Licensure is the process whereby a state grants dentists the legal authority to practice dentistry. The current system of licensure exams has been controversial. According to the American Dental Education Association, "ethical and practical questions about the use of human subjects, regional variations in examinations and results, and the reliability and validity of the exams have been some of the sources of concern."
Click the map to access each state's licensing board.
Each state sets its own licensure requirements (use this state map to navigate). There is no universal licensure exam (i.e. getting licensed in your state doesn't guarantee ability to practice in another state). Although specifics vary, all states have three requirements:
All states’ educational requirements are satisfied by graduation from a dental school accredited by the ADA Commission on Dental Accreditation.
All licensing boards use the National Board Dental Examinations to satisfy a major portion of their written exam requirements. The National Board Examination Parts I and II are developed and administered by the ADA’s Joint Commission on National Dental Examinations. The actual exams are conducted by regional or state examining boards.
Clinical exam requirements vary. Most candidates who do not achieve licensure on their first attempt fail in some aspect of the clinical exam. Currently, only two jurisdictions administer their own clinical exams (Delaware and Virgin Islands). The remaining boards contract that responsibility to one of the five regional testing agencies: Council of Interstate Testing Agencies (CITA), Central Regional Testing Service (CRDTS), Southern Regional Testing Agency (SRTA), North East Regional Board of Dental Examiners (NERB) and Western Regional Examining Board (WREB)
. States accept results of examinations administered by one or more testing
agencies of which they are not a member. Review the licensure laws and regulations from the individual state board websites for real-time information about which exams are accepted where licensure is sought. A summary is available on the ADA's website.
Licensure for International Students
Many dentists and dental students educated outside the United States and Canada wish to obtain a dental license to practice in the U.S. To become licensed to do so, internationally-trained dentists must follow different steps. Read more on ASDA's "Tips for International Dental Students" webpage. The ADA also has resources for international dentists.
ASDA Policy on Licensure (L-1)
ASDA believes that any clinical licensing examination intended to measure technical skill via a sequence of independent clinical tasks should:
- Be a non-patient based examination emphasizing the recognition, diagnosis and treatment planning of disease, in conjunction with the treatment of simulated disease by use of a typodont.
- Be administered in the final year of dental school.
- Provide opportunities for remediation, at the candidates‘ dental school, prior to graduation.
- Guarantee anonymity of candidates and examiners.
- Be administered by examiners who have been calibrated to provide standardized and consistent scoring.
- Not include a written examination that duplicates the content of the National Dental Board Examination Parts I or II.
- Be offered to candidates at the lowest reasonable cost possible.
- Be universally accepted by all state boards of dentistry.
- Be psychometrically sound.
While ASDA supports continual improvement of existing examinations and collaborative development of a new examination, the association believes the following alternatives are preferable to the current licensure process:
- Initial licensure without an independent clinical licensing examination. Graduates of a U.S. CODA-accredited dental school should be eligible for initial licensure without taking any additional clinical examination.
- A portfolio-type clinical examination based on cases compiled during the final year of dental school. Such an examination should require a standardized catalog of required clinical procedures and the portfolio should be evaluated by an examiner independent of the dental school. (Currently under development in California.)
- A non-traditional patient based clinical licensure examination. Although ASDA does not support the use of live patients in traditional clinical licensing examinations, the association recognizes the potential for creation of an ethical, patient-based examination.
- An Objective Structured Clinical Examination designed to evaluate a candidate’s diagnostic and treatment planning skills. (Currently accepted in Minnesota.)
- Completion of a one-year postgraduate residency program. Completion of a U.S. CODA-accredited postgraduate program that has a minimum duration of one year should be sufficient to substitute for the clinical licensure examination requirement in any jurisdiction. (Currently mandated in New York; accepted in Washington, Minnesota, California and Connecticut.)
ASDA’s Goals for Licensure
- The creation and acceptance of one content-uniform clinical licensure examination that is valid, reliable, anonymous and fair
- Substitution of successful completion of the National Board Dental Examination Part II for all written examinations covering clinical topics
- Eliminating the use of live human subjects
- Creation of dental school-based remediation programs for candidates who fail
- Reduction and control of costs associated with dental licensure examination for all parties involved