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Pennsylvania Dental Hygiene — Requirements & Free Practice

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Dental Hygienist License

License issued by the State Board of Dentistry to practice as a dental hygienist in Pennsylvania under the supervision of a licensed dentist.

Licensing authority: Pennsylvania State Board of Dentistry

Biennial renewal
No examination is required for this applicant pathway.
Continuing Education
Twenty credit hours of continuing education per biennium, including 2 hours of Board-approved child abuse recognition and reporting education (Dental Law § 3(j.2)(2)(ii); Board snapshot).
Cpr
Current certification in infant, child and adult cardiopulmonary resuscitation (49 Pa. Code § 33.105(b)).
Fee
Biennial renewal fee fixed by Board regulation (Dental Law § 3(j)).

Official no-examination sources

Effective from 2000-08-12.

Licensure by criteria approval (credentials/reciprocity)

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)
Clinical Exam Agencies
49 Pa. Code § 33.103(b) accepts the dental hygiene clinical examination administered by NERB, SRTA, WREB, CRDTS or CITA; the Board's snapshot page lists ADEX, CDCA, CRDTS, CITA, SRTA and WREB. NERB was renamed CDCA; CDCA, WREB and CITA merged into CDCA-WREB-CITA, which administers the ADEX examination and merged with ADEX in 2025; SRTA merged with CRDTS and from 2026 administers the CRDTS examinations.
Clinical Score Window
49 Pa. Code § 33.103(d): the Board recognizes clinical examination results for up to 5 years from the date scores are reported; after 5 years, passing scores are accepted only if the candidate has been in postgraduate training or practice as a dental hygienist in another jurisdiction.
Crdts Simulated Patient
CRDTS states that candidates must check with their state licensure board which simulated patient exams are accepted; Pennsylvania's rule and Board page name CRDTS without distinguishing its patient-based and simulated patient dental hygiene examinations.
Good Standing
Letter of good standing from the licensing authority of each state where the applicant has practiced; the Board may grant a personal interview (49 Pa. Code § 33.107).
Out Of State License
Currently licensed as a dental hygienist in another state or territory or in Canada, with credentials that meet the requirements of The Dental Law and 49 Pa. Code Chapter 33 Subchapter B (49 Pa. Code § 33.107).
Reciprocity
Granted only to applicants whose licensing boards confirm that they reciprocate with the Commonwealth (49 Pa. Code § 33.107).
Licensure by endorsement (Act 41, 63 Pa.C.S. § 3111)
No examination is required for this applicant pathway.
Discipline
No act constituting grounds for refusal, suspension or revocation and no discipline by the issuing jurisdiction, unless the Board in its discretion determines otherwise (49 Pa. Code § 33.107a(a)(3)-(4), (c)).
Experience
Active licensed practice for at least 2 of the 5 years immediately preceding the application (49 Pa. Code § 33.107a(a)(2)).
Insurance And Training
Application fee, professional liability insurance under Dental Law § 3.2, and 3 hours of approved child abuse recognition and reporting training (49 Pa. Code § 33.107a(a)(5)-(7)).
Interview
The applicant may be required to appear for a personal interview and submit additional information (49 Pa. Code § 33.107a(b)).
Out Of State License
Current license in good standing as a dental hygienist in another jurisdiction whose licensure standards are substantially equivalent to or exceed Dental Law § 3(d) and 49 Pa. Code §§ 33.102-33.103 (education and examinations) (49 Pa. Code § 33.107a(a)(1)).

Official no-examination sources

Effective from 2025-07-26.

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
Not less than eighteen years of age (Dental Law § 3(d)).
Child Abuse Training
3 hours of Board-approved continuing education in child abuse recognition and reporting for initial licensure (Board snapshot).
Clinical Exam Agencies
49 Pa. Code § 33.103(b) accepts the dental hygiene clinical examination administered by NERB, SRTA, WREB, CRDTS or CITA; the Board's snapshot page lists ADEX, CDCA, CRDTS, CITA, SRTA and WREB. NERB was renamed CDCA; CDCA, WREB and CITA merged into CDCA-WREB-CITA, which administers the ADEX examination and merged with ADEX in 2025; SRTA merged with CRDTS and from 2026 administers the CRDTS examinations.
Clinical Score Window
49 Pa. Code § 33.103(d): the Board recognizes clinical examination results for up to 5 years from the date scores are reported; after 5 years, passing scores are accepted only if the candidate has been in postgraduate training or practice as a dental hygienist in another jurisdiction.
Crdts Simulated Patient
CRDTS states that candidates must check with their state licensure board which simulated patient exams are accepted; Pennsylvania's rule and Board page name CRDTS without distinguishing its patient-based and simulated patient dental hygiene examinations.
Education
Graduation from a dental hygiene program at an approved institution meeting the standards of a U.S. Department of Education-recognized regional accrediting agency or the ADA Commission on Dental Accreditation (Dental Law § 3(d); Board snapshot: associate's degree).
Moral Character
Good moral character and not addicted to intoxicating liquor or narcotic drugs; criminal convictions are assessed individually under 63 Pa.C.S. § 3113 (Dental Law § 3(d)).
Licensure of a military applicant who does not meet the educational requirements

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)
Active Practice
Active practice for at least two of the previous five years before applying, with relevant military service experience credited (63 Pa.C.S. § 3303(a)(3)).
Board Discretion
The Board may issue the license (63 Pa.C.S. § 3303(a)).
Clinical Exam Agencies
49 Pa. Code § 33.103(b) accepts the dental hygiene clinical examination administered by NERB, SRTA, WREB, CRDTS or CITA; the Board's snapshot page lists ADEX, CDCA, CRDTS, CITA, SRTA and WREB. NERB was renamed CDCA; CDCA, WREB and CITA merged into CDCA-WREB-CITA, which administers the ADEX examination and merged with ADEX in 2025; SRTA merged with CRDTS and from 2026 administers the CRDTS examinations.
Clinical Score Window
49 Pa. Code § 33.103(d): the Board recognizes clinical examination results for up to 5 years from the date scores are reported; after 5 years, passing scores are accepted only if the candidate has been in postgraduate training or practice as a dental hygienist in another jurisdiction.
Crdts Simulated Patient
CRDTS states that candidates must check with their state licensure board which simulated patient exams are accepted; Pennsylvania's rule and Board page name CRDTS without distinguishing its patient-based and simulated patient dental hygiene examinations.
Military Applicant
A servicemember, veteran or military spouse who submits documentation of that status (63 Pa.C.S. § 3301).
Military Experience
Meets the qualifications of 63 Pa.C.S. § 3304 (relevant military experience) and all other noneducational requirements for licensure (63 Pa.C.S. § 3303(a)(4)-(5)).
Reactivation of a license lapsed for not more than five years
No examination is required for this applicant pathway.
Lapse
The license expired for failure to renew over a period not exceeding five years (Dental Law § 3.1(a)).
Requirements
Current biennial renewal fee, evidence of current CPR certification, notarized affidavit of the period of non-practice in Pennsylvania, and the continuing education for the unrenewed periods (49 Pa. Code § 33.106(a)).
Unlicensed Practice
Late fees for any period of practice without a current license (49 Pa. Code § 33.106(c)).

Official no-examination sources

Effective from 2000-08-12.

Reinstatement after revocation

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)
Clinical Exam Agencies
49 Pa. Code § 33.103(b) accepts the dental hygiene clinical examination administered by NERB, SRTA, WREB, CRDTS or CITA; the Board's snapshot page lists ADEX, CDCA, CRDTS, CITA, SRTA and WREB. NERB was renamed CDCA; CDCA, WREB and CITA merged into CDCA-WREB-CITA, which administers the ADEX examination and merged with ADEX in 2025; SRTA merged with CRDTS and from 2026 administers the CRDTS examinations.
Clinical Score Window
49 Pa. Code § 33.103(d): the Board recognizes clinical examination results for up to 5 years from the date scores are reported; after 5 years, passing scores are accepted only if the candidate has been in postgraduate training or practice as a dental hygienist in another jurisdiction.
Court Order
The Board does not reinstate a revoked license unless ordered to do so by a court, other than through a new application under section 3 (Dental Law § 4.1(b)(3)).
Crdts Simulated Patient
CRDTS states that candidates must check with their state licensure board which simulated patient exams are accepted; Pennsylvania's rule and Board page name CRDTS without distinguishing its patient-based and simulated patient dental hygiene examinations.
Rehabilitation
For a controlled-substance felony, the Board must be satisfied of significant progress in personal rehabilitation, and the person must meet all other licensing qualifications of the act, including the examination requirement (Dental Law § 4.1(b)(3)).
Waiting Period
A person whose dental hygienist license was revoked must apply for a license after a five-year period in accordance with section 3 of The Dental Law; after a revocation for a felony under The Controlled Substance, Drug, Device and Cosmetic Act, application for reinstatement may be made after at least ten years from the date of conviction (Dental Law § 4.1(b)(3)).

Public Health Dental Hygiene Practitioner Certification

Board certification of a licensed dental hygienist to practice without the authorization, assignment or examination of a dentist at the practice sites listed in section 11.9(b) of The Dental Law.

Licensing authority: Pennsylvania State Board of Dentistry

Certification of a licensed dental hygienist

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)
Clinical Exam Agencies
49 Pa. Code § 33.103(b) accepts the dental hygiene clinical examination administered by NERB, SRTA, WREB, CRDTS or CITA; the Board's snapshot page lists ADEX, CDCA, CRDTS, CITA, SRTA and WREB. NERB was renamed CDCA; CDCA, WREB and CITA merged into CDCA-WREB-CITA, which administers the ADEX examination and merged with ADEX in 2025; SRTA merged with CRDTS and from 2026 administers the CRDTS examinations.
Clinical Score Window
49 Pa. Code § 33.103(d): the Board recognizes clinical examination results for up to 5 years from the date scores are reported; after 5 years, passing scores are accepted only if the candidate has been in postgraduate training or practice as a dental hygienist in another jurisdiction.
Crdts Simulated Patient
CRDTS states that candidates must check with their state licensure board which simulated patient exams are accepted; Pennsylvania's rule and Board page name CRDTS without distinguishing its patient-based and simulated patient dental hygiene examinations.
Insurance
Professional liability insurance of at least $1,000,000 per occurrence and $3,000,000 per annual aggregate (49 Pa. Code § 33.116(b)(3)).
License
Hold a current license in good standing to practice as a dental hygienist in Pennsylvania (49 Pa. Code § 33.116(b)(1)); the statute requires having met the requirements for a dental hygienist license and passed the required examination for a dental hygienist (Dental Law § 11.9(a)(1)).
Rule Page Note
49 Pa. Code § 33.116(b) lists the qualifications as a current Pennsylvania dental hygienist license, 3,600 supervised hours and liability insurance and does not repeat the examination requirement; The Dental Law § 11.9(a)(1), which outranks the rule, requires the passed dental hygienist examination.
Supervised Practice
Certification statement signed by a licensed dentist verifying 3,600 hours of practice as a licensed dental hygienist under the dentist's supervision (49 Pa. Code § 33.116(b)(2); Dental Law § 11.9(a)(2)).
Certification by endorsement (Act 41, 63 Pa.C.S. § 3111)
No examination is required for this applicant pathway.
Discipline
Good standing and no disqualifying acts or discipline unless the Board in its discretion determines otherwise (63 Pa.C.S. § 3111(a)(3)-(4)).
Experience
Competency shown by continuing education or experience in the profession for at least two of the five years preceding the application (63 Pa.C.S. § 3111(a)(2)).
Out Of State Credential
Holds a current license, certificate, registration or permit from another state, territory or country whose requirements the Board determines are substantially equivalent to or exceed Pennsylvania's (63 Pa.C.S. § 3111(a)(1)).

Official no-examination sources

Effective from 2020-07-01.

Biennial renewal of the certification
No examination is required for this applicant pathway.
Continuing Education
For a public health dental hygiene practitioner, five of the twenty required continuing education hours must be public health-related courses (Dental Law § 3(j.2)(2)(ii)).
Renewal
Renewal application and permit renewal fee, renewed with the dental hygiene license (49 Pa. Code § 33.116(c)).

Official no-examination sources

Effective from 2009-12-12.

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