I hope this blog will serve as a guide to US dental license for foreign trained dentists wishing to practice dentistry in USA. Here you will find information about NBDE, WREB, international programs, etc. The information is mostly derived from my own experiences, as well as, several other sources that I will try to gather in one place, here.
Being a California dental school graduate myself and a former California Dental Association Student Representative, I wanted to talk today about the licensing process in California. Generally speaking, a foreign trained dentist, or for that matter anybody else, can obtain a license to practice dentistry in California by successfully completing one of the following scenarios:
1.California Board Examinations:
a.The Restorative Technique examination: is for all persons who:
i.Have been issued a dental degree by a foreign dental school not approved by the Board or accredited by a body that has a reciprocal accreditation agreement with a commission or accreditation organization (for practical purposes, this includes almost all foreign trained dentists), and
iii.Individuals must have submitted evidence of passing Parts I & II of the NBDE to the Board by July 12, 2004 to be eligible to sit for the RT Examination.
This is why if you are new here, or have not applied by July 12, 2004, it’s really too late to pursue this option, which is due to sunset by the end of this year. But if you were one of the few who met the requirement and passed the Restorative Technique examination then you may take either the California clinical examination or the Western Regional Examining Board (WREB) examination.
b.The Clinical examination: if for all persons who :
i.Successfully completed the Restorative Technique examination (above) or
ii.Graduates of schools accredited by the American Dental Association Commission on Dental Accreditation.
Although this examination is referred to as the “Clinical” examination, it does have both written and clinical components which will test you on the following subjects: Endodontics, Removable Prosthodontics Evaluation, Periodontics, Class II Amalgam Restoration, Class III or IV Composite Resin Restoration, Simulated Fixed Prosthetics, California Laws and Ethics.
Specific information about the clinical examination can be found in the handbook .
Total fee for the examination is $601, and re-examination fee $525
2. Application to the Dental Board of California for licensure after successful completion of the WREB examination (After January 1, 2005), this is what most applicants seek these days, since passing the WREB examination meets the clinical examination requirement of license in many more States while the California Board examination is only for license in California. In addition to passing the WREB examination, the board also requires satisfactory evidence of having graduated from a dental school approved by the board, having passed parts I and II of the National Board Examinations. Other requirements and conditions also apply, more information can be found here.
3. Application for Licensure by Credential – This would only apply to dentists with a “clear and valid” dental license in another US state.
4. Application for Licensure by Residency – This is one of the new and exciting options to obtain dental license. On February 1, 2008 the Office of Administrative Law approved the Board’s Emergency regulations implementing SB 683, qualification for dental license on the basis of completion of a minimum of 12 months of a general practice residency or advanced education in general dentistry program approved by the ADA’s Commission on Dental Accreditation (CODA). This is in lieu of having to sit for the California Clinical examination or the WREB examination. You should be a graduate of an ADA or board approved dental program, completed a CODA-approved GPR or AEGD, passed parts I & II of the NBDE, not failed the WREB clinical examination within the last five years, other conditions and requirements must be met also, more information can be found here.
When it comes to license requirements or application to international or advanced standing programs for foreign trained dentists, NBDE is by far considered the common denominator and the first step in this long process. Since NBDE is such an important step and because it should be among the very first ones on your list I thought I'll talk about NBDE first.
As of now the NBDE exam consists of two parts and it's administered by the ADA Joint Commission on National Dental Examinations (JCNDE). Part I of NBDE covers most aspects of the biomedical sciences while part II deals mostly with clinical dentistry issues.
NBDE Part I
It's extremely important that you carefully read and review the NBDE Part I Candidate Guide, you can download a copy of the guide here. The fee for the NBDE exam is $260. The following eligibility requirements for taking the NBDE exam apply to international dental graduates or foreign trained dentists, these requirements were adapted from the NBDE candidate guide (2008):
You must submit an examination application and fee to: The Joint Commission on National Dental Examinations 211 East Chicago Avenue, Suite 600 Chicago, Illinois 60611-2678
You can also use the online application, which is available here
You must have your official dental school course transcripts verified by: Educational Credential Evaluators, Inc. P.O. Box 514070 Milwaukee, Wisconsin 53202-3470 414-289-3400 http://www.ece.org/ You must contact Educational Credential Evaluators, Inc. (ECE) and request an ECE application form. The ECE form will describe what educational credentials are required and how to submit them to ECE. Fees for ECE services will also be listed ($85 at the time this blog is published). You should indicate that a General Report should be sent directly to the Joint Commission on National Dental Examinations. It takes approximately four weeks for ECE to evaluate credentials.
Educational Credential Evaluators, Inc. will send the ECE General Evaluation Report directly to a) you and b) the Joint Commission on National Dental Examinations (if it was requested by you on the ECE application).
The Joint Commission will hold the NBDE examination application, but will not process it before the ECE Evaluation Report is received. The ECE report must be received in the Joint Commission office by the application deadline.
Your name on the ECE report must match the name on the application. Any name changes must be accompanied by legal documentation.
There are other important information listed in the NBDE guide, again you should familiarize yourself with this guide and read it a couple of times.
Most schools require foreign trained dentists to take NBDE part I and they do assign a certain weight in their acceptance decision on your score on that exam, some may also require part II.
The NBDE exam is administered only at Prometric test centers in the US and Canada, once you register you will receive information directing you on how to register for a certain date. At one point in time (when I took the test), the test was paper-based only, gosh, I feel so old!
According to the official candidate guide, the NBDE could take up to 7 hours, divided into 3.5 hours segments, 200 questions each, with an optional one hour break.
Part II
Again, your first step is to become familiar with everything listed in the NBDE Part II Candidate Guide which you can download here. The examination fee for part II is $340. You do not need a new ECE report if you have already taken care of this during Part I.
Part II is also computer-based, administered in Prometric, you can submit a paper application, or register online here. Many other regulations and procedures are similar to Part I. The only difference is the scope of the exam, NBDE Part II tackles the different dental specialties, patient management, and pharmacology.
The exam is administered in two days, day one consists of two 3.5 hours segments, 200 questions each, of discipline-based questions. Day two consists of 100 case-based questions. You will be given several cases with 10-15 questions each.
Preparation for the NBDE Exam:
Obviously, a strong and solid background is needed before you tackle any of these exams, being a foreign trained dentist gives you at least a theoretical advantage because chances are that you are familiar with at least some of the subject covered in the NBDE exam, that should be derived from your text books and lecture notes, that was certainly my case, but you may want to also supplement your preparation efforts with other educational aids, I've used some of the following, but not all, so I can't attest to how effective they are, but I know that the following teaching aids are being used by many foreign trained dentists and other international students in lots of different ways:
Released national board dental exams from previous years, can be a great resource, the more recent, the better, they can serve to familiarize you with the format of the exam, and you can use them to test yourself and your preparation, don't count too much on seeing the same questions though in your exam. You can purchase those directly from the American Student Dental Association. I encourage you to become a member of ASDA, foreign-trained dentists or international dental graduates who are not yet enrolled in a US dental school can join at the associate level, the dues are $53 and you get decent discounts on reprints of the released NBDE exams.
First Aid for the NBDE Part I (First Aid) and First Aid for the NBDE Part II are both useful guides published by McGraw-Hill , with lots of good reviews, written by students who aced the National Dental Board Exams and reviewed by top dental school faculty and practitioners, include hundreds of high-yield facts and mnemonics to maximize study time, and test-taking strategies and advice.
Dental Decks: a flash card-based educational tool, could be very useful if you like that style of learning, you can check them out here. They can be somewhat pricey, so you may want to shop for them at other outlets or on eBay.
Kaplanprovides several resources to prepare for the NBDE exam, they offer prep courses for both parts at their centers, those could be expensive, but may work well for you if you need a strong classroom-like refresher of your information. They also offer online programs which are basically question-banks with or without lecture notes. They vary in prices depending on how long you will use the service, more like a subscription-based system.
The Student Doctor Network Forums provide a wealth of information about the NBDE and other issues relevant to foreign trained dentists or international dental graduates
The NEW NBDE:
Effective January 2010 the JCNDE will start reporting performance in the NBDE exams as pass or fail only, and possibly administer a new version of this exam that basically combines both parts into one exam that is for the most part composed of clinical cases-specific questions.
There are couple of interesting issues that will arise because of this change, and those are mainly related to international dental graduates (foreign trained dentists). You see up until now we only needed to take part I and use that score to apply to schools that used to look at the score and make their acceptance vs. rejection based on that score and many other criteria. When the new exam is rolled, this will be impossible, since you need to be enrolled in a dental school before being allowed to take the exam, as you can see, the new format can't be used as an admission requirements since you can't even take the exam before being already accepted into school, and because standard scores cannot be reported anymore.
What could make this even more complicated is the fact that with the new format schools may feel obliged to add more biomedical sciences courses to the curriculum of the international programs to make sure their students are adequately prepared to pass the NBDE in its new comprehensive format, this could very well mean longer programs (more than two years), and higher tuition. So, if you are reading this now, and you're still thinking, my advice to you is to go ahead and take part I and secure that important step toward obtaining your license to practice dentistry here.
I will try to do my best to explain several things related to obtaining license to practice dentistry in the United States for foreign trained dentists, this information should be useful one way or another to dentists who received their dental degrees from countries other than the US and want to be able to work as dentists in the US.
It's important to know that although I'm spending lots of time and effort compiling all of this, I can't guarantee the accuracy of all of the information listed here. It's always prudent to confirm this information and data with licensure authorities (state dental boards) in the state(s) you are considering to work in as they should have the most updated information. License requirements keep changing all the time making it even more important to get the most up-to-date information from the source directly.
The process of obtaining a license to practice dentistry in the US for international graduates or foreign trained dentists can be simply summarized in few steps (these steps represent an over-simplification, but should be useful as a basis):
Find out specific licensure requirements for the state or states you are considering to practice dentistry in, you can use this blog to find most of that information, but you have to always go back to the specific state dental board for the most up-to-date information.
Take at least the part I of the National Board Dental Examination (NBDE), you may elect to take part II too as some schools require that as part of their application process, more information about this exam will follow, including some of the changes that will affect this exam in the near future.
Apply to and get accepted in a two-year program at an accredited US dental school. You should select programs that grant a degree not a certificate as most dental state boards require a degree (DDS or DMD), I will try to go through most if not all the programs available out there and compare them.
Take a clinical license exam or apply to a post-grad program (depends on specific state).
Apply for license.
Since this is purely volunteer work done on my own free time, bare with me please if you can't find the information you are looking for right away, I will keep adding more info as time permits.
Good luck in your pursuit.
and 
are both useful guides published by McGraw-Hill , with lots of good reviews, written by students who aced the National Dental Board Exams and reviewed by top dental school faculty and practitioners, include hundreds of high-yield facts and mnemonics to maximize study time, and test-taking strategies and advice.
and 
. They also have very good reviews.
: seems like a nice way to "simulate" the national board dental exams, both parts I and II. It's a computer software that you download. They have several packages to chose from.