprints required (R 338.11267(1)(c)).
Life Support
Current BLS or ACLS certification with a hands-on component earned within the 2-year period before receiving the license (R 338.11267(1)(d)).
Nbdhe Exemption
The NBDHE requirement does not apply to an applicant who graduated from a dental hygiene program before 1962 (R 338.11267(1)(j)(iii)).
Training
One-time human trafficking training (R 338.11271), English language requirement (R 338.7002b) and implicit bias training (R 338.7004); disclosure of licenses held elsewhere (R 338.11267(1)(f) to (h)).
Relicensure lapsed up to 3 years
No examination is required for this applicant pathway.
Application
Relicensure application and fee; good moral character under 1974 PA 381 (R 338.11267(1)(a) and (b)).
Continuing Education
36 hours of board-approved continuing education earned within the 3-year period preceding the application, including 2 hours in pain and symptom management, 1 hour in dental ethics and jurisprudence and 1 hour in infection control (R 338.11267(1)(e)).
Lapse
Michigan RDH license lapsed 0 to 3 years (R 338.11267(1)).
Life Support
Current BLS or ACLS certification with a hands-on component earned within the 2-year period before receiving the license (R 338.11267(1)(d)).
Training
One-time human trafficking training (R 338.11271), English language requirement (R 338.7002b) and implicit bias training (R 338.7004); disclosure of licenses held elsewhere (R 338.11267(1)(f) to (h)).

Official no-examination sources

Effective from 2023-10-02.

Renewal
No examination is required for this applicant pathway.
Continuing Education
Not less than 36 hours of board-approved continuing education during the 3-year license cycle, including at least 12 hours on clinical issues, at least 12 hours synchronous live, at least 2 hours in pain and symptom management, 1 hour in dental ethics and jurisprudence including delegation, 1 hour in infection control, and no more than 18 hours asynchronous (R 338.11704(2) and (7)).
Life Support
Current BLS or ACLS certification for healthcare providers with a hands-on component (R 338.11704(5)).
Other Renewal Items
Human trafficking training attestation, 1 hour of implicit bias training per year of the cycle, and good moral character and disciplinary questions (licensing guide renewal checklist).

Official no-examination sources

Effective from 2023-10-02.

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

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