How to become a dental hygienist

Dental hygienist requirements at a glance

Every state requires dental hygienists to be licensed, and most require a degree from an accredited program plus written and clinical exams.^[ooh_hyg] The details (which clinical exam, extra courses, jurisprudence tests, fees) are set by each state board, so check your state before you enroll.

1. Finish high school and prerequisites. Most programs require college-level science and general-education courses before or during admission. The list differs by school, so read each program’s own requirements.
2. Complete a CODA-accredited dental hygiene program. There were 346 accredited dental hygiene programs in the United States as of mid-2025.^[coda_news] Graduating from an accredited program is an eligibility requirement for licensure.^{[adha_degrees]}
3. Pass the NBDHE. The National Board Dental Hygiene Examination has 350 multiple-choice items over about 9 hours, costs $600, and is passed at a scaled score of 75; it satisfies all or part of the written requirement in every state.^{[jcnde_nbdhe]}
4. Pass a clinical exam. Many states accept the ADEX dental hygiene exam from the American Board of Dental Examiners (formerly CDCA-WREB-CITA): a computer-simulated exam plus a manikin-based treatment exam, $1,150 plus a facility fee.^[adex_dh] Some states accept other regional exams.
5. Pass your state’s law exam and apply. Most boards add a jurisprudence or law and ethics test, fingerprints and CPR/BLS certification. See the state examples below.
6. Keep the license current. Licenses must be renewed, and continuing education is required.^[ooh_hyg]

Dental hygiene program options

A dental hygiene program can lead to an associate, bachelor’s or master’s degree, and the associate degree is the usual entry route: ADHA lists it as 2–3 years, the bachelor’s as 4 years or a 2+2 program, and the master’s as a two-year program.^{[adha_degrees]} BLS says programs usually take 3 years to complete.^[ooh_hyg]

ADEA’s averages are total in-state tuition and fees for the whole program; ADEA does not state the data year, so treat them as a guide and use each school’s published cost of attendance.^{[adea_dh_cost]} For a breakdown by program type see dental hygiene school cost, and for timelines see how long is dental hygienist school.

Dental hygienist license: three state examples

State license rules differ more than most students expect. Three of the largest states show the range:

Sources for each requirement are on the state pages.^{[dhbc_wreb][tac_103_1][fs_466_007]}

Is becoming a dental hygienist worth it?

For many people the numbers work: the median dental hygienist salary is $98,100, about $50,030 more than the dental assistant median, and BLS projects 8% job growth from 2025 to 2035 with about 15,000 openings a year.^{[oews_hyg][oews_asst][ooh_hyg]} With the default inputs above (an assistant earning the median who gives up $24,000 a year of pay for two years, borrows the full ADEA average tuition at 6% and becomes a hygienist at the median), the credential pays for itself in about 2.0 years after graduation.

The calculator cannot see your local market. Compare the dental hygienist salary in your state, check whether nearby programs have waiting lists, and remember that many hygienists work part time: the hourly pay page converts any schedule to a yearly figure. If you are deciding between careers, the hygienist vs assistant comparison lays out training and pay side by side.