Dental training in USA

Written and presented by:
Mohamed Elsafi, DDS, MS, FACP (Fellow of the American College of Prosthodontists)
Maxillofacial Prosthodontist
Assistant Professor of Otolaryngology- Head and Neck Surgery Dentistry Section
Washington University- School of Medicine, St.Louis, MO

Internationally trained dentists once in the U.S. have 5 different pathways into dental practice:

A.  Practice as a General Dentist in one of the U.S. states

A license in that state is needed before a dentist could practice dentistry. Licensure is a function of individual state governments. Licensure requirements vary from state to state. Each state board of dentistry has the most up-to-date information about licensure requirements

Step-By Step to State Licensure for International Dental Graduates:

Internationally trained dentists who wish to obtain a state dental license in the U.S. must meet three main requirements;

  1. Graduation from a dental education program accredited by the Commission on Dental Accreditation (CODA),
  2. successful completion of the computer-based National Board Dental Examinations Parts (NBDE) I and II
  3. successful completion of a clinical examination administered by a state or regional testing agency.

Graduates of programs that are not accredited by the CODA may be able to fulfill the educational requirement without repeating an entire accredited dental education program. Opportunities exist in some accredited dental programs for appropriately qualified individuals to be admitted with advanced standing—usually this means the applicant is accepted at the end of the second year and then completes the program with the other students. Most programs grant a dental degree at the end of the program; a few grant a certificate of completion.

(Caution: The certificate of completion may meet the licensure requirement only in the state where the program is located). The purpose of the additional education requirement is to prepare individuals from other countries for dental practice in the U.S. health care delivery system, including dental insurance and third party payers, regulation of dental practice by state boards and infection control requirements.

Most states require supplementary education of two to four years at the pre-doctoral level, however, a limited number of states will accept advanced education, such as a general practice residency (GPR), an advanced education in general dentistry (AEGD) program or a dental specialty residency. For state-by-state information on educational requirements see “Summary of State Educational Requirements for International Dentists.” at: http://www.ada.org/sections/educationAndCareers/pdfs/licensure_state_requirements_intl.pdf

It is very important to know the requirements in the state where you wish to become licensed prior to applying to an educational program to make sure it will meet the educational requirement.

National Board of Dentistry Examination (NBDE)

For information about the NBDE, go to http://www.ada.org/110.aspx . The clinical examination requirement varies from state to state; please contact the state board of dentistry where you wish to become licensed for information about which examination(s) is accepted by that state (www.dentalboards.org ). It is important to verify which clinical licensing examinations are accepted by the state board before taking an exam.

State Licensure Requirements

Each state has its own licensure requirements and application process. State licensure requirements are subject to change; you must contact the state boards of dentistry directly for information about licensure requirements. For contact information for the state boards of dentistry go to www.dentalboards.org and select “State Boards”.

Following is a brief summary of the steps involved for internationally-trained dentists to become licensed.

  1. Determine the state(s) where you wish to obtain a license and contact the state board(s) of dentistry (www.dentalboards.org) to obtain specific licensure requirements and a sample application. Some state board web sites have online licensure applications.
  2. Pass the NBDE Part I administered by the ADA Joint Commission on National Dental Examinations (JCNDE). In order to qualify for licensure, nearly all states require internationally trained dentists to complete additional education in a dental education program that is accredited by the ADA CODA and earn a DDS or DMD degree. The NBDE Part I is a requirement for acceptance into a dental education program, as well as for state licensure. Some programs may also require successful completion of NBDE Part II. As part of the application process for the NBDE, you will be required to have your credentials evaluated by the Educational Credentials Evaluators, Inc. (ECE) to determine your eligibility for the examinations. Contact the ECE (1-414-289-3400; www.ece.org ) or the ADA (1-800-232-1694; http://www.ada.org/110.aspx ) for more information.
  3. Apply to an accredited dental education program with advanced standing to earn a DDS or DMD degree, or to a supplemental or qualifying program that grants a certificate of completion. Some schools offer an International Dentist Program (IDP), which is a separate program and different from one with an advanced standing component. Most IDPs also grant a DDS or DMD, but a few offer a certificate of completion, which may not be recognized by all licensing jurisdictions for the purposes of licensure.
  4. Following the completion of the educational program, take the NBDE Part II.
  5. Pass a clinical licensing examination administered by a state or regional clinical testing agency accepted in the state where you wish to be licensed. The clinical examination requirement varies from state to state; please contact the state board of dentistry where you wish to become licensed for information about which examination(s) is accepted by that state. (www.dentaboards.org).
  6. Request an application from the state board of dentistry where you wish to become licensed. Carefully review the application and identify and complete any additional requirements. For example, complete a course or test on the state dental practice act and show proof of malpractice insurance.
  7. Send the completed application to the appropriate state dental board.

Most states require that graduates of international dental programs obtain additional general dentistry education at the pre-doctoral level and receive a DDS or DMD degree. A few states will accept completion of an advanced dental education program in a specialty or general dentistry instead of the pre-doctoral education. Information about states where international graduates may be eligible for licensure after completing advanced dental education programs can be viewed at:

http://www.ada.org/sections/educationAndCareers/pdfs/licensure_state_requirements_intl.pdf

What does this mean?

This means that you do NOT need to do the advanced standing (the two-year program) to get a license. You can do a specialty program and once you finish that program then you can get a license in one of several states.

In addition, Minnesota law allows internationally-educated dental graduates to apply for Minnesota licensure without additional education. There are no formal rules for the request for licensure process. The State Board will review application materials on a case-by-case basis. Graduates of non-accredited dental programs, who pass the clinical licensure examination and meet all other requirements, may obtain a three-year “limited general dentist license” permitting them to practice under general supervision pursuant to a written agreement with a Minnesota-licensed dentist. At the conclusion of three years, the board will grant an unlimited license without further restrictions if all supervising dentists who had entered into an agreement with the limited licensee recommend unlimited licensure and if no corrective or disciplinary actions have been taken by the Board against the limited licensee.

B. Join a specialty program

There are specialty programs that will consider admitting graduates of international dental schools. Please note this information is subject to change. Contact the school directly for the most accurate information

Advanced education programs are beyond the pre-doctoral education level and are intended to provide advanced training in general dentistry and in the nine ADA-recognized dental specialties (dental public health, endodontics, orthodontics, oral and maxillofacial pathology, oral and maxillofacial radiology, oral and maxillofacial surgery, pediatric dentistry, periodontics and prosthodontics).

Advanced Dental Education Opportunities for International Dental Graduates

http://www.ada.org/sections/educationAndCareers/pdfs/licensure_adv_edu_opp_intl_graduates.pdf

C. Enrol in Advanced dental education programs in the biomedical sciences and areas of dental practice that are not recognized dental specialties

These may include anatomy, anesthesiology, biochemistry, dental materials, immunology, implantology, microbiology, operative dentistry, oral biology, oral medicine, pharmacology and physiology. Depending on the program, advanced dental education programs may grant a certificate, a Master’s degree or a PhD degree. Some programs offer options to earn both a certificate and Master’s Degree. These programs may not meet states’ educational requirements for dental licensure.

D. Practice as a hygienist

The state of Florida currently grants eligibility for the clinical dental hygiene examination to international dental graduates who have taken and passed the National Board Dental Hygiene Examination (NBDHE). If the international dentist successfully completes the written NBDHE and the Florida clinical examinations, he/she is eligible to apply for a Florida dental hygiene license.

E. Other employment opportunities

International dentists who have not obtained a U.S. dental license may find opportunities for employment in dental industry or dental education. Examples include dental manufacturing, dental supply or pharmaceutical companies, teaching or university-based research. Positions in dental assisting and dental laboratory technology may also be available.

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