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Licensure Pathways

State dental boards may accept some or all of the following as evidence of clinical competence for a dental license.  

Traditional Clinical Examination:  A clinical examination administered by a testing agency or individual state (Delaware only).  The five U.S. testing agencies are:  the Central Regional Dental Testing Service (CRDTS), Council of Interstate Testing Agencies, Inc. (CITA), the Commission on Dental Competency Assessments (CDCA) [formerly the North East Regional Board of Dental Examiners, Inc./NERB], Southern Regional Testing Agency (SRTA), and Western Regional Examining Board (WREB).  Two of the testing agencies (CDCA and CITA) administer the ADEX examination, which is developed by the American Dental Board of Dental Examiners, Inc.  For more information go to the individual agency websites:;;;; or

Curriculum Integrated Format (CIF) Type Examination:  CIF is an alternative to the traditional single sitting format of an initial clinical licensure examination.  The CIF option is offered by CRDTS, CITA, CDCA and SRTA.  The CIF format allows dental students to be examined in sections, during the fourth year of dental school, instead of taking all parts at the very end of senior year. With the CIF, the manikin-based examinations are administered late in the junior year or early in the senior year, and the clinical patient-based examinations are administered during the senior year. Candidate scores are reported to students while they are in school; when necessary, students can seek remediation. Depending on the examination agencies’ published policies, students are permitted to retake the manikin examinations and the patient-based examinations prior to graduation.

Post-Graduate Year Residency (PGY1):  PGY1 is completion of a residency program at least one year in length in an accredited postdoctoral program in lieu of the clinical licensure examination as a pathway to licensure.  The PGY-1 is mandated by Delaware and New York.  PGY1 is an optional pathway to licensure in Minnesota, California, Colorado and Ohio.  Washington accepts completion of a PGY1 if completed in that state in certain settings.

Canadian Clinical Examination—Objective Structured Clinical Examination (OSCE):  The OSCE clinical examination for all Canadian dentists is administered by the National Dental Examining Board of Canada.  The OSCE is a station-type exam where candidates answer higher-order problem-solving questions based on models, radiographs, casts and case histories.   To learn more about the OSCE exam, visit the National Dental Examining Board of Canada website.  The Minnesota Board of Dentistry accepts OSCE results from University of Minnesota graduates only for initial licensure.
California Portfolio Examination:  In 2007, as a result of a legislative directive, the Dental Board of California began creating a portfolio examination pathway for initial licensure, in collaboration with the six dental schools and the California Dental Association.  Regulations for the portfolio examination became effective in November 2014. The portfolio examination relies on the student evaluation mechanisms currently applied by the dental schools to assess competence.  Performance is measured during competency evaluations conducted in the schools by calibrated examiners who are members of the dental school faculty.  The dental board regularly audits the examinations.  For more information go to (search: portfolio).

ADA Policies:  ADA policy statements on dental licensure may be found in Current Policies on