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The Issues

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."

licensure map

Click the map to access each state's licensing board.


Licensure Requirements

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 the ability to practice in another state). Although specifics vary, all states have three requirements:

  1. Educational
    All states’ educational requirements are satisfied by graduation from a dental school accredited by the ADA Commission on Dental Accreditation.
  2. Written
    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.
  3. Clinical
    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 Delaware administers their own clinical exam. The remaining boards contract that responsibility to one of the five regional testing agencies: 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.

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 candidate's 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.

Potential Alternatives to the Current Licensure Process

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 (OSCE) 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.)  

Help Educate Your Members About Licensure

ASDA’s 2013-14 Council on Education & Licensure developed a presentation to educate members about an important topic often left out of dental school curriculum: how to get your dental license. “A Guide to Getting Your Dental License” features commentary by Dr. Adam Shisler, 2011-12 ASDA president, and walks the viewer through the following:

  • The purpose of requiring dental licenses and understanding the entities that regulate them
  • An overview of the licensure process, including the National Board Dental Exams and the regional exams
  • Alternative pathways for obtaining a dental license
  • The specifics for applying for a license
  • ASDA’s stance on licensure
  • The ethical considerations when preparing for your licensure process
  • The evolution of the dental licensing process

Licensure Resources

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