Know what you're studying for
Today the NBDHE has 350 questions: 200 discipline‑based questions and 150 questions built around 12 to 15 patient cases. It runs in 2 sessions over 1 day, with about 7.5 hours of testing.
Under the updated test specifications, effective November 1, 2026, the 200 discipline‑based questions split into 3 areas: 56 on the scientific basis for dental hygiene practice, 124 on provision of clinical dental hygiene services, and 20 on research principles and community health.
The NBDHE is reported as pass or fail. A scale score of 75 is the passing standard, and it is not a percentage. Don't aim for a number of questions right; aim to be solid across every area.
A scale for the The NBDHE with a line at a scaled score of 75: scores at or above it pass, scores below it don't. The scaled score isn't the percentage of questions answered correctly.
Find your weak areas before you plan
Most students study what they already like. Start instead with a timed set of mixed questions across every area, case questions included, and look at your results by area, not just overall.
Your weakest areas go first in your plan. Keep the strong areas warm with short mixed sets so you don't lose them.
Plan your weeks backward from test day
- Pick your test date and count the weeks you have.
- Give each area time in line with how many questions it has on the exam, with extra for your weak areas.
- Put patient case practice in every study week, not just the last one.
- Save the last 1 to 2 weeks for full‑length timed practice and review.
An example study plan of 8 weeks ending on test day. Week 1 is a timed mixed diagnostic. Weeks 2 to 6 go to the weakest areas first, then the next areas, then the strong areas, with patient case practice in every week. The last 2 weeks are full-length timed practice and review.
A little every day beats a long cram on weekends. Short daily sessions are easier to keep up while you're in school or working.
Practice cases every week
Case questions make up a large part of the exam. Each case gives you a patient history, dental charts and radiographs, then asks a set of questions about that patient.
Practice reading a case quickly: the medical history and medications first, then the charting, then the question. Ask what the case is really testing before you look at the choices.
Practice in the exam's formats
The NBDHE uses single best answer questions, EXCEPT and NOT questions that ask for the one wrong choice, case sets, and testlets for community health: a scenario with a set of questions. Each format trips people up in its own way, so practice all of them.
After every practice set, read the reason for every answer, including the ones you got right. Knowing why each wrong choice is wrong is what moves a weak area.
Build up to a full day
Today Session 1 is 200 discipline‑based questions in 3 hours 30 minutes, and Session 2 is 150 case‑based questions in 4 hours. Work up to sets of that length, timed, so test day doesn't feel longer than anything you've done.
The NBDHE day: Session 1 is 200 discipline-based questions in 3 hours 30 minutes. Session 2 is 150 case-based questions in 4 hours. About 7.5 hours of testing in all.
Check your pace as you practice: how long you spend per question, and which formats slow you down.
The week before and test day
- Read the candidate guide's rules for test day, including ID and what you can bring.
- Stop learning new material in the last day or two. Review your notes on weak areas instead.
- Sleep, eat, and plan to arrive early. It's a long day.
- In the exam, mark questions you're unsure of and keep moving.
Read the NBDHE 2026 Candidate Guide (PDF) (opens in a new tab)
If you don't pass
It happens, and it isn't the end. You can test again after at least 60 days, and you can take the exam up to 4 times in any 12‑month period. Your results report shows how you did by area, including the case area.
If you don't pass the NBDHE: wait at least 60 days before you test again, and take the exam no more than 4 times in any 12-month period. Your results report shows how you did by area.
Use that report as your diagnostic: plan your next attempt around the areas it shows were weakest.