In this career guide, we’ll be discussing the complete path to becoming a Dental Hygienist in the United States. As you’ll learn, a career as a Dental Hygienist provides many flexible career options, for example, private practice, corporate, public health, clinician, and more. Our job is to make choosing a career path easier for you.
By reading over this guide, you are officially taking the FIRST step on your journey to becoming a dental hygienist. We are here to ensure you have the RIGHT information available to you by providing a step-by-step process that’s easy to follow and understand. Let’s get started!
You can click on any section in the table of contents to jump to that section in this guide.
Table of Contents
What Does A Dental Hygienist Do?
Overview Of The Steps To Become A Dental Hygienist (CHART)
Dental Hygienist Education Requirements And Prerequisites
Dental Hygiene Continuing Education Requirements
Understanding The National Board Dental Hygiene Examination (NBDHE)
The Dental Hygienist Regional State Examination
Dental Hygiene Boards by State
Renewing Your Dental Hygienist License
Transferring Your Out of State Dental Hygienist License
Dental Hygienist Career Paths
Dental Hygienist Salary
Dental Hygienist Industry Statistics
Dental Hygienist Earning Potential by State
Dental Hygienist Highest Paying US Cities
Choosing The BEST Dental Hygiene Program For You
Search Dental Hygienist Jobs In Your Area
You, as a dental hygienist, will be working with a dentist to meet the oral health needs of patients. As a registered dental hygienist, you may work with patients one-on-one taking x-rays, impressions of teeth when required, and will have the responsibility to report irregularities or patient health problems to the dentist. A dental hygienist’s role and responsibilities will vary and depend on the state you are licensed in and its regulations at the time. For example, some states may give licensed dental hygienist more or fewer responsibilities which may include:
Assessing a patient’s oral health conditions and patient screen procedures
Taking and developing dental radiographs (x-rays)
Removing calculus and plaque (hard and soft deposits) from all surfaces of the teeth
Applying preventive materials to the teeth (e.g., sealants and fluorides)
Teaching patients appropriate oral hygiene strategies to maintain oral health;
(e.g., tooth brushing, flossing and nutritional counseling)
Counseling patients about proper nutrition and its impact on oral health
Making impressions of patients’ teeth for study casts (models of teeth used by dentists to evaluate patient treatment needs)
Performing documentation and office management activities
This list of services is taken directly from adha.org
Before you CAN apply to the DENTAL HYGIENE PROGRAM, you will be required to complete the dental hygienist prerequisite classes. Each college has different requirements, so please visit their Admission page for more information. Approved programs can be found here – Commission on Dental Accreditation (CODA)
You will NEED to complete Medical, History, and Physical Examinations as per the College requirements.
Once you have successfully been accepted by the college for their accredited Dental Hygienist program, you will NEED to acquire the following education.
The education requirements to become a Licensed Dental Hygienist are as follows:
1) Graduate from an accredited dental hygiene program. After SUCCESSFUL completion of the program, you will be eligible to write the National Board Dental Hygiene Examination (NBDHE) and your State license examination.
2) PASS the National Board Dental Hygiene Examination (NBDHE) and your State license examination. (SEE NEXT SECTION)
3) Ensure your license remains ACTIVE by completing the CE (continuing education) requirements as per your State.
The first step to becoming a licensed dental hygienist is to graduate from an accredited dental hygiene program. A program that’s accredited means that it has been approved by the Commission on Dental Accreditation (CODA). The Commission on Dental Accreditation (CODA) ensures each program that has been accredited will provide you with the foundation you need to sit for the National Board Dental Hygiene Examination (NBDHE) and your State license examination.
Typically, it will take 2 years to graduate from a dental hygienist program successfully. The 2-year program will give you an associate’s degree in dental hygiene. However, you can further your education by 2 more years and receive your baccalaureate and master’s degrees. These types of degrees will allow you to pursue a career in teaching and/or research, as well as for clinical practice in school or public health programs.
To be eligible to write the National Board Dental Hygiene Examination (NBDHE) and your State license examination, you need at a minimum a 2-year Associate’s Degree.
The curriculum for an accredited dental hygiene program covers several topics and can be challenging. You must be mentally prepared for what’s ahead when applying for a program and becoming a licensed dental hygienist.
So, what do you learn in dental hygiene school? What does the training include? What are some skills you’ll learn during the program?
Professional communication skills
Knowledge of ethical standards and behavior
Learn how to apply and analyze new research techniques in dental hygiene care
You will also learn how to do the following:
Educate patients on oral health and hygiene practices
Apply dental hygiene research advances to the oral care you provide
Take oral X-rays and apply fluoride and fissure sealants
Offer periodontal therapies such as plaque or stain removal
If you are just starting to pursue your educational requirements to become a dental hygienist, here are accredited entry-level programs by State: American Dental Hygienist Association
As mentioned, once you have successfully graduated from a program, you will be eligible to sit for the National Board Dental Hygiene Examination (NBDHE) and your State license examination.
Entry-Level Programs: The programs listed here are entry-level accredited programs. After successful graduation, you will receive an Associates Degree (2-year) and be eligible to SIT for the National Board Dental Hygiene Examination (NBDHE) and your State license examination.
Degree-Completion Programs: These programs allow you to upgrade your CURRENT Dental Hygiene certification or Associates Degree into a Bachelors in dental hygiene or in a related area.
Re-Entry Programs: If you want to start practicing again and re-enter the field of Dental Hygiene, then these programs are right for you.
Once you have successfully PASSED the National Board Dental Hygiene Examination (NBDHE) and your State examination, you will have to meet CE (continuing education) requirements. The continuing education requirements apply to anyone with an ACTIVE license who want to continue to work as a dental hygienist in their State.
Each state has its dental hygiene CE requirements, so please visit the appropriate governing Board of Dentistry in the state you are currently practicing in. To help you, we have included a link to the States Requiring Continuing Education for License Renewal.
After graduating from an accredited program and fulfilling all the dental hygiene education requirements, you are required to PASS the National Board Dental Hygiene Examination (NBDHE). The purpose of the NBDHE is to help STATE boards assess your qualifications and your abilities to determine how effective you would be as a licensed dental hygienist. From what we’ve read,
“All United States licensing jurisdictions recognize NBE results; these jurisdictions include all 50 states, the District of Columbia, Puerto Rico, Guam, and the US Virgin Islands.” – ada.org
In this section, we’ll be exploring the NBDHE, and the structure like registration, scope, format, scoring, etc
The following will be eligible:
– Current students enrolled in an accredited dental hygiene program who have approval from the director of the program confirming that the student is prepared in all NBDHE disciplines
– Graduate students of a dental hygiene program that has been accredited by the Commission on Dental Accreditation (CODA). Evidence of eligibility required
– Graduates from a NON-ACCREDITED dental hygiene program in the U.S or Canada where the program is equivalent to an accredited program. As stated here –
“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 the summary of accreditation standards). Accreditation standards in effect at the time the candidate applies for examination are used in evaluating the program.” – ada.org (page 13)
Registering For The NBDHE:
This examination is administered by Pearson VUE. Ensure the following steps are completed before registering:
1) To take the NBDHE examination, you will need to register and get your DENPIN here – org/DENTPIN.
2) Every time a candidate is applying to take the NBDHE, a new application and fee MUST be submitted. Please apply here – org/NBDHE. Applications will only be approved if the candidate meets all eligibility requirements.
3) All approved applications will be VALID for 6 months. A candidate MUST schedule an exam date within these 6 months, or a new application and fee will need to be submitted.
CURRENT NBDHE FEE SCHEDULE
NBDHE Examination Structure:
The NBDHE examination will cover all the fundamentals that a dental hygienist is expected to perform on the job. There are a total of 350 multiple choice questions covering two sections – a discipline-based component and a case-based component. Let’s explore the breakdown of each section and the number of questions in each.
Discipline-Based Component focusing on 3 major areas (200 items):
Scientific Basis for Dental Hygiene Practice: 61 questions
Provision of Clinical Dental Hygiene Services: 115 questions
Community Health/Research Principles: 24 questions
Case-Based Items (150 Items): Exploring 12-15 dental hygiene patient cases:
In this section of the exam, you will be provided with specific patient information (in the form of a patient box), and you will be required to take the appropriate course of action. These questions are on the exam to test the candidate’s ability to make proper judgments when faced with different situations. With case-based questions, you will be given information about a patient’s age, sex, dental charts, compliant, etc.
EXAMPLE OF PATIENT BOX
CURRENT NBDHE STRUCTURE
Scoring The NBDHE:
The system used to score the National Board Dental Hygiene Examination (NBDHE) determines a candidate’s level of cognitive skills. The scoring system is structured to determine if the candidate will be able to perform what’s required of them safely WITHOUT jeopardizing the well-being of a patient.
The NBDHE is scored using the following criterion:
1) The score scale ranges from 49 to 99, with “75” being the minimum PASSING score.
2) The TOTAL score is computed by looking at the total number of correct answers selected by the candidate.
The NBDHE Results:
The results are reported as follows: PASS or FAIL
For scores above 75, you will receive a “PASS” reading with no more information. However, those candidate’s who “FAIL” will receive a numerical score for each section covered on the NBDHE.
National Board Examination results are usually available after three to four weeks. A candidate can view results online by logging into the My Account Summary page.
After successfully PASSING the National Board Dental Hygiene Examination (NBDHE), your State will require you (the candidate) to PASS the regional exam too. Each US state will grant you the ability to practice in their State, which is why an independent examination is required. For example, to become a licensed dental hygienist in Florida, the candidate MUST PASS the NBDHE (National Board Exam) and their Regional State ADEX Dental Hygiene Examination.
Below we have included a map of the US States and applicable dental hygiene examination.
NOTE: We encourage you to visit your STATE Dental Licensing Board for more information on other regional examinations they accept as an equivalent. We have attached the State Licensure by Credential/Endorsement Chart to help you find more information about the licensing process. For Regional state examination information, please view the Clinical Exam For Initial Licensure column.
Alaska | Alabama | Arizona | Arkansas | California | Colorado | Connecticut | District of Columbia | Delaware | Florida | Georgia | Hawaii | Iowa | Idaho | Illinois | Indiana | Kansas | Kentucky | Louisiana | Massachusetts | Maryland | Maine | Michigan | Minnesota | Missouri | Mississippi | Montana | North Carolina | North Dakota | Nebraska | New Hampshire | New Jersey | New Mexico | Nevada | New York | Ohio | Oklahoma | Oregon | Pennsylvania | Rhode Island | South Carolina | South Dakota | Tennessee | Texas | Utah | Virginia | Vermont | Washington | Wisconsin | West Virginia | Wyoming |
Each state has its renewal process and applicable fees. We encourage you to visit your local State Dental Hygiene Board to find out more. Click here to find a list of Dental Hygiene Boards by State.
If you are currently licensed as a dental hygienist in your state and are planning to practice in another state, then you CAN transfer your license through reciprocity. You will need to VISIT your local State Dental Hygiene Board to find out more about the process. However, our research has determined ALL States require that the following criteria is met for you to be eligible to transfer you’re your license to another state:
1) The candidate has graduated from a dental hygiene school accredited by the Commission on Dental Accreditation (CODA) of the American Dental Association (ADA).
2) The candidate has successfully PASSED the National Board Dental Hygiene Examination
3) The candidate has successfully PASSED their Regional Dental Hygiene Clinical exam.
4) The candidate has practiced dental hygiene for a specific number of years lawfully. Please refer to your State Dental Hygienist Board for minimum years required.
5) The candidates CURRENT license is in good standing
6) The candidate MUST complete a Level II Background check completed by the Professional Background Information Service (PBIS). No Fingerprint Background Check is conducted when applying for Licensure by Credentials
If you are TRANSFERRING your license to another state, visit your local State Dental Hygiene Board to find out more about the process and requirements. Click here to find a list of Dental Hygiene Boards by State.
Here is a detailed CHART illustrating the various career path options available to you as a dental hygienist. CHART made available by adha.org.
The average annual dental hygienist salary is $78,637, with the average dental hygienist hourly pay being $38.10.
Figures are reflective as of April 2020 (Indeed.com)
Figures are reflective as of May 2019 (bls.gov)
Figures are reflective as of May 2019 (bls.gov)
Figures are reflective as of April 2020 (Indeed.com)
Figures are reflective as of April 2020 (Indeed.com)
Before applying and accepting an offer to a dental hygiene program, it’s imperative to ask yourself a few questions. We have listed the MOST common areas that you need to give some consideration. See below:
1) Is the program your applying to accredited by the Commission on Dental Accreditation (CODA)?
To become licensed in your state and be eligible to sit for the National Board Dental Hygiene Examination (NBDHE), you need to ensure that you have graduated from an accredited dental hygiene program. Only accredited programs meet all the CODA requirements and standards. Learn more about the accreditation procedure here. – https://www.ada.org/en/coda
So, when applying, make sure the dental hygiene college program is accredited by asking the admissions office
2) How long does it take to complete the dental hygienist program?
Some college programs will offer a full-time study option, and some will ONLY have a part-time study option. Obviously, a part-time study option will lengthen the complete process to graduate. So, be sure to clarify with the admissions office how long does it take to become a dental hygienist if you are going down the part-time route vs. the full-time. Hence, before applying to a program, you need to take into consideration your commitments and flexibility.
3) What is the COST of your dental hygiene program? What will be covered in the tuition?
These programs can be costly, so you need to consider your budget. However, remember this is a lifetime investment that may lead to many opportunities. Ask about student loan programs and other government lending options to help you. Also, don’t forget to ask what does the tuition cover, for example, books, examination fees, background checks, medical, etc.
4) Is there a waiting list to get into the program?
There is a high demand for dental hygienists, so it’s imperative to make sure if there is immediate availability for the dental hygienist program in your area. Some schools will have a waiting list for one or two years. This waiting period will delay your acceptance, graduation, and career. Hence, you may need to consider relocating or applying to another dental hygiene program where immediate availability is ensured.
5) What percentage of your graduates passed the National Board Dental Hygiene Examination (NBDHE) on their first sitting?
This is an area you should definitely research because it will give you an overall impression of the quality of the teaching provided by the college in preparing you for the NBDHE. A high first-time PASSING rate is indicative of high-quality education and teaching. So, make sure you do your comparisons across the different colleges you are applying to.
6) What resources do you provide students to excel in graduating from your dental hygiene and PASSING the NBDHE successfully?
When sitting down with the admissions office, it’s essential to found out what resources they will provide to you FREE of charge. For example, practice tests, study guides, flash notes, etc will be critical to consolidating your understanding and knowledge of the program material.