National Board Dental Hygiene Examination (NBDHE) 2024

National Board Dental

Hygiene Examination

(NBDHE)

2024 Candidate Guide

IMPORTANT NOTE: COVID-19 may continue to have an impact on examination programs implemented by DTS. Candidates should

regularly monitor

ADA.org/NBDHE

, to understand the potential impact of COVID-19 on Examination Program administrations.

Candidates must comply with all required test center procedures, including those pertaining to COVID-19.

You are required to read this Guide before you apply to take the examination.

At the time of application, you will be required to confirm that you have read this Guide, understood its contents, and agree to

the policies and procedures contained herein.

Changes to the National Board Dental Hygiene Examination (NBDHE) Program may occur after publication of this Guide. Updated

PDFs will be posted to

ADA.org/NBDHE

. You will be subject to the policies and procedures currently in effect at the time of your test

administration.

The Department of Testing Services (DTS) is a shared service of the American Dental Association (ADA) that

employs testing professionals and provides professional examination services in all relevant areas (e.g., test

design, content development, administration, analysis, and reporting). At the direction of the governing bodies

it supports, DTS advises on policy based on testing industry best practices and professional experience, and

implements policy for the orderly, secure, and fair administration of examination programs within its charge.

 
National Board Dental Hygiene 
Examination (NBDHE) 
2024 Candidate Guide 
 
 
©2024 Joint Commission on National Dental Examinations  All rights reserved.    Updated: 04/23/2024 
NBDHE 2024 Candidate Guide |  1 
 
Table of Contents 
OVERVIEW ............................................................. 2 
About this Guide and  
Examination Program ......................................... 2 
Purpose of the National  
Board Examinations ........................................... 2 
Examination Fairness ......................................... 3 
Dental Hygiene Licensure  
and the NBDHE
®
 ................................................ 3 
Ethical Conduct .................................................. 4 
EXAMINATION CONTENT  
AND PREPARATION MATERIALS ........................ 5 
Examination Specifications ................................ 5 
Scope of the Examination .................................. 5 
Patient Box ......................................................... 8 
Dental Charts ...................................................... 9 
Testlet ...............................................................10 
Sample Testlet On Community  
Health/Research Principles ..............................10 
Sample Item Formats .......................................11 
Acronyms and Abbreviations ............................12 
Examination Preparation  
and Resources .................................................12 
Confidentiality of  
Examination Materials ......................................12 
Practice Test .....................................................13 
RESULTS INFORMATION ...................................14 
Scoring of Examination ....................................14 
Results Audits ...................................................15 
Results Reports ................................................15 
ELIGIBILITY REQUIREMENTS ........................... 16 
Eligibility for Re-Examination ........................... 17 
EXAMINATION INFORMATION .......................... 18 
Examination Fees ............................................ 18 
Eligibility Extension Requests .......................... 18 
Administration Schedule .................................. 19 
Application Procedures .................................... 20 
Test Center Procedures .................................. 21 
Identification Policy .......................................... 21 
Reschedule or Cancel  
a Testing Appointment ..................................... 22 
No-Show Policy ............................................... 22 
Emergencies on the Day  
of a Testing Appointment ................................. 23  
Testing Problems on the Day  
of the Testing Appointment .............................. 23 
Testing Accommodations ................................ 24 
Unacceptable Forms  
of Documentation............................................. 25 
EXAMINATION REGULATIONS  
AND RULES OF CONDUCT ................................ 26 
Rules of Conduct ............................................. 26 
Privacy and Security ........................................ 27 
Examination Misconduct .................................. 28 
Irregularities and Appeals ................................ 30 
Non-Appealable Policies ................................. 31 
Arbitration Requirement ................................... 31 
Agreement to Arbitrate .................................... 31 
   

NBDHE 2024 Candidate Guide | 2

OVERVIEW

ABOUT THIS GUIDE AND EXAMINATION PROGRAM

This document is the official candidate guide for the National Board Dental Hygiene Examination (“NBDHE

” or

the “Examination”). It provides information about application and examination procedures, program policies,

examination content, test security, rules of conduct, ramifications of rule violations, and scoring. The governing

body for the NBDHE is the Joint Commission on National Dental Examinations (“JCNDE” or “Governing Body”).

The NBDHE is implemented by the Department of Testing Services (“DTS”). The JCNDE is an agency of the

American Dental Association (“ADA”), while DTS is a shared service of the ADA. Examinations are administered

by Pearson VUE (“Pearson VUE” or “Administration Vendor”) in the United States and Canada. Collectively, the

Governing Body, DTS, and the set of activities, policies, and procedures occurring in support of this examination

are referred to as the “NBDHE Program” or simply the “Examination Program.”

The Joint Commission on National Dental Examinations (JCNDE) would like to thank you for your interest in this

examination. As the agency responsible for overseeing the development and administration of this examination,

the JCNDE appreciates the time and energy you are devoting to preparation. The JCNDE takes its responsibilities

extremely seriously and works diligently to help ensure its examinations provide valid, reliable, and fair

evaluations of candidate knowledge, skills, and abilities.

PURPOSE OF THE NATIONAL BOARD EXAMINATIONS

The purpose of the National Board Examinations (NBEs) (i.e., the INBDE

, DLOSCE™, and NBDHE

) is to assist

jurisdictional boards in determining the qualifications of those who seek licensure to practice dentistry or dental

hygiene. These examinations assess important knowledge, skills, and abilities required for safe practice, and their

relevant application in a problem-solving context. Licensure boards use the information provided by the NBEs to

help protect the public health.

Acceptance of the NBEs is at the discretion of individual licensing jurisdictions. Currently, all United States

licensing jurisdictions recognize the INBDE and NBDHE; these jurisdictions include all 50 states, the District of

Columbia, Puerto Rico, Guam, and the US Virgin Islands. Please see ADA.org/dlosce for information concerning

the specific licensing jurisdictions that currently accept DLOSCE results as either full or partial fulfillment of board

clinical licensure examination requirements.

Additional information regarding licensure and licensure requirements can be found at the following links:

• Licensure Overview | American Dental Association

• Interactive Licensure Map | American Dental Association

NBDHE 2024 Candidate Guide | 3

EXAMINATION FAIRNESS

Fairness, diversity, and inclusion are values that are of critical importance to society and to health professions.

The Governing Body and DTS have devoted and continue to devote substantial time and energy to these

considerations, to comprehensively consider the relevant issues and implement examination programs that are

fair, valid, and reliable, providing candidates with the opportunity to demonstrate their knowledge, skills, and

abilities in support of accurate and valid skill measurement. Fairness efforts are rooted in professional standards

as promulgated in the Standards for Educational and Psychological Testing

. This document — published by the

American Educational Research Association, American Psychological Association, and National Council on

Measurement in Education — provides professional guidance on all aspects of testing, and specifically notes that

fairness is fundamental to validity.

Fairness considerations are embedded throughout this Examination Program, affecting every aspect of how this

examination is constructed, administered, scored, and reported, appropriately recognizing the critical importance

of fairness to society, and reflecting the core values of those who work closely and care deeply about this

program.

DENTAL HYGIENE LICENSURE AND THE NBDHE

Licensure of dental hygienists in the United States is the responsibility of specific jurisdictions (e.g., states, the

District of Columbia, and US territories), with corresponding licensure decisions made by jurisdictional boards.

Specific dental hygiene licensure requirements vary among jurisdictions, but all jurisdictions have three basic

requirements: an educational requirement, a written examination requirement, and a clinical examination

requirement. All jurisdictions accept graduation from a dental hygiene program accredited by the Commission on

Dental Accreditation (CODA) as fulfilling the educational requirement. Most jurisdictions also accept graduation

from a Canadian dental hygiene program accredited by the Commission on Dental Accreditation of Canada

(CDAC).

The NBDHE is intended to fulfill or partially fulfill jurisdictional written examination requirement. Acceptance of

National Board Examination results is completely at the discretion of the jurisdiction, which in turn can place a

limit on acceptance of NBDHE results that it deems appropriate.

Additional information about dental hygiene licensure can be found on the American Dental Hygienists

Association website at adha.org/licensure.

The JCNDE is responsible for the development and administration of the NBDHE, in addition to the dental

licensure examinations which include the Integrated National Board Dental Examination (INBDE

) and the Dental

Licensure Objective Structured Clinical Examination (DLOSCE

). The JCNDE relies heavily on dental hygienists

who act as subject matter expert consultants to inform the development of this examination.

American Educational Research Association, American Psychological Association, National Council on Measurement in Education. (2014).

Standards for Educational and Psychological Testing. Washington, DC: Author.

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ETHICAL CONDUCT

Health care professionals play a vital role in society by providing services that contribute to the overall health and

well-being of individuals and their communities. In light of this responsibility, such professionals must behave

ethically at all times. This obligation begins at the time of application to school and continues through the

educational process, the licensure process, and the entirety of professional practice.

As professionals devoted to the prevention of disease and the promotion and improvement of the public’s health,

dental hygienists hold a position of trust within society. The American Dental Hygienists’ Association’s Code of

Ethics for Dental Hygienists establishes standards of behavior to guide the public’s expectations and support

dental hygiene practice, laws, and regulations. By holding themselves accountable to the standards stated in the

Code, dental hygienists enhance the public’s trust on which their professional privilege and status are founded.

The purpose of this Examination Program is to provide licensure boards with information as to whether a

candidate possesses the necessary skills to safely practice at an entry-level. Accordingly, all candidates are

expected to pass the examination on their own merit without assistance. All candidates are required to maintain

confidentiality with respect to examination content.

Applicants are required to abide by these ethical standards and to read, understand, and comply with the

examination regulations and rules of conduct for this examination. The obligation to abide by these ethical

standards includes a commitment to honesty, truthfulness, full disclosure, accuracy, fairness, and integrity in all

matters pertaining to examinations completed now and in the future (examination applications, examination

procedures, applications for licensure, etc.).

Misconduct resulting in an irregularity in the examination process is a very serious matter. Violation of the rules of

conduct or examination regulations may result in civil liability, voiding of examination results, retest penalties, or

other appropriate penalties.

Under certain circumstances, misconduct and irregularities in the examination process may be reported to

relevant licensing authorities. A candidate who acts unethically risks potential delay, denial, suspension, or

loss of licensure.

The Examination Program Governing Body, licensure boards, and the profession expect strong ethical behavior

from all candidates. The Governing Body annually publishes policies and procedures applicable to misconduct

and irregularities in the application and examination process. This information is available in later sections of this

document. The Governing Body expects all candidates to carefully read and understand this information and their

obligations as candidates for this examination.

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EXAMINATION CONTENT AND PREPARATION MATERIALS

EXAMINATION SPECIFICATIONS

Examination items are developed by test construction teams composed of subject-matter experts in accordance

with examination specifications approved by the JCNDE. Test constructors are appointed based on expertise in

six areas: biomedical sciences, radiology, periodontics, dental hygiene curriculum, clinical dental hygiene, and

community dental health.

The Universal/National tooth notation system is used on all National Board Examinations. This system is a

sequential tooth numbering system, designating the permanent dentition with numbers 1 through 32, and the

primary dentition with letters A through T.

SCOPE OF THE EXAMINATION

The NBDHE

is a comprehensive examination consisting of 350 multiple-choice items covering functions that a

dental hygienist is expected to be able to perform. Only functions that can be delegated to a dental hygienist in a

majority of states are included in the examination. The examination contains a discipline-based component and a

case-based component, with test specifications as follows:

Discipline-Based Component (200 items)

The discipline-based component includes items addressing three major areas:

• Scientific Basis for Dental Hygiene Practice

• Provision of Clinical Dental Hygiene Services

• Community Health/Research Principles

The distribution of items in this component is presented below.

Scientific Basis for Dental Hygiene Practice (61 items)

• Anatomic Sciences

o Anatomy

▪ Head and neck anatomy

▪ Dental anatomy

 General anatomy

 Root anatomy

▪ Histology and Embryology

o Physiology

o Biochemistry and Nutrition

o Microbiology and Immunology

o Pathology

▪ General

▪ Oral

o Pharmacology

NBDHE 2024 Candidate Guide | 6

Provision of Clinical Dental Hygiene Services (115 items)

• Assessing Patient Characteristics

o Medical and dental history

o Head and neck examination

o Periodontal evaluation

o Oral evaluation

o Occlusal evaluation

o General

• Obtaining and Interpreting Radiographs

o Principles of radiophysics and

radiobiology

o Principles of radiologic health

o Technique

o Recognition of normalities and

abnormalities

o General

• Planning and Managing Dental Hygiene

Care

o Infection control (application)

o Recognition of emergency situations and

provision of appropriate care

o Individualized patient education

▪ Planning of individualized instruction

▪ Provision of instruction for prevention

and management of oral diseases

1. Dental caries

2. Periodontal disease

3. Oral conditions

▪ Anxiety and pain control

▪ Recognition and management of

compromised patients

▪ Dental hygiene treatment strategies

1. Diagnosis

2. Treatment plan

3. Case presentation

▪ General

• Performing Periodontal Procedures

o Etiology and pathogenesis of periodontal

diseases

o Prescribed therapy

▪ Periodontal debridement

▪ Surgical support services

▪ Chemotherapeutic agents

▪ General

o Reassessment and maintenance (e.g.,

implant care)

• Using Preventive Agents

o Fluorides - systemic and topical

▪ Mechanisms of action

▪ Toxicology

▪ Methods of administration

 Water fluoridation

 Self-administered

o Pit and fissure sealants

o Other preventive agents

• Providing Supportive Treatment Services

o Properties and manipulation of materials

o Polishing natural and restored teeth

o Making of impressions and preparation of

study casts

o Other supportive services (e.g., tooth

desensitization)

o General

• Professional Responsibility

o Ethical principles, including informed

consent

o Regulatory compliance

o Patient and professional communication

o General

NBDHE 2024 Candidate Guide | 7

Community Health/Research Principles (24 Items)

• Promoting Health and Preventing Disease Within Groups

• Participating in Community Programs

o Assessing populations and defining objectives

o Designing, implementing, and evaluating programs

• Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results

Case Based Items (150 items)

The NBHDE’s case-based component includes 150 items involving 12 to 15 dental hygiene patient cases. These

cases present information dealing with adult and child patients, and some cases may involve patients of the

following types: geriatric, adult-periodontal, pediatric, special needs, and medically compromised. A medically

compromised patient is one whose health status may require modification of standard treatment or special

consideration. The patient information is presented by means of patient histories, dental charts, radiographs, and

clinical photographs.

Case-based items address knowledge and skills required in the following areas:

• 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

NBDHE 2024 Candidate Guide | 8

PATIENT BOX

Some questions in this examination involve a Patient Box. The Patient Box presents information available to the

dentist and dental hygienist at the time of the visit. If no information is presented in each area of the Patient Box,

assume the information is either unknown or is not available. For example, if no allergies are listed, assume the

patient has no known allergies at the time of visit. Always consider information presented in the Patient Box when

answering questions and pay close attention to all provided patient information.

NBDHE 2024 Candidate Guide | 9

DENTAL CHARTS

Some cases in this test involve dental charts. Below are samples of the types of dental charts used within the test.

NBDHE 2024 Candidate Guide | 10

TESTLET

A testlet consists of a case study or problem with a set of associated test questions, each of which typically

presents four (4) multiple choice response options. The testlet format is used for NBHDE

items appearing in the

Community Health/Research Principles and Case-Based sections. A sample testlet appears below.

SAMPLE TESTLET ON COMMUNITY HEALTH/RESEARCH PRINCIPLES

A dental hygienist employed at a public health clinic in a rural county of the United States is assigned the project

of developing a preventive dental health program for a sub-group of the population.

COMMUNITY PROFILE: The primary employers in this county have been coal mining companies. The

unemployment rate in the county has increased by 32 percent since the closing of the coal mine companies.

• The median age of the population is 46. In the county there are five general dentists, three dental

hygienists, and one public health-centered dental clinic. The clinic employs a full-time dentist and dental

hygienist. The public health clinic sees low-income children and senior citizens on a sliding-fee schedule.

• The dental hygienist employed by the public health clinic conducts dental screenings for the kindergarten

students each year. The mean deft scores for the kindergarten students for the last three years are: d =

1.02, e = 0.87, f = 4.22.

• The community does not have water fluoridation because of multiple water sources. The state funds a

0.2%-sodium fluoride rinse program in grades K-5. The state mandates that a dentist or a dental hygienist

perform deft/dmft/DMFT and GI indices on all students in grades 1, 2, 3, 5, 7, and 10. On a yearly basis,

all pathology is brought to parents’ attention and referred to a dental professional.

1. Which population group is dentally underserved in this community?

a. Adult age

b. Geriatric age

c. Early childhood age

d. Elementary school age

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2. What would be the next step for the dental hygienist to take in program planning after selecting the target

population?

a. Appraise the program

b. Define goals for the program

c. Compile data on the target group population

d. Develop educational components

3. Each of the following is perceived as a barrier to dental care for this community EXCEPT one. Which is

the EXCEPTION?

a. Lack of water fluoridation

b. Maldistribution of providers

c. Lack of affordable services

d. Loss of income and insurance

4. What can be stated about the deft scores of the kindergarten students?

a. Early exfoliation

b. High decay rate

c. Late eruption pattern

d. Treatment needs are being met

5. How often should the fluoride rinse for grades K-5 be performed?

a. Daily

b. Weekly

c. Monthly

d. Three times a week

e. Based on the caries rate of the child

SAMPLE ITEM FORMATS

A multiple-choice examination item consists of a stem, which poses a problem, followed by a list of possible

answers. The stem of an examination item is usually either a question or an incomplete statement. For NBDHE

purposes, an item must have at least three and not more than five possible responses. Only one of the responses

is considered the correct or best option.

Completion items require the correct completion of a concept or idea.

The sensation of touch, pain, pressure, or temperature is determined by the

A. degree of myelinization of a nerve fiber.

B. frequency of the stimulation to a nerve fiber.

C. method of stimulation of a nerve fiber.

D. strength of the stimulation to a nerve fiber.

Question items communicate a problem or set of circumstances.

Which muscle(s) does the phrenic nerve innervate?

A. Abdominal

B. Diaphragm

C. Internal intercostal

D. Sternocleidomastoid

NBDHE 2024 Candidate Guide | 12

Negative items are characterized by a word such as EXCEPT or NOT in the stem. These key words are

capitalized.

Each of the following is affected by saliva EXCEPT one. Which is the EXCEPTION?

A. Carbohydrate breakdown

B. Dental caries

C. Oral microflora

D. Protein digestion

ACRONYMS AND ABBREVIATIONS

Commonly used acronyms and abbreviations may appear on the examination. Please refer to the Acronyms and

Abbreviations document posted at ADA.org/NBDHE.

EXAMINATION PREPARATION AND RESOURCES

All examination questions are reviewed annually by a team of subject matter experts before they are used for

examination purposes. This process helps to ensure that questions reflect the most recent research and

guidelines. For information about how and when newly emerging guidelines are incorporated into the

examination, candidates should review the document entitled Recent and Forthcoming Updates to Examinations

posted at ADA.org/NBDHE.

The JCNDE does not endorse or recommend any specific texts or other teaching aids (e.g., review courses) that

are advertised as NBDHE preparation materials.

The JCNDE recommends that candidates use textbooks and lecture notes as primary sources for study. A

number of resources are used by subject matter experts to create examination questions and may be useful study

tools, including:

• Reference Texts for the NBDHE

• Technical Report for the NBDHE

CONFIDENTIALITY OF EXAMINATION MATERIALS

Examination items represent confidential, copyrighted intellectual property. Obtaining, using, or distributing

examination items is strictly prohibited, regardless of the method employed (memorization, recording, copying, or

other means). This prohibition includes the discussion, distribution, or online posting of remembered examination

questions or answers, in whole or in part.

The use or sharing of examination items violates the examination regulations and rules of conduct of this testing

program. Such activities could provide an unfair advantage and threaten the validity and credibility of the

examination. Since all examinations copyrighted property, these prohibited activities also violate federal copyright

laws.

The Department of Testing Services investigates all reports of candidates’ alleged production, misuse, or

sharing of current examination materials, and will pursue formal action against anyone who violates the

Examination Regulations or federal copyright law. Violations could result in the voiding of exam results,

legal action, or other appropriate penalties.

NBDHE 2024 Candidate Guide | 13

PRACTICE TEST

The JCNDE has developed NBDHE

™

practice test modules to help candidates understand the types of questions

and question formats that will be asked on the NBDHE. In this regard, these modules may be helpful as a

resource when studying and preparing for the examination.

Practice modules are not intended to provide an indication of how students will perform on the official NBDHE, nor

should practice test results be used to make comparisons with actual examination results. In both the practice test

and the official administration, there is no penalty for guessing. Practice test results will include the total number

of correct responses (i.e., the raw score) as well as raw scores for each of the major areas covered on the

Practice NBDHE. Results are for personal use only. The modules/sections in the practice test have fewer items

than the actual exam. Practice test content may or may not reflect the types of questions currently appearing on

the examination, and recent advances in the profession.

The NBDHE practice modules are protected by U.S. copyright laws. The practice items are intended for use by

students for individual study. They may not be reproduced in any format, whether paper or electronic, without the

expressed written permission of the Joint Commission on National Dental Examinations (JCNDE). Any

unauthorized disclosure of practice module content could result in civil liability, criminal penalties, or other

appropriate penalties.

Candidates may choose to complete individual modules and/or comprehensive practice tests. The modules are

available for purchase at home.pearsonvue.com/jcnde-nbdhe.

At the Pearson VUE test center (http://www.pearsonvue.com/nbdhe), candidates will be given an opportunity to

take a brief optional tutorial before beginning the examination. The tutorial provides the opportunity to become

familiar with the steps involved in proceeding through the examination.

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RESULTS INFORMATION

SCORING OF EXAMINATION

The examinations of the JCNDE are all criterion-referenced, with the minimum passing score for each

examination determined by subject matter experts through rigorous standard-setting activities. On a periodic

basis, passing standards for each examination are separately reviewed and updated by subject matter experts

and the JCNDE itself, in order to reflect any changes in the level of knowledge, skills, and abilities required to

safely practice.

National Board Examination results are reported as either “pass” or “fail,” based on a candidate’s performance

with reference to the corresponding standard established for the Examination Program. Results are reported only

as “pass” for candidates who achieve passing scores. For remediation purposes, the JCNDE provides

performance information to candidates who have failed the examination. For the NBDHE, this information is

provided at an overall level, for the thirteen (13) discipline areas, and for the case area. The determination as to

whether a candidate has either passed or failed the examination is based solely on the overall scale score (i.e.,

not on subarea scales). This overall scale score achieved is provided to unsuccessful candidates in their results

report. With respect to candidates who tested prior to 2012, numerical scores for prior attempts are still reported.

While examination results are reported as “pass” or “fail,” the underlying mechanism for determining the “pass/fail”

result involves computation of a quantitative scale score that is subsequently evaluated against a minimum

passing scale score (i.e., the standard). Using scale scores, it is possible to meaningfully compare the

performance of one applicant with the performance of all applicants. Scale scores range from 49 to 99, with a

score of 75 representing the minimum passing score. Scale scores are not raw scores (i.e., the number of

questions answered correctly). A scale score of 74 does NOT mean that a candidate would have passed the

examination if they had answered one more question correctly. When standards are updated a corresponding

modification is made to the scoring scale, so that a scale score of 75 continues to reflect the minimum passing

score.

Many different forms of the examination are available for administration, so that from a test security perspective

candidates do not all see the same set of questions when they take the examination. Each examination form in

turn includes questions that enable the Examination Program to place different forms of the exam on a common

measurement scale, thereby adjusting the forms for any minor differences in difficulty. Because of this

adjustment, applicant results and scores have the same meaning, regardless of the particular examination form

that was administered.

Candidate results are computed based on the responses provided by the candidate, considered against the

examination form scoring key. Candidates are not penalized for guessing.

Some questions on the examination are experimental and are not scored. The data collected on unscored

questions is used to determine whether the question is appropriate for use in future test construction. Unscored

questions look the same to candidates as scored questions.

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RESULTS AUDITS

As a routine part of quality assurance procedures, results are audited before they are distributed. Candidates can

also request to have their examination results audited or checked for accuracy an additional time, beyond that

indicated above. To request this second audit, login to your account and follow the audit request instructions.

Additional fees will apply (see the Examination Fees section of this Guide). Results audits require approximately

four to six weeks to complete and must be requested within 30 days of the reporting date indicated on the official

report of results.

RESULTS REPORTS

Examination results are typically available approximately three to four weeks after the examination date. Results

can be viewed online by logging into ADA.org/DENTPIN.

By signing their application, candidates educated by accredited programs (either currently enrolled or who have

graduated within the last five years) give express permission for their results to be shared with the dean and their

designee(s).

Results are provided to others if permission is granted in the form of a results report request from the candidate,

or if such delivery is consistent with or required by JCNDE policy.

If misconduct has occurred concerning a past administration, at the discretion of the JCNDE results reports may

contain information concerning the incident (see Examination Regulations and Rules of Conduct).

After receiving their results report, candidates may request that additional reports be sent to other entities.

Fees are nonrefundable and nontransferable. All fees are in US dollars.

Results report requests can be made by signing into your DENTPIN account at ADA.org/DENTPIN and going to

the ‘Requests’ tab. DTS will provide a history of results to dental and dental hygiene boards and any additional

recipients indicated.

Scores cannot be voided at the request of a candidate after completing any part of the examination.

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ELIGIBILITY REQUIREMENTS

The JCNDE does not discriminate based on race, ethnicity, religion, gender, age, disability, sexual

orientation, or marital status. To participate in the NBDHE

, a candidate must qualify through one of the

following provisions:

Dental Hygiene Student

A student in a dental hygiene program accredited by CODA is eligible for examination when the dental hygiene

program director (or a designee) certifies that the student is prepared in all NBDHE disciplines. If the dental

hygiene program is accredited by CODA, the approval of the director (or the designee) meets this requirement.

Graduate of an Accredited Program

A dental hygienist who is a graduate of a dental hygiene program accredited by CODA during the time the dental

hygienist was enrolled is eligible for examination following the JCNDE’s receipt of evidence of graduation.

To fulfill this NBDHE

eligibility requirement, one of the following is required: a copy of a dental hygiene program

diploma or a copy of a final transcript with the conferred degree. If a candidate submits an application without

proof of graduation, the application will not be processed. Recent graduates who are retaking the examination

must also provide proof of graduation. Proof of graduation should be emailed to n[email protected] in an email

that includes your DENTPIN.

Graduate of a Nonaccredited Program

A dental hygienist who is a graduate of a U.S. or Canadian dental hygiene education program that was not

accredited during the time the dental hygienist was enrolled is eligible for examination only if the program was

equivalent to an accredited program (see summary of accreditation standards). Accreditation standards in effect

at the time the candidate applies for examination are used in evaluating the program.

To fulfill this NBDHE

eligibility requirement, the following is required:

1. a letter of recommendation from the dean of an accredited dental school or the director of an accredited

dental hygiene program, certifying that the nonaccredited program met each of the requirements in terms

of length of study, subjects, functions, and hours.

2. a letter of recommendation from the secretary of a board of dentistry of a U.S. licensing jurisdiction,

certifying that the nonaccredited program met each of the requirements in terms of length of study,

subjects, functions, and hours.

The following provisions are required for the verification of educational credentials obtained from nonaccredited

dental hygiene schools — schools not accredited by the CODA or the Commission on Dental Accreditation of

Canada (CDAC).

• Candidates must have official dental hygiene school transcripts verified by Educational Credential

Evaluators Inc. (ECE).

• If a candidate does not have a DENTPIN

, they must register for one through the DENTPIN

homepage

at ADA.org/DENTPIN prior to submitting an ECE report. The Department of Testing Services will discard

ECE reports that cannot be matched to a DENTPIN

using candidate supplied name and date of birth.

ECE prepares evaluation reports that identify U.S. equivalents of educational qualifications earned in other

countries.

Educational Credential Evaluators Inc.

P.O. Box 514070, Milwaukee, WI 53202-3470

414.289.3400 or www.ece.org

NBDHE 2024 Candidate Guide | 17

1. Contact Educational Credential Evaluators Inc. (ECE) and request a General Report. The ECE evaluation

report request will describe what documents are required, the manner in which to submit them to ECE,

and the applicable fee. To request an evaluation report, visit ECE.org and request that a General

Evaluation report be sent to the JCNDE.

2. Only official reports electronically transmitted from ECE to the Department of Testing Services will be

accepted. Personal copies are not acceptable.

3. The Department of Testing Services will not process an examination application before the ECE

Evaluation Report is received.

4. The name on the ECE report must match the name on the application exactly. Any name changes must

be accompanied by legal documentation.

The full accreditation standards for dental hygiene education programs is available to download from the Current

Accreditation Standards page on ADA.org/CODA. Graduates must be competent in problem solving strategies

related to comprehensive patient care and management of patients.

A dental student from an accredited dental school is eligible for examination if the dean of the dental school

certifies that the student has completed the equivalent of a CODA-accredited dental hygiene program. The means

of fulfilling this requirement is a letter from the dean of the accredited dental school.

Dental Student

A dental student is eligible for examination if the eligibility requirements for the INBDE

are met.

Dentist (Graduate of an Accredited or Nonaccredited Dental Program)

A dentist is eligible for examination if the eligibility requirements for the INBDE are met.

ELIGIBILITY FOR RE-EXAMINATION

Candidates who have passed the NBDHE

may not retake the examination unless required by a state board or

relevant regulatory agency.

Candidates who have not passed the NBDHE may apply for re-examination. An examination attempt is defined as

any examination administration where the candidate has been seated at a computer at a test center and

electronically agreed to the confidentiality statement to start the examination.

Candidates must wait a minimum of 60 days between each unsuccessful NBDHE attempt, with a

maximum of four (4) such administrations permitted during any one-year period of time. The preceding

restrictions are not subject to appeal.

Under the JCNDE’s Five Years/Five Attempts Eligibility Rule, candidates must pass the examination

within a) five years of their first attempt or b) five examination attempts, whichever comes first.

Subsequent to the fifth year or fifth attempt, candidates may test once every 12 months after their most

recent examination attempt.

The Five Years/Five Attempts Eligibility Rule applies to examination attempts occurring on or after January 1,

2012. Examination attempts occurring prior to this date are not considered under this regulation.

NBDHE 2024 Candidate Guide | 18

EXAMINATION INFORMATION

EXAMINATION FEES

Fees are non-refundable and non-transferable. All fees are in U.S. dollars.

FEE TYPE

DESCRIPTION

FEE AMOUNT

Examination Fee

This fee includes official results reporting to the candidate, three

licensing jurisdictions (provided result report requests are requested at

the time application), and the candidate’s dental hygiene program

(CODA accredited dental hygiene school).

$565

Processing Fee for

International

Candidates

This processing fee applies to candidates who are students or

graduates of a dental hygiene program that is not in the United States

or Canada.

$350

Results Report Fee

(optional)

This fee covers a single results report for a recipient NOT selected at

the time of application.

$50 per report

Results Audit Fee

(optional)

DTS is willing to audit a candidate’s results if the request is received

within 30 days of the reporting date on the official results report.

$65

NBDHE Certificate

Candidates can order an 8.5x11National Board Certificate with optional

frame. To purchase, candidates must log in with their DENTPIN.

DENTPIN.

Eligibility Extension

Fee

Candidates can extend their eligibility period for a fee. The extension is

for 45 days and is available once per application.

$135

Rescheduling Fee

Candidates can reschedule testing appointments for a fee if notice is

received at least one full business day (24 hours) before the

appointment and within the authorized eligibility period.

$25

ELIGIBILITY EXTENSION REQUESTS

Candidates may request a 45-day extension (weekends and holidays included) to their eligibility window by

logging into their DENTPIN

account at ADA.org/DENTPIN.

Candidates may request only one extension per application and cannot have an examination appointment

currently scheduled. Any candidate with a currently scheduled appointment must cancel that appointment before

proceeding with an extension request; failure to do so will result in the extension request being denied. The

eligibility extension request does not supersede any other rules regarding a candidate’s eligibility.

Candidates interested in a 45-day extension must pay a corresponding fee. This fee must be paid at the time the

extension request is submitted. This fee is non-refundable and non-transferable.

Please Note:

Once DTS processes a candidate’s application, that candidate is eligible to test for a six-month period, unless

other considerations — including retest rules and program requirements—limit the eligibility period to a shorter

timeframe. Candidates are encouraged to consider their test administration date carefully, as any last minute

requested changes (e.g., for medical reasons, personal reasons, or due to a missed testing appointment) may not

be approved.

NBDHE 2024 Candidate Guide | 19

ADMINISTRATION SCHEDULE

The following table provides the administration schedule for the NBDHE

™

. The NBDHE contains 350 questions

that are administered in two separate sessions, with an optional 30-minute scheduled break between the

sessions. Within each of these two sessions, candidates will also have an opportunity to take an optional, 15-

minute scheduled break. The time available to answer test questions is seven (7) hours and 30 minutes. The total

administration time is nine (9) hours, including the optional tutorial, scheduled breaks, and post-examination

survey. No questions are presented on screen during scheduled breaks.

NBDHE ADMINISTRATION SCHEDULE

Optional Tutorial

15 minutes

Session One

Discipline-based Items (100 items)

3 hours 30 minutes

(plus 15-minute scheduled break)

Please note: the 3 hours and 30

minutes is for all 200 questions in

session one and the time will continue

after the optional break

Scheduled Break (optional)

Discipline-based Items (100 items)

Scheduled Break (optional)

30 minutes

Session Two:

7-8 Patient Cases

(approximately 75 items)

4 hours

(plus 15-minute scheduled break)

Please note: the 4 hours is for all of

the patient cases in session two and

the timer will continue after the

optional break

Scheduled Break (optional)

7-8 Patient Cases (approximately 75 items)

Post-examination Survey (optional)

15 minutes

Total Time

9 hours

Taking a break at any time other than a Scheduled Break is considered an “Unscheduled Break.” During an

unscheduled break, candidates may NOT access personal belongings or prohibited items, study, refer to notes or

texts, use a telephone, eat, or drink any food or beverages, or leave the test center.

Locker access during an unscheduled break is strictly prohibited.

NBDHE 2024 Candidate Guide | 20

APPLICATION PROCEDURES

Before applying to take this examination, candidates must first obtain a Dental Personal Identification Number

(DENTPIN

). Register for a new DENTPIN or retrieve an existing DENTPIN at ADA.org/DENTPIN.

The DENTPIN is a unique personal identifier used by U.S. dental education system and standardized testing

programs, such as the Dental Admission Test, Advanced Dental Admission Test, and the Admission Test for

Dental Hygiene — as well as application service programs such as the American Dental Education Association

(ADEA) Postdoctoral Application Support Service (ADEA PASS), the ADEA Associated American Dental Schools

Application Service (ADEA AADSAS), the Texas Medical & Dental Schools Application Service (TMDSAS), the

ADEA Centralized Application for Advanced Placement for International Dentists (ADEA CAAPID), and the ADEA

Dental Hygiene Centralized Application Service (ADEA DHCAS). In each case, the DENTPIN is used to uniquely

identify individuals, and for the confidential and secure reporting, transmission, and tracking of test scores and

academic data.

Once a DENTPIN is obtained, candidates can submit an application through the Examination Program website. A

new application and fee must be submitted before each testing attempt. A submitted application will be processed

only if the candidate meets all eligibility requirements for testing. Application processing takes place Monday

through Friday during standard business hours.

Once DTS processes a candidate’s application, that candidate is eligible to test for a six-month period, unless

other considerations—including retest rules and program requirements—limit the eligibility period to a shorter

timeframe.

If a candidate does not take the exam during their eligibility window the application fee is forfeited and the

candidate will need to submit a new application and payment in order to sit for the examination.

During the application and testing process, candidates will be required to provide their legal name, DENTPIN

address, date of birth, and other requested information to allow proper identification by the testing program. ALL

submitted information must be accurate. When including a middle name, candidates must use either their full

middle name or their middle initial. If it is determined that a candidate deliberately falsified personal information in

the DENTPIN system, examination application, or at the test center, scores will be voided and all schools will be

notified. Possible repercussions associated with deliberate falsification include a required two-year waiting period

before taking the examination again, or a complete banning from the Examination Program and any other

examination program implemented by DTS.

If the name on a candidate’s application fails to EXACTLY match the name appearing on IDs brought to the

Administration Vendor test center, the candidate will NOT be permitted to test. As a result, the testing

appointment and application fee will be forfeited, and the candidate will be required to submit a new application

and fee before taking the examination.

Candidates are responsible for identifying any changes and corrections to their application (such as name, birth

date, etc.) and submitting corresponding requested updates at least two weeks prior to their testing appointment.

These changes require completing a “DENTPIN Request Form” which is available at ADA.org/DENTPIN. All

changes and corrections must be emailed to d[email protected] along with the candidate’s DENTPIN (if known)

and any appropriate supporting documentation, such as a marriage certificate or court documents. Updates made

to contact information (address, email address, etc.) using the “Update Your DENTPIN” page at

ADA.org/DENTPIN will NOT automatically update existing test applications and score report requests. Candidates

are responsible for identifying any corrections or omissions and must notify the testing program separately via

email at dentpin@ada.org.

NBDHE 2024 Candidate Guide | 21

Candidates are encouraged to consider choice of testing appointment date carefully, as any last-minute

requested changes (e.g., for medical reasons, personal reasons, or due to a missed testing appointment) may not

be approved.

TEST CENTER PROCEDURES

The Administration Vendor will electronically capture the identity of each candidate biometrically (e.g., through

photograph, fingerprint or palm vein scan) before candidates can proceed with testing. Candidates must consent

to these procedures before they are permitted to test. Electronic capture of biometric data allows for a more

efficient return to testing after breaks. Biometric and other identifying information will be retained by the

Administration Vendor and will be utilized for identity verification at potential future test administrations (e.g.,

retesting).

Administration Vendor staff will visually inspect eyeglasses and hair accessories as part of check-in procedures.

Staff may also use an electronic detection wand to scan for electronic devices. Jewelry, except for wedding and

engagement rings, is prohibited. Updates to security protocols at check-in may change with little to no advance

warning. Candidates can view the current check-in procedures at the Administration Vendor’s website.

Administration Vendor staff will observe candidates at all times during the testing appointment. This observation

includes staff walking through the secure testing room, as well as video recording of the candidate’s examination

session. Administration Vendor staff are required to report behavior that might represent a violation of rules and

regulations.

Administration Vendor staff are not authorized to answer questions from candidates regarding examination

content, examination software, specific examination program policies, and scoring.

IDENTIFICATION POLICY

When you arrive at the administration vendor test center to take your examination, two original, current (not

expired) forms of identification (ID)ꟷone primary and one secondaryꟷwill be required. An expired ID WILL NOT

be accepted, even if that ID is accompanied by temporary identification or documentation that a new, valid ID has

been requested.

The primary ID must be a government-issued ID with your photograph, name, and signature. Examples of

acceptable primary IDs include, but are not limited to a driver’s license, passport, or passport card. All IDs, with

the exception of passports, must be in English.

The secondary ID must contain your name and signature. Examples of secondary IDs include, but are not limited

to debit cards, library cards, or a credit card.

Only physical forms of IDs will be accepted by test center staff. Digital or paper copies of IDs will not be accepted.

WARNING! Your DENTPIN record (which is the name on your application) must match your IDs exactly or

you will be denied admission to testing and forfeit your testing/application fee.

NBDHE 2024 Candidate Guide | 22

RESCHEDULE OR CANCEL A TESTING APPOINTMENT

To reschedule or cancel a testing appointment, candidates must either use the scheduling tools on the

Administration Vendor website, or contact the Administration Vendor using the contact information provided on

the Administration Vendor website. This must be done in advance of the testing appointment. Additional fees

apply, and must be paid directly to the Administration Vendor (see the Examination Fees section of this Guide).

Local test centers where candidates complete their examination cannot schedule, reschedule, or cancel your

appointment. Appointments must be canceled or rescheduled by the business day prior to the scheduled test, and

at least 24 hours in advance of the scheduled appointment. Candidates will receive a confirmation notice when

rescheduling their testing appointment; please retain a copy of this notice.

NO-SHOW POLICY

Candidates who do not appear for a scheduled testing appointment and do not cancel or reschedule their

appointment by the required time in advance of the test date will forfeit all testing fees, be required to submit a

new application, and must pay the fee to schedule a new appointment.

NBDHE 2024 Candidate Guide | 23

EMERGENCIES ON THE DAY OF A TESTING APPOINTMENT

If an emergency occurs on the day of a testing appointment that prevents a candidate from sitting for their

examination, a written request for relief must be submitted to DTS. This request should include applicable

documentation and be sent to testingprob[email protected] within five business days of the scheduled appointment.

Examples of emergencies and applicable documentation include, but are not limited to, the following:

• Sudden illness on the examination day. Provide a doctor’s note or hospital records confirming that you

were treated on the day of the examination.

• Death of a member of the family on the examination day. Provide a copy of an obituary, prayer card,

funeral service program, or death certificate confirming that the relative passed away or services were

held on the day of the examination.

Testing appointments affected by emergencies occurring prior to the day of the scheduled appointment should be

handled through the Administration Vendor’s rescheduling and cancellation process indicated previously.

TESTING PROBLEMS ON THE DAY OF THE TESTING APPOINTMENT

If a candidate encounters a problem during their examination, the administration should not be resumed until the

issue has been documented and resolved by the test center administrator. If a candidate continues to have issues

with their testing experience after having requested such assistance, they should again alert test center staff and

request that staff resolve the issue. If the issue persists, the candidate should immediately discontinue testing.

Candidates who continue to test despite the presence of continued, significant issues waive their right to appeal

for a remedy on the basis of those encountered issues. Concerns not resolved at the time of testing must be

submitted in writing within five business days of the testing appointment to testingprobl[email protected].

Candidates must contact testingpro[email protected] directly, and state the specific relief being requested. Upon

receipt of directly communicated information, DTS will conduct an investigation and notify the candidate of the

outcome. Candidates with documented, unresolved testing issues could be offered the courtesy of a retest within

30 days. If the candidate accepts the retest courtesy, the retest will replace the results of the initial test, and the

initial test results will be voided. Candidates who continue to test despite severe issues — and particularly those

who continue to test, wait for their results to be released, and call DTS afterwards upon receipt of a poor score —

are unlikely to obtain the remedy they seek.

Test center incident reports submitted on behalf of the candidate — and comments submitted by the candidate

via post examination surveys — are considered indirect communication to DTS. These indirect communications

may be considered by DTS as part of its general quality assurance procedures, but would not result in specific

relief for the candidate.

Examination results cannot be canceled or adjusted under any circumstances.

NBDHE 2024 Candidate Guide | 24

TESTING ACCOMMODATIONS

The Examination Program provides reasonable and appropriate testing accommodations in accordance with the

Americans with Disabilities Act. These accommodations occur for individuals with documented disabilities or

medical conditions who demonstrate a need for accommodation, request an accommodation prior to testing, and

who are approved by the Examination Program to receive accommodations based on the information submitted.

Testing accommodations are offered to those with a qualified disability or a medical condition in order to offer

equal access to testing. Candidates must request testing accommodations with each application, but — for

subsequent administrations—will not be required to submit additional documentation covering the same disability

or condition.

Information concerning specific accommodations provided will not be shared outside of DTS, the test center, and

the Examination Program, and will not be indicated on examination results.

In considering a request from a candidate with a disability, the Examination Program is guided by a focus on

validity. Testing accommodations are provided so all candidates have the opportunity to demonstrate their

knowledge and skills, as opposed to having the measurement of their knowledge and skills inappropriately reflect

a disability.

To determine whether a candidate qualifies for accommodations under the Americans with Disabilities Actꟷor as

a result of a current medical conditionꟷthe Examination Program requires a complete evaluation of the candidate

as well as a completed and signed Testing Accommodations Request. A health care professional appropriately

qualified to evaluate the disability or medical condition must conduct the evaluation. For more information on

accommodations and an explanation of how to request testing accommodations, please consult the Testing

Accommodations Request area on the Examination Program website (see the section entitled “Application

Procedures”).

If you have a documented disability recognized under the Americans with Disabilities Act and require testing

accommodations, you must submit the following prior to testing:

1. A completed testing application

2. The Testing Accommodations Request Form through your DENTPIN account

3. Documentation to support the testing accommodation request.

You may submit your testing accommodation request in one of the following ways.

Before applying to test

• You may submit your testing accommodation request prior to submitting your examination application.

The Examination Program will review your request, and if approved, the Examination Program will add

the approved testing accommodation to your record after you complete your examination application.

• To submit a testing accommodation request before applying to test, please sign into your DENTPIN

account and click “Submit Request” from the top ribbon menu. From the dropdown menu, select

“Accommodations Request”.

• Fill out and submit the Testing Accommodation Request Form. This will include a file uploader for

attaching the required supporting documentation. Requested testing accommodations should align with

the identified functional limitation, so that the adjustment to the testing procedure is compliant with federal

guidelines.

NBDHE 2024 Candidate Guide | 25

While applying to test

• During the application submission process, select “Yes” when asked “Are you requesting testing

accommodations under the Americans with Disabilities Act?”.

• Fill out the Testing Accommodation Request in the examination application, which will appear after the

payment page. This will include a file uploader for attaching supporting documentation. Requested testing

accommodations should align with the identified functional limitation, so that the adjustment to the testing

procedure is compliant with federal guidelines.

Candidates can schedule a testing appointment AFTER testing accommodation requests have been

approved. Testing accommodations cannot be added to a previously scheduled testing appointment. If

candidates schedule testing appointments before testing accommodations are approved, candidates will

be required to cancel the appointment and pay a rescheduling fee. Candidates requesting

accommodations must receive their eligibility email with approved accommodations before scheduling a

testing appointment.

UNACCEPTABLE FORMS OF DOCUMENTATION

Please do not submit the documents indicated below. They will not be accepted.

• Handwritten letters from health care professionals

• Handwritten patient records or notes from patient charts

• Diagnoses on prescription pads

• Self-evaluations

• Research articles

• Original documents (submit copies only)

• Previous correspondence to the Examination Program (DTS maintains copies of all correspondence)

NBDHE 2024 Candidate Guide | 26

EXAMINATION REGULATIONS AND RULES OF CONDUCT

RULES OF CONDUCT

Rules have been established that govern the administration of this examination to ensure results accurately

reflect candidates’ skills. Examination regulations and rules of conduct help preserve the integrity of the

examination process and provide standardized examination administration conditions that yield valid and reliable

results.

The Examination Program bears no responsibility for inaccurate information or inappropriate permissions received

from test center administrators. It is your personal responsibility to understand and comply with the Examination

Regulations indicated in this guide. If a candidate’s conduct is determined to violate the terms set forth in this

Guide, the Examination Program will act to strictly enforce its policies and procedures.

Accessing official examination content prior to testing, breaching the confidentiality of examination content, or any

attempt to subvert the examination process represent violations of test regulations. Conduct occurring before,

during, or after testing that violates the examination regulations and rules of conduct could result in invalidation of

examination results and other penalties.

Candidates must be truthful in completing the application and must abide by all instructions regarding examination

conduct. Failure to comply with the examination regulations and rules of conduct could result in a determination of

the presence of an irregularity, and examination results could consequently be voided. If results are voided as a

result of an irregularity, candidates could be prohibited from testing for a specified time period or, in egregious

cases, from retesting at all. Additionally, candidates could face civil or criminal prosecution.

By applying for the examination, candidates agree to abide by the following Rules of Conduct:

1. The candidate certifies that they are registering for this examination for the purpose indicated in the

Examination Purpose section of this Candidate Guide. The examination may not be taken on behalf of

anyone else or for any reason other than for the purpose indicated. Candidates may not take the

examination to practice or to obtain an advance review of the content

2. Candidates are not allowed to complete an examination for any reason other than that indicated by the

Examination Purpose. If available information suggests a previously eligible candidate might be

completing an examination for other purposes, the Examination Program may revoke the candidate’s

eligibility, and the candidate could be required to re-establish eligibility to take the examination.

3. Candidates will not give, receive, or obtain any form of unauthorized assistance prior to the examination,

during the examination (e.g., in the testing room or when on a break), or subsequent to the examination.

4. Candidates will maintain the confidentiality of examination content at all times. Candidates will not

reproduce or attempt to reproduce examination materials through memorization, recording, copying, or

other means. Candidates will not provide information concerning examination content that might affect the

examination’s ability to accurately assess candidates’ skills, or that might provide unfair advantage to

other candidates. For example, Candidates will neither make use of nor participate in the sharing or

distribution of information regarding examination content or answers (via electronic means or otherwise).

5. Candidates will not bring any unauthorized materials, as listed in the Examination Misconduct section of

this Guide, into the secure testing area. All unauthorized materials must be placed in an assigned locker

and may not be accessed during testing.

6. Candidates will not remove information about the exam (written, printed, recorded, or other) from the test

center.

7. Candidates will comply with Administration Vendor test center policies and procedures and will not create

a disturbance in the test center.

8. Candidates will not tamper with the computer testing equipment and facilities.

9. Candidates will cooperate fully with any investigations involving testing irregularities and agree to have

their examination analyzed to detect aberrancies.

NBDHE 2024 Candidate Guide | 27

10. This Examination is a secure examination protected by U.S. copyright laws. Any unauthorized disclosure

of the examination’s content could result in civil liability, criminal penalties, voiding of examination results,

or other appropriate penalties.

Test content (in whole or in part) is prohibited from being disclosed before, during, or after the test to anyone,

including but not limited to: family, friends, classmates, colleagues, or test preparation organizations. This applies

to any content disclosed through discussions, emails, in writing, online (e.g., blogs, social media, websites), or

otherwise.

Candidates who receive unreleased test items should immediately contact DTS at tests[email protected], and

should NOT review the materials they have received. Candidates who have been found to be in possession of

such information — or to have participated in the distribution of this information — may have their examination

results voided. Penalties might be imposed subsequent to discovery and investigation of the original incident,

which could occur years after the incident itself.

Candidates are encouraged to report any activities where information about examination questions is disclosed,

so that DTS can investigate and take any necessary action. Report such activity to DTS at testsecurity@ada.org.

PRIVACY AND SECURITY

The Examination Program will maintain the privacy and security of candidates’ personal information using industry

standard methods. DTS will collect and retain personal information to serve candidate needs, administer the

examination, fulfill Examination Program responsibilities (e.g., to maintain the integrity of the test and detect and

prevent unlawful activity), and fulfill legal requirements. Examination results shall be retained indefinitely, along

with testing records and candidates’ personal information.

Before the examination is administered, candidates will be required to provide a written release concerning the

collection of their biometric information. Biometrics are collected by the Administration Vendor for purposes of

verifying identity and detecting and preventing unlawful activity; the data is stored securely by the Administration

Vendor.

As applicable and in accordance with the purpose of the Examination Program, examination results will be

released or reported to state boards, education programs, or other entities upon written candidate authorization or

designation by electronic means through the electronic application or score report request form. Examination

results may be released or reported in the absence of such authorization when policies indicate that such

notification is appropriate (e.g., notification of state boards concerning an irregularity). Examination results may be

released to education programs to enable those programs to understand student outcomes. For research and

policymaking purposes, examination results may be released — with personally identifying information removed

— to individuals or entities that the Examination Program deems legitimately interested. Information regarding

privacy policies is made available to all candidates and the public.

The ADA provides technical support for the Examination Program and uses data security procedures to protect

the integrity of personal and exam information. Security safeguards include administrative, technical, and physical

safeguards over data and data processing systems. For information on policies relating to your use of the ADA

website, please refer to the Privacy Notice and Terms of Use available at ADA.org.

NBDHE 2024 Candidate Guide | 28

EXAMINATION MISCONDUCT

The Examination Program strives to report results that accurately reflect the skills and performance of each

candidate. The standards and procedures for administering each examination are intended to provide candidates

with a reasonable opportunity to demonstrate their skills, and to facilitate accurate evaluation of those skills The

Examination Program reserves the right to withhold, void, or invalidate any result when, in the Examination

Program’s judgment, it is reasonable to question the validity of the result. Reasons for withholding, voiding, or

invalidating results, or for imposing other appropriate penalties, could include, but are not limited to, the following:

• Unusual answer patterns

• Atypical score increases from one examination attempt to another

• Discrepancy in, or falsification of, a candidate’s identification

• Information indicating that a candidate has engaged in misconduct or a violation of the examination

regulations, rules of conduct, or test center procedures

• Sharing remembered exam questions or answers. This includes sharing through social media platforms,

online discussion forums, or other means

• Taking an examination on behalf of another individual, or having another individual take an examination

on your behalf

• Falsification of application information or supporting documents

• Falsification of a candidate’s results or results report

• Inconsistent performance on different sections of the exam from one examination attempt to another

• Improper access to secure exam content

• Evidence is available concerning the presence of an examination administration irregularity

• Any other information indicating the results might not be valid.

When examination results are voided or invalidated, the candidate is notified in writing. This notice includes

information about the decision and the procedure for appeal. Results will remain voided until an appeal process

has been completed, or the time for appeal has expired.

When previously reported results are voided, the score report recipient will be notified in writing that the result has

been voided.

If it is determined a candidate has engaged in irregular behavior, information regarding this determination

becomes a part of the candidate’s record. At its sole discretion, the Examination Program may elect to send a

summary report documenting the incident to legitimately interested parties. This would include all parties to whom

a candidate has instructed results be sent (both currently and in the future).

In situations where an irregularity has occurred, individuals who are involved or implicated with respect to the

occurrence of the irregularity, or who are reasonably believed to have witnessed the irregularity, could be asked

to provide information concerning the irregularity.

The Examination Program reserves the right to pursue other remedies, including prosecution of anyone

whose conduct unlawfully undermines the security of the examination or the integrity of the examination

process.

No personal items are permitted in the secure testing area. Any personal belongings brought to the test center

must be stored in a designated locker; storage is limited. Personal belongings may be inspected. Notes or any

materials accessed during the examination or on an unscheduled break could be confiscated. Accessing personal

belongings or a locker during an unscheduled break violates the examination regulations. Test administrators are

not authorized to provide permission to candidates to access personal belongings or lockers during an

unscheduled break.

NBDHE 2024 Candidate Guide | 29

Items that are prohibited from the secure testing area include, but are not limited to, the following:

• Books, notes, study materials, scratch paper, tissues, and markers

• Personal earplugs and headphones NOT provided by the Administration Vendor.

• Dental instruments, models, or materials

• Slide rules, paper, calculating devices, rulers, and other measuring devices (except those items approved

in advance under testing accommodations)

• Electronic devices such as cell phones, recording devices, iPods, tablets, and headsets

• Tote bags, purses, wallets, backpacks, and briefcases

• Highlighters, pens, erasers, pencils, dictionaries, and translators

• Food, candy, gum, and beverages (except those items approved in advance under testing

accommodations)

• Outerwear, such as coats, jackets, gloves, or head coverings (religious attire is allowed)

• Good luck charms, statues, religious or spiritual items, and similar objects

• Watches (digital, analog, or smart) or timing devices (a timer is provided on the computer screen during

the examination)

• Magnifying devices

• Jewelry (except for wedding and engagement rings)

The test center will provide two note boards (without graph lines) and two low-odor fine tip markers during the

examination. Used note boards will be replaced by test center staff upon request. Scratch paper, pencils, and

markers not furnished by the testing center are prohibited. You are not guaranteed to receive graph lines on your

provided materials.

Candidates may not write on the note boards before the test begins or during scheduled breaks. The note boards

should not be folded, bent, distorted, or modified in any manner. Markers cannot be used any surface other than

the note boards. Candidates may not touch the monitor during the examination. All items provided must be

returned to the test administrator before leaving the test center. Test center note boards will not be stored for

multiple day examination use. Any notes taken will be surrendered at the end of each testing day and erased.

Candidates may not engage in conversation with others during testing or while on an unscheduled break.

Discussing the examination is strictly prohibited.

Test center administrators will report the activity of candidates who take unscheduled breaks.

During an unscheduled break, candidates may NOT access personal belongings or prohibited items,

study or refer to notes or texts, use a telephone, eat or drink any food or beverages from lockers, or leave

the test center. Test administrators are NOT authorized to provide permission to engage in these

activities.

Although the examination is administered under strict supervision and security, examination irregularities can

sometimes occur. Examination results could be voided based upon a breach of examination security, invalid

examination conditions, or candidate violations of the examination regulations, rules of conduct, or test center

procedures. If irregularities are detected during the examination, or evidence of irregular behavior is disclosed

when the examination is scored or afterward, those involved will have their examination results voided and face

appropriate penalties.

Failure to comply with examination regulations, rules of conduct, and test center procedures could result

in a determination of the presence of an irregularity, and examination results could be withheld, canceled,

considered invalid, or another appropriate penalty could be imposed. Candidates might also be directed

to leave the test center before the examination is completed. If results are withheld or invalidated, or

NBDHE 2024 Candidate Guide | 30

other penalties are proposed or imposed as the result of an irregularity, candidates could be prohibited

from testing and other appropriate penalties could be imposed.

IRREGULARITIES AND APPEALS

An irregularity is defined as a situation in which there could be a question about the validity of examination results

in accurately reflecting the ability and skills of a candidate.

For example, such questions could be raised when:

• there is communication between candidates during the testing session.

• unauthorized assistance occurs.

• candidates have inappropriate access to examination content (e.g. remembered questions or answers

are shared by email, online posting, or other means).

• conduct prohibited by the examination regulations, rules of conduct, or test center procedures occurs, or

examination administration disruptions are present, including natural disasters and other emergencies.

When an irregularity is identified, results for the candidate(s) involved will be voided pending resolution of the

corresponding appeal(s). If an appeal is denied or no appeal is filed, the results of the candidate(s) involved could

remain voided and/or other appropriate remedies imposed.

Rule violations and/or irregularities occurring in one Examination Program implemented by DTS may result in

penalties that impact a candidate’s ability to test in another Examination Program implemented by DTS.

Candidates whose results are subject to being voided are notified by written correspondence and provided with a

copy of the Limited Right of Appeal for Examination Candidates. Appeals must be submitted in writing within

30 days of notification of the irregularity. Appeals must clearly state the specific relief being requested

and include corresponding arguments, evidence, and documentation in support of the request.

The candidate will be notified of the appeal decision within 60 days after receipt of the appeal.

When considering an appeal, the Examination Program strives to ensure that examination results accurately

reflect candidates’ skills, and that the appealing candidate has an opportunity equal to, but not greater than, the

opportunity provided to other candidates.

Results will be voided when there is a reasonable and good faith basis to do so. If it is determined that voiding

results is not warranted under the circumstances, the results will be released.

Candidates should be aware that irregularities - other than natural disasters and emergencies beyond the control

of the candidate - are considered to be a serious breach of the examination process.

The Examination Program strives to handle irregularities and their investigation in a confidential, professional, fair,

and objective manner.

Candidates should be aware that reports of irregularities may have consequences beyond the voiding of results or

the imposition of other appropriate penalties.

• Information regarding the irregularities may be brought to the attention of school authorities, regulatory

agencies, or other entities, by other sources.

• Additional information concerning a candidate may surface within the context of an investigation into an

irregularity.

Candidates are encouraged to report suspicious activity or observations of violations of the examination

regulations to DTS at testsecurity@ada.org.

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NON-APPEALABLE POLICIES

The JCNDE considers certain policies to be non-appealable. This includes, but is not limited to, the following:

• The 60-day wait period between administrations.

• Testing more than four (4) times in a 12-month period.

• The nullification of a test result or reimbursement of a paid administration due to complaints about test

questions or accompanying stimulus materials (e.g., an image).

• Exceptions to the educational degree confirmation policy (i.e., for candidates educated by non-CODA

accredited programs).

• The outcome of an audited test result.

• An adjustment or modification to a test score.

ARBITRATION REQUIREMENT

Arbitration has become an increasingly common way to resolve legal differences. Generally speaking, the

advantages of arbitration over traditional lawsuits are that arbitration is less expensive and issues are resolved in

less time. If a candidate wishes to pursue a dispute that has not been resolved by the appeal process mentioned

above and detailed in the Limited Right of Appeal for Examination Candidates, the candidate must use the

procedure described in the following Agreement to Arbitrate.

AGREEMENT TO ARBITRATE

1. In the event that any legal dispute arises between you and the Examination Program, in connection with

your participation in this Examination Program, where that dispute is not resolved by the appeals process

detailed in this Guide and elsewhere, you agree that the exclusive means for resolving the dispute shall

be Binding Arbitration as described by the terms of this Agreement. This means that you waive the rights

you may have to resolve the dispute in a court of law, or by any other means that might otherwise be

available to you.

2. The American Dental Association (“ADA”) agrees to be similarly bound except that the ADA reserves its

full rights to pursue injunctive and other appropriate relief in any state or federal court in cases of unfair

competition or violations of, or threats to violate, any intellectual property rights of the ADA. With respect

to any action filed by the ADA pursuant to this paragraph 2, you consent to submit to the jurisdiction of the

state or federal court in which the ADA seeks relief.

3. Arbitration proceedings initiated pursuant to this Agreement to Arbitrate shall be conducted in accordance

with the then current Consumer Arbitration Rules of the American Arbitration Association. The arbitrator’s

award shall be binding and may be entered as a judgment in any court of competent jurisdiction.

Information about the American Arbitration Association, its rules, and its forms are available from the

American Arbitration Association website, www.adr.org.

4. In the event of Arbitration, and except to the extent the Consumer Arbitration Rules provide otherwise, the

parties shall bear their own costs and attorneys’ fees associated with the Arbitration proceedings, unless

the arbitrator directs one of the parties to pay the other’s costs, or attorneys’ fees, or both.

5. To the fullest extent permitted by law, no Arbitration brought pursuant to this Agreement shall be joined to

any Arbitration involving any other party whether through “Class Arbitration” proceedings or otherwise.

6. This Agreement is part of the application to take this examination. Your assent to be bound by it is a

requirement for taking the examination, but you can only sit for the examination if you also fulfill all other

conditions imposed by the Examination Program.