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National Board Dental Hygiene Examination 2021 guideline updates

Jan. 26, 2021
Make the most of your time studying! Read on for notable changes to the dental hygiene board exam this year.

On January 1st, 2021, one of the first things I did was check the National Board Dental Hygiene Examination (NBDHE) guidelines. The following highlights changes the candidate guide that are most important for you to know if you are taking the National Board Dental Hygiene Examination (NBDHE) in year 2021.

1. AAP classifications: master both the old and new sets of guidelines. 

This is directly from the candidate guide: “The new classifications will be implemented in the fall of 2021 for the NBDHE. During the transition period, it is recommended that individuals become knowledgeable with both sets of classifications.”

If you are studying with the new classification only, please take the time to review the older classification system as well.

To determine which system the question is referring to, look at the answer choices. For example, If the question asks which Case Type (0, I, II, III, IV, V) you would assign to a patient, it refers to the 1999 system. If the question asks which Stage/Grade you would assign to a patient, it refers to the 2018 system.

2. “First statement is _________, the second statement is __________” questions are not included in the updated guide.

If you scroll to page 11 of the 2021 NBDHE Candidate Guide, you will see that there are only three question formats currently being used for the examination.

  • Completion (e.g., The patient who has vitiligo will show areas of skin _____.)
  • Question (e.g., The patient reports to have bulimia nervosa. What advice can the clinician provide to help the patient’s oral home care?)
  • Negative (e.g., Each of the following bacteria are related to periodontitis EXCEPT one. which is the EXCEPTION?)

As you can see, the “first statement is true, second statement is false” type questions have disappeared!

3. There are experimental questions that are not scored.

On page 13 of the 2021 NBDHE Candidate Guide, you can find this statement: “Some questions on the examination are experimental and are not scored.”

With that said, the best you can do is to pretend that every question will count towards your score and continue to conquer each question. Don’t let a question format that wasn’t included in the three mentioned above throw you off!

4. Each question has 3-5 answer choices.

A lot of students assume that a question will only have 4 answer choices, so I wanted to point this out. The fact that a question can have 3-5 answer choices probably won’t change the way you perform, but I thought it was important to discuss this so you do not suddenly wonder if your computer at the test center is not functioning properly.

5. Be sure to review the short-format question count and schedule.

The number of questions for the test specifications, found on pages 5-7 of the 2021 NBDHE Candidate Guide, has changed during the COVID-19 pandemic. The discipline-based component will consist of 85 questions (1 hour 30 minutes) and the case based component will consist of 70 items (1 hour 50 minutes).

The schedule can be found on page 17 of the 2021 NBDHE Candidate Guide. Although the break is only 15 minutes, take this time to stretch and get your blood flowing before sitting back down!

Please be advised that the NBDHE will return to its standard format, we just don’t know when that will be! Stay tuned for updates!

A word of caution

Continue practicing with the “first statement is true; second statement is false” question format! Wait, you might think “didn't you just tell me that those questions are gone?!” And yes, those have disappeared from the student guide, but I would still advise you to practice those. There may be some residual questions and you want to practice for every scenario you can imagine.


Taking the NBDHE can be a stressful situation at the best of times, let alone during COVID-19. At StudentRDH, we strive to provide you with the most up-to-date information about the examination, keep you posted on the question formats to the best of our ability, and provide relevant content that will help you be successful!

Don’t forget, even if your classmates may feel as if they were more challenged on certain topics, know that every student is presented with a different set of questions. Therefore, your experience and your classmates’ experiences can and will be very different. Always assume that you will have to master every single topic you have studied at school. Trust your own judgement about what you should study, or what your weaknesses are and spend your time reviewing accordingly.

After the exam, take a deep breath because you did it!

Sending you all of the positive energy and intentions we have,

Claire Jeong, MS, RDH, is an entrepreneur, author, educator, researcher, and international speaker. She is the founder of StudentRDH dental hygiene exam prep solutions and DentalToaster CE platform. Claire is the 2019 Ontario Memory Champion. With her expert knowledge in education, she created the WakeUp Memory system, which teaches how to use the brain and remember anything. She is the Esther Wilkins Alumni Award recipient, recognized for her work to support young dental hygiene professionals. Lastly, Claire is on the editorial board of RDH magazine and on the advisory board to dental hygiene schools. Email her at [email protected].

Amanda Mitchell, MA, BAS, RDH, is a professor of dental hygiene and teaches preclinical sciences, advanced clinical sciences, and a variety of didactic courses. Amanda enjoys her time in the clinical and classroom settings with her students and has launched her own board review tutoring business. She has been a CE speaker and author for major companies in the dental industry and enjoys applying the newest research in her approaches. Amanda is currently an active member in the Dallas Dental Hygienists’ Association serving as a delegate, trustee, and on multiple committees.