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Virginia Dental Hygiene — Requirements & Free Practice

US-VA · License preparation

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Combined practice

Practice is unavailable for ADEX Dental Hygiene Computer Simulated Clinical Examination (CSCE OSCE). Available questions cover only examinations with mounted question banks.

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Licenses, application pathways and examination requirements

Each license and applicant pathway has its own requirements and exemptions. Choosing practice questions does not determine your eligibility.

Temporary Dental Hygiene Permit

Temporary permit under Va. Code § 54.1-2726 for graduates serving in state-operated or qualifying charitable dental clinics.

Licensing authority: Virginia Board of Dentistry · Application information

Issuance of a temporary dental hygiene permit

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)
Clinical Examination Timing
The Board's temporary permit instructions (revised June 2023), item 7, require at application an original score report "from a Board Approved testing agency documenting passage of a clinical competency examination" and refer to Guidance Document 60-26; 18VAC60-25-160 A lists only a completed application and verification of graduation for the permit and provides that the permit is not renewed unless extraordinary circumstances prevented the permittee from taking a board-approved clinical competency examination during its term.
Education
Graduate of an accredited (CODA/CDAC) dental hygiene program (Va. Code § 54.1-2726 A; 18VAC60-25-130 A 1).
No Prior Virginia License Or Failure
Has not held a Virginia dental hygiene license and has not failed an examination for a license to practice dental hygiene in Virginia (Va. Code § 54.1-2726 A).
Npdb Report
A current National Practitioner Data Bank self-query report (18VAC60-25-130 A 3).
Qualifying Service
Serves in the Department of Health or the Department of Behavioral Health and Developmental Services in a state-operated dental clinic, or in a qualifying Virginia 501(c)(3) clinic for the indigent and uninsured, and is certified to the Board by the Commissioner or the corporation's chief executive officer (Va. Code § 54.1-2726 A-B).
Reissuance (renewal) of a temporary dental hygiene permit
No examination is required for this applicant pathway.
Extraordinary Circumstances
Reissuance is in the Board's discretion and the permit is not renewed unless the permittee shows that extraordinary circumstances prevented taking a board-approved clinical competency examination during the permit term (Va. Code § 54.1-2726 B; 18VAC60-25-160 A 2).

Official no-examination sources

Effective from 2026-09-22.

Dental Hygienist License

License required to practice dental hygiene in Virginia under Va. Code § 54.1-2722; issued by examination or by credentials.

Licensing authority: Virginia Board of Dentistry · Application information

Licensure by credentials

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)
Active Practice
Active clinical practice for 24 of the past 48 months immediately preceding application, documented by original notarized employer statements (18VAC60-25-150 (2); Board application instructions item 13).
Education
Graduation from, or a certificate issued by, a CODA or CDAC accredited dental hygiene program (18VAC60-25-150 (1)).
Good Moral Character
Satisfactory proof that the applicant is of good moral character (Va. Code § 54.1-2722 B(i)).
Good Standing
Certification of good standing from each state in which the applicant is or has ever been licensed (18VAC60-25-150 (3)).
Licensed Elsewhere
A current, unrestricted license to practice dental hygiene in another U.S. jurisdiction (Va. Code § 54.1-2722 C(ii); 18VAC60-25-150 (2)).
No Grounds For Denial
Has not committed any act that would constitute grounds for denial under Va. Code § 54.1-2706 (Va. Code § 54.1-2722 C(iii)).
Npdb Report
A current National Practitioner Data Bank self-query report (18VAC60-25-130 A 3).
Other Accepted Clinical Examination
Instead of the ADEX examination, a clinical competency examination substantially equivalent to that required for licensure by examination is accepted: Guidance Document 60-26 accepts a passing score of the clinical competency exam required in the state in which the hygienist was originally licensed, with components from one testing agency only; certificates and Canadian exams are not accepted.
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 Retake After Three Failures
A candidate who has failed any section of a board-approved examination three times must complete at least seven hours of additional clinical training in each section to be retested before a fourth attempt (18VAC60-25-140 B).
Adex Scoring
Guidance Document 60-26: each ADEX component (treatment clinical examination and computer simulated clinical examination) scored conjunctively with a minimum passing score of 75%; score reports from a single testing agency, including every attempt and any failure.
Education
Graduation from, or a certificate issued by, a CODA or CDAC accredited dental hygiene program (18VAC60-25-140 A 1; Va. Code § 54.1-2722 B(ii)).
Exam Older Than Five Years
An applicant who passed the board-approved clinical examination five or more years before the application is received may be required to retake a board-approved examination or complete board-approved continuing education, unless the applicant shows clinical, unrestricted, and active practice in a U.S. jurisdiction for 48 of the past 60 months (18VAC60-25-140 C).
Good Moral Character
Satisfactory proof that the applicant is of good moral character (Va. Code § 54.1-2722 B(i)).
Npdb Report
A current National Practitioner Data Bank self-query report (18VAC60-25-130 A 3).
Licensure by examination for a graduate of a dental school outside the United States (Va. Code § 54.1 2722 D)

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 Scoring
Guidance Document 60-26: each ADEX component scored conjunctively with a minimum passing score of 75%; score reports from a single testing agency.
Board Instructions On Accreditation
The Board's Application Instructions for Dental Hygienists (revised June 2023) state: "Approval will not be granted to applicants who do not hold a diploma or certificate from a dental program accredited by CODA or CDAC, as required by §54.1-2709.B(ii) of the Code of Virginia and by 18VAC60-25-130 of the Regulations Governing the Practice of Dental Hygiene." 18VAC60-25-130 A 1 and 18VAC60-25-140 A 1 likewise require a CODA or CDAC accredited program; Va. Code § 54.1-2722 D grants this route.
Foreign Dental Education
Proof of graduation from a dental school outside the United States, as approved by the Board (Va. Code § 54.1-2722 B(ii) and D(i)).
Foreign Dental Eligibility
The applicant was or is eligible to practice dentistry in a country or jurisdiction outside the United States (Va. Code § 54.1-2722 D(ii)).
Good Moral Character
Satisfactory proof that the applicant is of good moral character (Va. Code § 54.1-2722 B(i)).
Npdb Report
A current National Practitioner Data Bank self-query report (18VAC60-25-130 A 3).
Annual renewal of an active or inactive dental hygienist license
No examination is required for this applicant pathway.
Continuing Education
At least 15 hours of approved continuing education to renew an active license, with current hands-on CPR (18VAC60-25-190 A).
Renewal
Renewal form and fee in the licensee's birth month each year; a late fee applies within one year after the deadline (18VAC60-25-180).

Official no-examination sources

Effective from 2026-09-22.

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