Who runs it and who accepts it
The National Board Dental Hygiene Examination (NBDHE) is developed by the Joint Commission on National Dental Examinations (JCNDE), an agency of the American Dental Association. The ADA's Department of Testing Services carries it out, and Pearson VUE delivers it at test centers in the U.S. and Canada.
All U.S. licensing jurisdictions recognize the NBDHE: all 50 states, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands. It counts toward each one's written exam requirement for hygiene licensure, and each decides how it uses the result.
The NBDHE is one part of getting licensed. Most states also require graduation from an accredited program and a clinical exam. Your state board sets the full list, so check it early.
What's on it
Today the NBDHE has 350 questions: 200 discipline‑based questions and 150 questions built around 12 to 15 patient cases.
Question counts by area are from the JCNDE's updated test specifications, effective November 1, 2026. Session times are from the JCNDE's NBDHE 2026 Candidate Guide.
The 3 discipline areas
Session 1 covers 3 areas. These are the question counts under the updated test specifications, effective November 1, 2026.
Scientific basis for dental hygiene practice
56 questions
The science that clinical care rests on. Pharmacology is part of this area, and the updated specifications name local anesthesia within it.
Provision of clinical dental hygiene services
124 questions
The largest area: 124 of the 200 discipline‑based questions. It includes patient assessment (with periodontal and occlusal evaluation), dental radiography, dental hygiene care planning (including anxiety and pain control and local anesthesia), periodontal disease management, preventive agents and professional responsibility.
Research principles and community health
20 questions
These questions come as testlets: a scenario followed by a set of questions about it. The area takes this name in the updated specifications.
New or more explicit from November 1, 2026
The updated specifications keep 200 discipline-based and 150 case-based questions. They name these topics, some newly and some more explicitly than before:
- Local anesthesia
- Occlusal evaluation
- Emerging technologies
- Implant care
- Documentation and risk management
The ADA's Department of Testing Services says the changes aren't expected to substantially change how candidates prepare. Candidates use the specifications that apply on their test date.
Read the Department of Testing Services' update on exam changes (PDF) (opens in a new tab)
The patient cases
Session 2 is built around 12 to 15 patient cases, adult and child. The JCNDE's examples include these kinds of patients:
- Geriatric
- Adult periodontal
- Pediatric
- Special needs
- Medically compromised
Each case is presented with:
- Patient history
- Dental charts
- Radiographs
- Clinical photographs
How the questions are written
Every NBDHE question has a stem and 3 to 5 options, with one correct or best answer.
Completion
The stem is an unfinished statement. You choose the option that completes it best.
Question
The stem asks a direct question.
EXCEPT and NOT
The stem asks for the option that doesn't fit. The words EXCEPT and NOT are in capitals.
Testlets
Community health and research questions come as a scenario followed by a set of questions.
Our practice questions will use the same formats as the exam: single best answer, EXCEPT questions, case sets and community health testlets.
What the questions assume
Subject matter experts review every question each year, and the JCNDE's candidate guide says every question uses the Universal/National tooth numbering system. According to the ADA's Department of Testing Services, in its update dated September 23, 2026, the questions also reflect:
- The 2017 AAP/EFP classification of periodontal diseases, used on the exam since 2021
- The 2017 ACC/AHA hypertension guideline and the American Heart Association's 2021 statement on antibiotic prophylaxis
- The ADA's patient considerations for hypertension in dental care, which differ from those in one widely used hygiene textbook
- The American Society of Anesthesiologists' 2020 physical status amendment and the 2020 International Association of Dental Traumatology guidelines
- Radiography wording: the term “film” isn't used, and darkroom processing isn't tested
- Smoking usually given in cigarettes per day, though some questions may still use packs or pack‑years (1 pack is 20 cigarettes)
Our lessons are being written to the guidelines the exam uses today, including the 2017 periodontal classification.
Before test day
The steps, in order, from the JCNDE's NBDHE 2026 Candidate Guide.
- 1
Check that you're eligible
Students in accredited hygiene programs can sit for the NBDHE before graduating, once their program director confirms they are ready. Graduates of accredited programs apply with proof of graduation. The candidate guide lists the other routes, including for graduates of non‑accredited U.S. or Canadian programs that are shown to be equivalent.
- 2
Get a DENTPIN
You need a DENTPIN to apply. Your results arrive through your DENTPIN account later, so keep the login.
- 3
Apply to the JCNDE
Once your application is processed, you usually have 6 months to take the exam. Retest rules or your program can make that window shorter.
- 4
Schedule with Pearson VUE
The NBDHE is a computer‑based exam taken at Pearson VUE test centers, year‑round. The JCNDE suggests scheduling 60 to 90 days ahead.
- 5
Reschedule early if plans change
Changes go through Pearson VUE by the business day before your appointment, and at least 24 hours ahead.
Plan backward from the date you want. Your window to test, usually 6 months, starts once your application is processed, and the JCNDE suggests booking 60 to 90 days ahead.
Read the eligibility and scheduling rules in the candidate guide (PDF) (opens in a new tab)
Test day
Today the exam runs in 2 sessions over 1 day: about 7.5 hours of testing inside a 9‑hour appointment.
- Tutorial (optional)15 min
- Session 1 + break200 discipline‑based questions in 3 hours 30 minutes, plus an optional 15‑minute break within the session3 h 45 min
- Break between sessions (optional)30 min
- Session 2 + break150 case‑based questions in 4 hours, in 2 halves of about 75 questions each, plus an optional 15‑minute break within the session4 h 15 min
- Survey (optional)15 min
- The whole appointment9 h
Testing time is 7 hours 30 minutes. Each session's optional break is counted inside its block. From the administration schedule in the JCNDE's NBDHE 2026 Candidate Guide.
Scoring and results
75 is not 75%
The NBDHE is reported as pass or fail. A scale score of 75 is the passing standard, and it is not a percentage or a count of right answers.
- Scale scores run from 49 to 99. 75 is the minimum passing score.
- There's no penalty for guessing, so don't leave a question blank.
- Some questions are unscored pretest items that don't count toward your result.
- The exam is criterion‑referenced: your result depends on meeting the standard, not on how other candidates did.
- Results usually arrive 3 to 4 weeks after the exam, through your DENTPIN account.
- If you pass, your report says you passed. Only candidates who don't pass see their overall scale score, along with how they did by discipline area and on the cases.
If you don't pass
Not passing is hard. The rules for trying again are clear, and the wait gives you time to plan.
- Wait at least 60 days after an attempt before you test again.
- You can take the exam up to 4 times in any 12‑month period.
- Pass within 5 years of your first attempt or within 5 attempts, whichever comes first. After that, you can test once every 6 months. The JCNDE shortened this wait from 12 months to 6 in June 2025.
- Once you pass, you can't retake the exam unless a licensing board requires it.
Your results report shows your scale score and how you did by area. Start with the areas it showed were weakest.
What's changing
June 2025
A shorter wait after the 5‑year or 5‑attempt limit
By JCNDE action, candidates past the limit can test once every 6 months, down from 12.
November 1, 2026
Updated test specifications
Still 200 discipline‑based and 150 case‑based questions. The discipline split becomes 56, 124 and 20, the third area is called research principles and community health, and local anesthesia, occlusal evaluation, emerging technologies, implant care, and documentation and risk management are named, some for the first time.
No earlier than 2028
Multi-stage adaptive testing
The JCNDE plans to move the NBDHE to multi‑stage adaptive testing no earlier than 2028. It says this will shorten the exam and improve test security, so question counts and timing may change from 2028.
NBDHE Board Prep is being built on the updated specifications. We will update it when the exam changes. See what it will include.
Practice materials and the rules
The JCNDE publishes free NBDHE sample questions and paid practice test modules, delivered through Pearson VUE. Both are copyrighted, and they can't be reproduced without the JCNDE's written permission.
Go to the JCNDE's NBDHE page (opens in a new tab)Read the NBDHE 2026 Candidate Guide (PDF) (opens in a new tab)
Don't use remembered exam questions
NBDHE questions are confidential. Getting, using, discussing or posting remembered questions or answers, in whole or in part, is prohibited and can lead to voided results and legal action.
Our questions are original
Every practice question is written from named textbooks and other published sources. We never use questions recalled from the real exam, and our questions are not taken from JCNDE materials.
What to do next
Make a free study plan
Pick how long you have until your exam and how many minutes a day you can study. The plan gives each area time in line with how many questions it has.
Join the list
NBDHE Board Prep enrollment opens in 2027, with a free readiness diagnostic. We'll email you when it does.