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Missouri Dental Hygiene — Requirements & Free Practice

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Dental Hygienist License (certificate of registration and license to practice as a dental hygienist)

Missouri license to practice as a dental hygienist under Chapter 332 RSMo; no temporary dental hygienist license may be issued (RSMo 332.301).

Licensing authority: Missouri Dental Board · Application information

Licensure by examination (RSMo 332.231, 332.251; 20 CSR 2110 2.050)

All of the following:

Application Window
The application, including passing the jurisprudence examination, must be completed within one year of submission (20 CSR 2110-2.050(2)(J); RSMo 332.261.2).
Background Check
Missouri State Highway Patrol and FBI fingerprint background check (20 CSR 2110-2.050(2)(I); RSMo 332.015).
Bls
Current American Heart Association BLS for the Healthcare Provider or Board-approved equivalent; online-only courses are not accepted (20 CSR 2110-2.050(1)(E)).
Competency Exam Window
The state or regional entry-level competency examination must have been passed within the previous five years; competency scores must be sent directly by the testing agent (20 CSR 2110-2.050(1)(C), (2)(G)).
Education
Satisfactory completion of a course in dental hygiene in an accredited dental hygiene school (CODA-accredited, minimum two academic years) and an official transcript sent directly by the school (RSMo 332.231, 332.011(1); 20 CSR 2110-2.050(1)(A), (2)(D)).
Jurisprudence Scheduling
To sit the jurisprudence examination the applicant must have passed the National Board Examination and either be preparing for the competency examination (application filed 30 days before) or have passed it within five years; the passing grade is 80% (20 CSR 2110-2.050(1)(D)).
National Board Scores
Certification of passage of the National Board Examination must be sent directly by the sponsoring body; passing it is a prerequisite to the dental hygienist examinations (RSMo 332.251.2; 20 CSR 2110-2.050(2)(F)).
Reapplication After Void License
A dental hygienist whose license became void after four years unrenewed reapplies and is examined in the same manner as an original applicant unless applying under RSMo 332.281 (RSMo 332.261.5).
Remediation
After failing a clinical competency examination twice the Board may require remedial instruction from an accredited dental hygiene school; after a third failure the Board may deny the application (20 CSR 2110-2.050(3); RSMo 332.251.4).
Srta Exam Merged
20 CSR 2110-2.050(5) still names the Southern Regional Testing Agency (SRTA); SRTA merged with CRDTS and from 2026 the merged organization administers the CRDTS dental hygiene examinations, so SRTA is not a separate current alternative.
State Board Competency Exam
20 CSR 2110-2.050(5) also accepts a competency examination administered by an individual state dental board; no specific examination is named, so this alternative is shown as a condition, not an exam.
Licensure of a military or law enforcement spouse licensed in another jurisdiction (RSMo 324.009.3(2))
No examination is required for this applicant pathway.
Board Jurisprudence Notice
The Board’s Application for Licensure by Reciprocity (MO 375-1093) states: "Information regarding the Missouri jurisprudence examination will be forwarded to you following review of your completed application." RSMo 324.009.3(2) directs the Board to waive any examination requirement for these applicants.
Eligibility
Nonresident or resident military or law enforcement spouse as defined in RSMo 324.009.1(4) and (6), holding a valid current license in another jurisdiction for at least one year (RSMo 324.009.2).
Waiver Bar
The waiver does not apply to applicants barred under RSMo 324.009.4 (revocation, pending investigation or discipline, license not in good standing, disqualifying criminal record).

Official no-examination sources

Effective from 2026-08-28.

Licensure by reciprocity for a dental hygienist licensed in another jurisdiction (RSMo 324.009; RSMo 332.281)
Missouri Jurisprudence Examination (Dental Hygiene)
Fee
Non-refundable application fee of $100 for a dental hygienist (Application MO 375-1093).
Licensure
Holds a valid current license issued by another state, a branch or unit of the military, a U.S. territory or the District of Columbia and has been licensed there for at least one year, at the same practice level (RSMo 324.009.2).
Rsmo332281Alternative
RSMo 332.281 separately provides licensure without examination for a dental hygienist licensed in another state for at least two consecutive years whose qualifications are at least equivalent to Missouri initial registration requirements; the Board may by rule require the Missouri laws examination and, where licensure was denied, revoked or suspended for incompetency or a practical examination was failed, a practical examination (no specific practical examination is named).
Verification
Verification of every license held in another state, territory or the District of Columbia must be submitted to the Board (Application MO 375-1093).
Waiver Bar
Examination, education and experience requirements are not waived for an applicant whose license was revoked elsewhere, who is under investigation, has a complaint pending or is under discipline, who lacks a license in good standing, or who has a disqualifying criminal record (RSMo 324.009.4).
Biennial renewal, including renewal of an expired license within four years (RSMo 332.261.3 5; 20 CSR 2110 2.071)
No examination is required for this applicant pathway.
Bls
Current BLS or ACLS certification or equivalent (20 CSR 2110-2.071(5)).
Continuing Education
Thirty hours of continuing education in the two-year period preceding renewal; for renewal of an expired license, thirty hours for each expired renewal period, earned within four years (RSMo 332.261.4-5; 20 CSR 2110-2.071(4), (9)).
Late Renewal
An expired license may be renewed within four years with the renewal fee and renewal penalty fee; after four years the license is void (RSMo 332.261.5; 20 CSR 2110-2.071(8)).

Official no-examination sources

Effective from 2025-10-30.

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

Missouri Jurisprudence Examination (Dental Hygiene)

Provider
Missouri Dental Board
Format
Open book, multiple choice; may be offered online through a secure Board website
Exam questions
50 multiple choice questions
Passing score
At least 80%
Examination outline
  • RSMo Chapter 332 Dentists (Dental Practice Act)
  • 20 CSR 2110-2 General Rules
  • 20 CSR 2110-3 Well-Being Rules
  • 20 CSR 2110-4 Sedation
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