Preparing for National, Regional, and State Dental Hygiene Board Examinations
Preparing for board examinations requires deliberate planning, study and review, time management, organization of information and schedules for applications, and a positive “can-do” attitude. Conscientious dental hygienists will organize a plan for success well in advance and be prepared to satisfy board requirements with confidence in their professional knowledge and skills. This book is a guide through the evidence-based knowledge on which dental hygiene practice is based. Systematic use of this book enables one to reinforce professional education, integrate concepts and ideas from many dental hygiene educators, and identify subject areas where additional study is warranted.
The introductory chapter is a primer in navigating the licensure system—whether a new graduate, a practicing dental hygienist who is moving to another licensing jurisdiction, or a dental hygienist returning to practice after a lapse of activity—to prepare for both didactic and clinical board examinations. A dental hygienist must master all subject matter and skills necessary for practice; therefore, each chapter focuses on different aspects of such knowledge and skills. However, success on board examinations also relies on being psychologically, emotionally, and physically prepared to demonstrate competence. It is essential to become thoroughly familiar with the format, logistics, and requirements of any preparatory examination for licensure.
This chapter discusses licensure structure and explains how it functions with the interaction of numerous agencies and organizations. Information on the National Board Dental Hygiene Examination (NBDHE) as well as a discourse on clinical board examinations is provided. The chapter concludes with an overview of this review book, including its purpose and organization, as well as instructions on how to use the text effectively.
In the United States, licensure is under the authority of an individual state or jurisdiction. Licensure of dental hygienists is a means of regulation to protect the public from unqualified individuals and unsafe practice of the profession. Each state has a state practice act that defines the practice of dental hygiene, establishes educational and testing requirements for licensure, sets parameters for enforcement of the law within that jurisdiction, and creates a state board of dentistry or dental hygiene to serve in accordance with the statute. A certificate for successful completion of an examination is not authorization to practice. Beginning practice without a license is illegal. Dental hygiene licensure requirements vary from state to state, but nearly every state has three requirements:
It should be noted that recognition of an accrediting agency is a governmental function. In health care fields with a domain of specialized education, accreditation is conducted by a dedicated agency within the profession. In dentistry, the U.S. Department of Education (USDE) has recognized the CODA of the American Dental Association (ADA) as the official accrediting body for schools of dentistry, dental hygiene, dental assisting, and dental laboratory technology. The CODA is also listed in the publications of accreditation agencies by the Council for Higher Education Accreditation (CHEA). A diploma, certificate, associate’s degree, or baccalaureate degree in dental hygiene indicating graduation from an accredited program is an essential component for licensure that is based on the accreditation system carried out under the auspices of the CODA. States that provide for licensure of a dentist or dental hygienist from a nonaccredited school generally require evidence of an educational program that is equivalent to an accredited program. The NBDHE is developed and administered by the Joint Commission on National Dental Examinations (JCNDE). Client-based clinical examinations are conducted by five regional testing agencies (Boxes 1-1 and 1-2). The licensure boards of California, Delaware, Florida, and the Virgin Islands of the United States administer independent examinations. Nevada, administers the American Dental Hygiene Licensing Examination (ADHLEX). Clinical examinations accepted for initial licensure are shown in Figure 1-1.
A license is applicable only within the geographic boundaries of the issuing state. However, most states have some provision for granting dental hygiene licensure by credentials or endorsement. Requirements generally include an active license in good standing, recent practice experience, successful completion of the NBDHE, successful completion of a clinical examination, and graduation from an accredited program. Specifics differ from state to state and are subject to change. For example, some states accept NBDHE scores only if earned within the last 5 to 10 years, or limit recognition of clinical board examination results to those from particular testing agencies.
State boards of dentistry or dental hygiene are governmental agencies that control and manage dental hygiene licensure in accordance with laws adopted by the legislature of the states. In general, boards have the power or influence to grant, deny, and revoke licenses. Board members are charged with the following duties:
Significant variations exist from jurisdiction to jurisdiction in the way regulatory boards are organized, in the power or authority they have, and even in their titles. For the purpose of clarity in this text, the term state board or state board of dentistry is used to refer to the regulatory body in a respective legal jurisdiction that is empowered to determine prerequisites for licensure and issue licenses to practice dental hygiene (see Box 1-3).
Frequently, licensure candidates and even licensed practitioners confuse the state board with the state dental association. Although strong ties may exist between a state board and the state dental association, distinct legal differences exist between these two bodies. The state board of dentistry is a governmental agency, established by law, which functions as an arm of the state legislature to regulate the practice of dentistry and dental hygiene. Its sole purpose is to protect the public from incompetent or unethical practitioners. In contrast, a state dental or dental hygiene association is a voluntary organization of practitioners, who join together to promote the oral health of the public and to advance the profession.
Practitioners need to understand both this distinction and the interplay between state boards and professional associations. Professional associations do not determine requirements for licensure or regulate practice; this is founded by law and implemented through state boards. Professional associations do, however, initiate programs and research projects and propose legislative changes that may ultimately be incorporated into the legal requirements for practice. In most states, state board members are appointed by the governor. Alabama, Nebraska, North Carolina, Oklahoma, and the District of Columbia are the exceptions, with designation being done through election by members of the profession or through appointment by another governmental body. Typically, professional associations nominate and influence these appointments.
All states have some form of dental hygiene representation on the board. Recent years have seen a trend toward self-regulation, with the establishment of separate dental hygiene state boards and advisory committees. Currently, about 17 states have varying degrees of self-regulation for dental hygienists (Arizona, California, Connecticut, Delaware, Florida, Iowa, Maine, Maryland, Michigan, Missouri, Montana, Nevada, New Mexico, Oklahoma, Oregon, Texas, and Washington). In Canada, over 90% of d/>