In all states dental hygienists must be licensed to practice. Specific dental hygiene licensure requirements vary from state to state. All states have three basic requirements: an educational requirement, a written examination requirement and a clinical examination requirement.

North Carolina requires that a hygienist must successfully complete an accredited dental hygiene program and receive a minimum of an Associate’s Degree in Dental Hygiene. Also, licensees must pass the written National Board Dental Hygiene Examination and the clinical Council of Interstate Testing Agencies, Inc (CITA) Examination.

During the final semester of their dental hygiene program, students take a computerized written test known as the National Board Dental Hygiene Examination (NBDHE). The purpose of the NBDHE is to assist state boards in determining qualifications of dental hygienists who seek licensure to practice dental hygiene. The examination assesses the ability to understand important information from basic biomedical, dental, and dental hygiene sciences and also the ability to apply such information in a problem-solving context. A passing score on the DHNBE ensures that each applicant for licensure has achieved the level of knowledge, skill and judgment necessary to practice in a safe and responsible manner.

Following graduation from an accredited dental hygiene program and receiving a passing score on the DHNBE, licensees must successfully complete the CITA – ADEX Dental Hygiene examination. The CITA – ADEX Dental Hygiene examination is based on specific performance criteria used to measure clinical competence.  This examination consists of two components.  They are a 100 question Computer Simulated Clinical Examination (CSCE), and a Patient Treatment Clinical Examination (PTCE), which is performed on patients.  Each component requires a passing score of 75% of greater.  Once candidates pass the CITA – ADEX exam, they have met the clinical examination requirement for licensure. Each individual state has additional requirements before issuing a dental hygiene license.

In North Carolina, candidates must also pass written online examinations administered by the North Carolina State Board of Dental Examiners in two subject areas: infection control/sterilization and North Carolina jurisprudence. Once licensees pass these examinations, they may apply for a license to practice dental hygiene in North Carolina.

More information concerning testing and licensure can be found at: