CANDIDATE MANUAL
American Board of Dental Examiners
(ADEX) Dental Hygiene Examination
2016
(rev.)
American Board of Dental Examiners, Inc.
Approved by:
American Board of Dental Examiners, Inc.
Administered by:
The Commission on Dental Competency Assessments
(NERB is now the CDCA)
1304 Concourse Drive, Suite 100
Linthicum, MD 21090
www.cdcaexams.org
Copyright © 2016 American Board of Dental Examiners
Copyright © 2016 The Commission on Dental Competency Assessments
ATTENTION DENTAL HYGIENE CANDIDATES
The ADEX Dental Hygiene Examination is administered on behalf of a number of state
dental boards and in accordance with state licensing requirements. This examination should
be valid in any state accepting the ADEX Dental Hygiene Examination. However, to be
certain, candidates should check with the state dental board of any state in which
they wish to be licensed to determine whether this examination will qualify them for
licensure in that state.
Currently two testing agencies administer the ADEX Dental Hygiene Examination. This
Manual is published by The Commission on Dental Competency Assessments (CDCA).
Criteria, content, basic administration, and scoring systems are uniform. There are
administrative elements that are unique to each agency. Therefore, candidates must
obtain and thoroughly read the Manual published by the agency that will be administering
the examination at the date and site the candidate selects.
For information about examination sites, dates, and fees, visit the CDCA website:
www.cdcaexams.org.
Occasionally examinations are interrupted or postponed because of severe weather, power
outages, or other extraordinary occurrences. T h e CDCA reserves the right in their sole
discretion, to delay, halt, postpone, or cancel an examination because of unforeseen and
serious events.
Please read this Manual in detail prior to attending the clinical examination, and
have it with you during the orientation and examination.
Please retain this Manual for future reference.
CONTENTS
INTRODUCTION...................................................................................................... 1
About the American Board of Dental Examiners, Inc. (ADEX) ........................................... 1
ADEX Mission Statement ............................................................................................. 1
Purpose of the Examination ......................................................................................... 1
About the ADEX Dental Hygiene Examination – 2016 ...................................................... 1
ADEX Status .............................................................................................................. 2
The Candidate Manual ................................................................................................ 2
The ADEX Examination Development ............................................................................ 2
Three Time Examination Policy..................................................................................... 3
CLINICAL EXAMINATION........................................................................................ 4
Judgment Skills.......................................................................................................... 4
Patient selection and eligibility ................................................................................. 4
Case selection ........................................................................................................ 5
Calculus requirements............................................................................................. 6
Radiographs .......................................................................................................... 8
Clinical Skills ....................................................................................................... 10
Instruments ........................................................................................................ 10
Calculus Detection .............................................................................................. 11
Calculus Removal ................................................................................................ 13
Periodontal assessment......................................................................................... 13
Tissue management ............................................................................................. 14
Minor tissue trauma.............................................................................................................................................14
Major tissue trauma .............................................................................................................................................14
Final case presentation ......................................................................................... 15
Infection Control ...................................................................................................... 15
Table of Evaluation Criteria........................................................................................ 16
POINT SYSTEM ..................................................................................................... 17
COMPUTER SIMULATED CLINICAL EXAMINATION (CSCE) ..................................... 19
Content................................................................................................................... 19
Standards for the CSCE ............................................................................................ 19
Disciplines and Subject Matter Addressed in the CSCE ................................................. 1
SUPPLEMENTAL TESTING AGENCY INFORMATION ............................................... 21
GLOSSARY ............................................................................................................ 22
INTRODUCTION
American Board of Dental
Examiners, Inc.
party assessment of the judgment and
clinical skills of candidates applying for
dental hygiene licensure. This examination
will identify areas of deficiency or
weakness within skill sets allowing
candidates the opportunity for
remediation.
The American Board of Dental Examiners,
Inc. (ADEX) is a private not-for-profit
consortium of state and regional dental
boards throughout the United States and
some international jurisdictions. The ADEX
provides for the ongoing development of a
series of common national dental and
dental hygiene licensing examinations.
These exams are uniformly administered
by individual state or regional testing
agencies on behalf of participating and
licensing jurisdictions. The Commission on
Dental Competency Assessments (CDCA)
is a member of the ADEX and have
adopted the ADEX Dental and Dental
Hygiene Examinations.
ADEX Dental Hygiene
Examination – 2016
The ADEX Dental Hygiene Examination is
the examination approved by the ADEX
and administered by The Commission on
Dental Competency Assessments (CDCA).
The ADEX Dental Hygiene Examination
consists of two components – the
Computer Simulated Clinical Examination
(CSCE) and the Patient Treatment Clinical
Examination (PTCE) performed on
patients. The examination is used to assist
licensing jurisdictions in making decisions
concerning the licensure of dental
hygienists. The examination for 2016
consists of judgment skills and clinical
skills and evaluated as follows.
ADEX Mission Statement
To develop clinical licensure examinations
for dental professionals.
ADEX’s mission is further to develop
examinations that:
1. are professionally relevant,
defensible and psychometrically
sound.
2. identify deficiencies early in the
candidate’s training to allow for
safe and thorough remediation
within his/her educational setting.
3. are fair and effectively measure
candidates skills in order to verify
minimal competency and thus
protect the public.
Computer Simulated Clinical
Examination (CSCE)
• Clinically based questions presented
on a computer
• 100 graded questions
• Passing score of 75 or greater
Patient Treatment Clinical
Examination (PTCE) Performed on a
patient
• Judgment skills
• Clinical skills
• Passing score of 75 or greater
Purpose of the Examination
The purpose of the ADEX Dental Hygiene
Examination is to provide state dental
boards with a uniform, accurate, third
1
The examination is based on specific
performance criteria used to measure
clinical competence. In this Manual ADEX
provides the candidate with the criteria,
content and scoring for the ADEX Dental
Hygiene Examination. We believe this
Manual answers most of the commonly
asked questions regarding the
examination process. Bring/have this
Manual with you to the clinical
examination and keep it available in the
cubicle for easy reference. A thorough
understanding of this Manual is crucial to
success on the exam.
Administrative information includes:
candidate eligibility, fees, forms,
schedules, examination sites, dates for
the examinations, and policies. These
procedures are provided by the testing
agency the candidate chooses to use, such
as the CDCA.
Individual jurisdictions may require a state
jurisprudence or other additional
examinations. It is the candidate’s
responsibility to contact the licensing
jurisdiction of interest to determine
current eligibility and additional
requirements.
Candidates taking this examination do so
voluntarily and agree to accept the
provisions and to follow the rules
established by the ADEX and CDCA for the
examination as detailed in this Manual.
ADEX Examination
Development
The ADEX Dental Hygiene Examination is
developed and revised by the ADEX
Dental Hygiene Examination Committee
(DHEC). This committee is comprised of
representatives from every ADEX member
district. The committee has considerable
content expertise and also relies on
practice surveys, current curricula,
standards of competency and the
American Association of Dental Board’s
(AADB) “Guidance for Clinical Licensure
Examinations in Dentistry” to ensure that
the content and protocols of the
examination are current and relevant to
practice. Examination criteria, content,
and evaluation methodologies are
reviewed annually, and are determined by
such considerations as:
ADEX Status
To achieve ADEX Status, candidates must
successfully complete both the CSCE and
the PTCE of the ADEX Dental Hygiene
Examination with a score of 75 or greater
in each of the examinations.
The Candidate Manual
The Candidate Manual supports and
assists candidates in their preparation to
participate and perform successfully in the
two examinations. The Manual is designed
to present the required administrative
information, as well as setting forth the
criteria and necessary requirements.
The ADEX sets forth criteria and scoring
standards that must be followed by all
testing agencies administering the ADEX
Dental Hygiene Examination.
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•
•
2
Patient selection and eligibility
Psychometric validity
Potential to ensure that a skill can
be evaluated reliably
Three Time Examination Policy
Candidates failing either the CSCE or the
PTCE on three successive attempts must
begin the entire examination process
again and retake both the CSCE and
Patient Treatment Clinical Examinations of
the ADEX Dental Hygiene Examination
administered by the CDCA.
Previously passed clinical examinations
will not be recognized for successful
completion of the entire clinical
examination series in dental hygiene and
attainment of ADEX Status. A new
application must be filed together with
appropriate documentation and applicable
fees. (See Supplemental Section of the
Manual).
3
CLINICAL EXAMINATION
100-point scale. Candidates must earn 75
or greater to pass.
Examiners for the ADEX examination
evaluate candidates on their clinical and
judgment skills. Judgment skills include
presenting an eligible patient, an
acceptable case, a selection of teeth that
meets all calculus requirements, and
diagnostic-quality radiographs. Clinical
skills include detection and removal of
calculus, accurate periodontal pocket
depth measurements, tissue
management, and final Case Presentation.
This section describes in detail the
evaluation criteria for both of the
categories.
Judgment Skills
Patient selection and eligibility
For the PTCE, the candidate must
present his/her own patient. Selecting an
eligible patient is essential to successfully
completing this examination. Candidates
who present ineligible patients will fail the
examination.
Patient selection and management is an
important part of the examination and
should be completed independently,
without help or assistance of faculty or
colleagues. Candidates must carefully
assess any physical or medical conditions
that may be impacted by the examination
process. Patients should be informed of
the time commitment and the process of
the examination.
The ADEX uses a triple-blind scoring
system, which requires three examiners to
perform independent evaluations of the
candidate’s performance in meeting
specific criteria for Case presentation,
calculus detection, calculus removal,
periodontal pocket depth measurements,
tissue management, and final Case
presentation. Points are awarded on a
An eligible patient must:
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•
•
•
An ineligible patient:
Be at least 18 years of age.
Have a physician’s written
clearance, if needed.
Be presented with required
radiographs of diagnostic-quality.
Have an acceptable health history
including a blood pressure within
the guidelines of this examination.
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4
Dentist
Dental Hygienist
Dental student
Final Year Dental Hygiene student
Currently taking or history of
injectable or oral bisphosphonate
therapy
Latex allergy
1st or 3rd trimester of pregnancy
Oral herpetic lesions - This
condition may be left to the
discretion of the Clinic Floor
Examiner (CFE)
Case selection
The presentation of a full quadrant and
additional teeth for the ADEX
Examination is known as the “Case.”
Candidates indicate their selection of
teeth for the clinical examination on
the appropriate examination forms.
QUICK TIP
The Case selection must include:
• A full quadrant with at least six natural,
permanent teeth and two posterior teeth
from a second quadrant
• At least two molars
o One must be located in the primary
The candidates’ treatment phase is
performed on a pre-determined selection
of the patient’s teeth. The candidates
select their Case in accordance with the
criteria requirements presented below.
Examiners evaluate the Case during the
Pre-Treatment Evaluation to
determine that it meets all
requirements. During clinical treatment
time, candidates remove all calculus on
all surfaces within the Case selection.
During p o s t - t r e a t m e n t evaluation,
examiners evaluate the selection to
ensure that the candidate properly
removed all calculus while maintaining
tissue integrity.
The Case selection consists of one full
quadrant plus two posterior teeth from a
second quadrant.
quadrant
o One of the teeth in the second quadrant
must be a molar
• One of the molars must have both a mesial
and a distal contact. Another molar must
have at least one contact.
o To be considered a contact, the adjacent
surface must be no more than 2 mm from
the molars
o Must be free of excessive soft debris
OPTIONAL: If candidates cannot identify
12 surfaces of qualifying calculus in a
primary quadrant they may select
surfaces on up to 2 posterior teeth in the
secondary quadrant. The teeth on which
these surfaces are found would be in
addition to the 2 teeth that are already
part of the Case Selection. So, there could
be up to 4 teeth from the secondary
quadrant in the Candidate’s Case
Selection.
There must be two molars in the
selection. One of the six teeth in the
quadrant and one of the two teeth in the
second quadrant must be molars. The
required two molars must have three
mesial and/or distal contacts with an
adjacent tooth within 2mm or less.
QUICK TIP
A Case Selection with the following tooth selection is strongly discouraged:
• Class III furcation or mobility
• Retained primary teeth (prohibited)
• Advanced periodontal disease
• Gross caries
• Orthodontic brackets or bonded retainer
• Defective restorations
• Implants included in the treatment selection
• Extensive full or partial esthetic
(prohibited)
veneers
• Partially erupted third molars
• Multiple localized probing depths in
5
excess of 6mm
Third molars: If the p r i m a r y quadrant
has a third molar, the candidate must
choose whether to include the third molar
in the selection. If the candidate
chooses not to include the third molar
in the case selection, that tooth does
not needed to be treated and will not
be evaluated. All other teeth in the
quadrant and/or the additional teeth
must be debrided and will be evaluated
for remaining calculus, plaque, and stain.
•
Detect mesial and distal deposits by
exploring from facial and/or lingual.
Primary teeth and restored implants
located in the selection will not count
toward any calculus requirements, nor
will they count as molars for purposes of
meeting the molar requirements.
However, t hey can constitute a contact
with a molar to help meet the initial Case
presentation criteria.
The Case must include 12 surfaces of
qualifying subgingival calculus distributed
as follows:
• At least 8 of the 12 must be on
surfaces of premolars and molars
• At least 5 of the 8 must be on mesial
or distal surfaces of the posterior
teeth within 2mm or less of an
adjacent tooth
• At least 3 of the 5 mesial or distal
surfaces must be on molars within
2mm of an adjacent tooth. Only one
distal surface of a second or third
terminal molar may be used or one
mesial or distal surface on a molar
that does not have an adjacent tooth
• The remaining 4 of the 12 qualifying
surfaces qualifying calculus are the e
of the candidate and must be
subgingival.
Primary teeth and restored implants
may count as a proximal contact with a
molar. No other criteria can be met by a
primary tooth or a restored implant.
Calculus requirements
In the Case selection the candidates must
list 12 surfaces where they detect
qualifying calculus. Examiners will add
two more surfaces from within the
Case Selection. All surfaces in the
selection must be debrided and will be
evaluated. The Case Selection must meet
the following calculus requirements:
• All selected teeth must have subgingival calculus.
• Qualifying surfaces may occur with or
without associated supragingival
deposits.
6
12
8/5/3
• Twelve surfaces of subgingival calculus are present in the Case selection, distributed in the following
manner:
• At least 8 of the 12 surfaces of subgingival calculus found on posterior teeth in the case
• At least 5 of the 8 surfaces of subgingival calculus must be located on mesial or distal surfaces of
posterior teeth within 2mm or less of an adjacent tooth
• At least 3 of the 5 surfaces must be located on mesial or distal surfaces on molars within 2mm or
less of an adjacent tooth
• Only one of the 3 can be located on a surface with no adjacent tooth
• Remaining 4 surfaces of subgingival calculus may be located on any surface in the case selection
4
QUICK TIP
CHARACTERISTICS OF QUALIFYING SUBGINGIVAL CALCULUS
• Explorer-detectable moderate to heavy subgingival calculus
• Distinct and easily detected with an 11/12 explorer as it passes over the
calculus
• Must be apical to the gingival margin
• May occur with or without supragingival deposits
• A definite jump or bump detected by the explorer with one or two strokes
• Ledges or ring deposits
• Spiny or nodular deposits
• Significantly enough in quantity to be readily discernible or detectable
• Mesial and distal deposits detectable from lingual and/or facial
7
Radiographs
In addition to selecting an eligible patient,
candidates must present a full mouth
series of diagnostic quality radiographs
and bitewings or panoramic and bite wing
radiographs of the patient. All
radiographs (periapicals, bitewings
and panoramic) must depict the
current condition of the dentition with
a written narrative on the Progress
Form explaining any recent dental
procedures and/or surgeries.
9. Teeth must appear in Universal
Notation System (1-32).
10. Candidate number, date films are
exposed, patient’s name and L & R
indications must be on the mount or
digital printout.
11. Neither the candidate’s name nor
name of the school should be visible
on the mount or digital printout.le.
12. If the candidate mounts the
radiographs incorrectly or there is
incomplete information on the
mount, the candidate will be notified
and must correct the error.
Radiographic images may be displayed on
monitors if they are available from the
school’s database.
All radiographs must be of diagnostic
quality, i.e., they must be of sufficient
quality for a dentist to accurately
diagnose caries, periodontal health, or
other dental diseases and abnormalities
Although a full- mouth series plus
bitewings or panoramic radiographs with
bitewings must be presented and
evaluated, only the images of the
primary quadrant and additional
teeth selected by the candidate will
be scored.
1. Present 16-20 images, including two
or four bitewings, depending on the
number needed to show the mesial
and distal surfaces, DEJ, and
alveolar crestal bone of all posterior
teeth or;
2. Panoramic radiographs with bitewings
are acceptable in place of the fullmouth series.
3. Periapical and panoramic images
must be current within 3 years.
4. Bitewings must be current within 1
year. They may be vertical or
horizontal.
5. The radiographs may or may not be
exposed by the candidate.
6. Duplicates, conventional, or digital
radiographs printed on photo quality
paper are acceptable.
7. Evidence of calculus on radiographs is
not necessary for Case presentation.
8. Convexity of dimple on conventional
radiographs must face the front of the
mount.
Exemptions: The following conditions
are exempt from the diagnostic
standards:
13. Un-erupted, partially erupted, and
super erupted third molars
(Examiners consider a third molar
erupted if the entire occlusal plane of
the third molar is in alignment with
the occlusal plane of the rest of the
teeth.)
14. A third molar with tissue covering any
part of the occlusal surface of the
tooth, even though the tooth is in the
occlusal plane
8
patient will be declared ineligible, and
the candidate will fail the exam.
Examiners review and score the
radiographs as a separate criterion based
on whether they are an accurate
depiction of the patient’s dentition and the
images of the candidate’s selected teeth
(both quadrant and all additional teeth)
are of diagnostic quality. Also required is
a written description of any restorative
and/or surgical treatment, which the
patient has undergone since the
radiographs were taken. If t w o
examiners independently confirm the
radiographs presented are of such
poor quality that t h e y cannot
identify pathosis or determine if
they belong to the patient, the
Candidates will not be permitted to take
radiographs at the exam sites unless an
emergency arises.*
*National Council on Radiation Protection
and Measurement (NCRP) Report #145
“Administrative use of radiation to provide
information not related to the health of
the patient shall not be permitted.
Students shall not be permitted to
perform radiographic exposure of patients,
other students or volunteers solely for
purposes of their education or Licensure.”
QUICK TIP
RADIOGRAPHS
• Full mouth periapical, including two or four bitewings, or a panoramic radiograph
with two or four bitewings
• Periapical and panoramic images must be current within 3 years
• Bitewings must be current within 1 year
• Duplicates, conventional, or digital radiographs are acceptable.
• Candidate number, date films are exposed, and patient’s name must be on the
mount or digital printout
• Teeth must appear in Universal Notation System (1-32).
9
Clinical Skills
Examiners are standardized using the
11/12 explorer and the recommended
probe. It is in the candidate’s best
interest to use these instruments during
the examination. Presenting instruments
other than those recommended will cause
a delay in the evaluation process.
The clinical skills section of the ADEX
Dental Hygiene Examination evaluates the
candidate’s ability to:
• Detect calculus,
• Remove calculus without damaging
the surrounding tissue,
• Measure periodontal pocket depths
accurately,
• Present the patient for final clinical
skills evaluation free of calculus,
plaque, and extrinsic stains in the case
selection.
There are two recommended
instruments for evaluation on the ADEX
Examination.
1. Explorer: an 11/12 explorer
(e.g., the ODU 11/12) is
recommended for use by
candidates and examiners for
calculus detection.
2. Probe: a probe, marked with
1mm increments (e.g., the UNC
probe) is recommended for use for
the probing exercise.
The ADEX D e n t a l H y g i e n e
E xamination allows candidates 2 hours
to complete the calculus detection,
periodontal pocket measurements, and
calculus and stain removal exercises.
Instruments
Candidates may use instruments of their
choice for patient treatment. For
evaluation, it is extremely important that
all candidates and examiners use the
same evaluation instruments to ensure
that the examination is standardized for
all candidates at all testing sites.
Additional requirements for instruments
and materials may be found in the testing
agency’s Supplement Section to this
Manual.
Figure 1: 11/12 explorer
Figure 2: probe
10
Calculus Detection
The presence or absence of explorer
detectable qualifying sub- gingival
calculus on the surfaces of three selected
teeth must be accurately recorded.
calculus may be counted: mesial (M),
distal (D), facial (F), and lingual (L).
Points are earned if the candidate’s “Yes”
or “No” answer matches the answer of at
least two of the three examiners’ answers
for that surface.
During Pre-Treatment Evaluation,
examiners assign three teeth from
anywhere in the mouth for the candidate
to evaluate for the presence or absence of
calculus. Three examiners evaluate the
mesial, distal, facial, and lingual surfaces
of those three teeth and document their
findings.
Each tooth has only four surfaces where
calculus may be counted: mesial (M),
distal (D), facial (F), and lingual (L).
Note: Complete the calculus detection
exercise prior to removing any
calculus. If calculus is removed prior
to completing the detection exercise,
the candidate will be unable to make
an accurate evaluation of the
presence or absence of calculus.
Examiners assess calculus detection
during pre-treatment evaluation.
Examiners use the 11/12 explorer and
compressed air for calculus detection. At
the start of clinical treatment time and
prior to removal of any calculus,
candidates evaluate the four surfaces of
the three assigned teeth. If any readily
detectable qualifying subgingival calculus
is present on a surface, the candidate
indicates “Yes” on the appropriate form. If
the candidate finds no calculus on a
surface, he/she enters “No” on the form.
Each tooth has four surfaces where
Errors are assessed when the candidate
does not indicate any answer or if both
“Yes and “No” are indicated.
11
Candidates should ensure that c a l c u l u s
is detectable when:
• The 11/12 explorer is inserted into the
sulcus/pocket in contact with the
crown, and then i s s l i d apically
along the root using the side of the
tip of the explorer to detect calculus.
• Interference with the apical sliding
motion along the tooth surface
indicates dental calculus.
• Detect calculus when interference
occurs during the sliding motion of
the explorer.
• When calculus stops the explorer
during the apical movement along the
•
•
•
12
tooth surface, move the explorer
laterally out and away from the tooth
surface and continue the sliding
movement apically, moving back
under the calculus piece to regain
contact with the root surface.
Continue the apical sliding motion
until the soft base of the
sulcus/pocket is reached.
Use compressed air to deflect the
tissue and visually observe calculus
deposits whenever possible.
Calculus found on the line angle will
be counted as being present on the
mesial or distal surface.
the quadrant will not count as part of
the six teeth required and points may
be deducted.
Calculus Removal
The treatment phase of the examination is
the removal of calculus. Calculus removal
must include the entire Case selection.
All surfaces in the Case selection will
be evaluated for remaining calculus,
both supragingival and subgingival.
Candidates will treat all teeth in the Case
selection indicated on the appropriate
form, including the entire primary
quadrant and all additional teeth selected.
Debride all surfaces on all teeth in the
selection. All surfaces in the selection will
be scored for remaining calculus.
Remaining subgingival calculus and
supragingival calculus are scored equally.
Periodontal assessment
Pocket depths must be accurately
assessed and recorded on the two
examiner-assigned teeth – one posterior
and one anterior. During Pre-Treatment
evaluation, examiners assign one
anterior and one posterior tooth for
measurement of periodontal pocket
depths. Three examiners measure and
record periodontal pocket depths on the
two assigned teeth using a probe marked
with 1mm increments and document their
findings.
Examiners will evaluate the surfaces of
calculus listed by the candidate. If
examiners are unable to validate 12
surfaces of qualifying calculus in the
selection, the candidate will not be
able to earn points for removing
calculus on 12 surfaces. Candidates
earn points for removal of calculus only
on surfaces validated by two examiners
to have qualifying calculus present. If 12
surfaces of qualifying calculus are not
present, candidates will have fewer
opportunities to earn points for calculus
removal.
At the start of clinical treatment time
and prior to removal of calculus,
measure the periodontal pocket depths
and record measurements o n the
Progress Form. Each tooth has three
surfaces where measurements are
evaluated: mesio-lingual (ML), distolingual (DL), and lingual (L). During
P o s t - T r e a t m e n t Evaluation, the
candidate’s measurements are evaluated
and scored. The measurements made by
the candidate must be no more than ± 1
mm from the median of the
measurements made by the three
examiners.
Record each measurement in the
appropriately labeled space on the
Progress Form. For example, the
periodontal pocket depths for the mesiolingual surface of the assigned tooth must
be recorded in the space labeled “ML,”
the lingual reading must be recorded in
the space labeled “L,” etc. Errors are
assessed for any space left blank.
For example, if two of the three examiners
are able to locate only 10 surfaces of
qualifying calculus in the Case Selection,
the candidate will have only 10
opportunities to earn points for calculus
removal. When selecting t h e
s u r f a c e s , quadrant and/or the
additional teeth, the exclusions listed
previously must be considered.
Excessively decayed or primary teeth in
13
Minor tissue trauma
Definition: Any injury that is inconsistent
with the procedure and is expected to
heal without professional treatment by a
dentist or physician.
Examples of minor tissue trauma:
small lacerations, cavitron burns,
abrasions on papillae, gingiva, tongue,
lip.
If four or more areas of minor tissue
trauma are validated, a major tissue
trauma error is assessed, resulting
in automatic failure of the clinical
examination module.
Complete the periodontal assessment
prior to the beginning of treatment.
Record periodontal pocket depth
readings before removing calculus in
order to ensure measurements are within
± 1 mm of the examiners’
measurements.
Do not use any copies or reference
materials for this section. Candidates
found using previously recorded and/or
copied periodontal charts or other copies
of the patient’s periodontal pocket depth
measurements will be dismissed for
unprofessional conduct and will
automatically fail.
Major tissue trauma
Definition: Any injury that is inconsistent
with the procedure and that will not heal
on its own without professional treatment
by a dentist or physician.
Examples of major tissue trauma:
amputated papilla, significant cavitron
burns, severely lacerated soft tissue,
exposure of the alveolar process, broken
instrument tip evident in the sulcus or soft
tissue, root surface abrasions that require
additional definitive treatment.
The unwarranted presence of major tissue
trauma will result in automatic failure of
the examination.
Points are awarded to candidates whose
patients exhibit no minor tissue trauma
Tissue management
Examiners evaluate subgingival calculus,
supragingival calculus, plaque and stain
removal from all surfaces, as well as
tissue management in the Case selection.
The candidate must effectively utilize
hand instruments, prophy cups and/or
brushes, ultrasonic/sonic cleaning
devices, and dental floss without causing
unwarranted soft tissue trauma
(abrasions, lacerations, or burns) during
this examination.
Minor
tissue
trauma
Any injury that is inconsistent with
the procedure and is expected to
heal without professional treatment
by a dentist or physician
Major
tissue
trauma
Any injury that is inconsistent with the
procedure and that will not heal on its own
without professional treatment by a dentist
or physician
Examples of minor tissue
trauma: small lacerations; cavitron
burns; abrasions on papillae,
gingiva, tongue, lip
Examples of major tissue trauma:
amputated papilla, significant cavitron
burns, severely lacerated soft tissue,
exposure of the alveolar process
If four or more areas of minor
tissue trauma are validated, a
major tissue trauma error is
assessed, resulting in automatic
failure of the clinical
examination module.
The unwarranted presence of major tissue
trauma will result in automatic failure of the
examination.
14
Only remaining calculus that is not a part
of the 12 surfaces evaluated for calculus
removal is counted as an error under final
Case presentation. At least two out of
three examiners must independently
assess an error for points to be withheld.
around any of the teeth treated during
the oral d e b r i d e m e n t or on any other
soft tissue structures. At least two of
three examiners must independently
identify tissue trauma on the gingiva or
soft tissue structure for points to be
withheld. Pre-existing tissue injuries
and/or conditions should be noted by
the candidate in the Notes section on the
Progress Form.
All forms are collected when the
candidates check out with the CFE when
the patient is back from the Post
Treatment Evaluation.
Final case presentation
.
Candidates earn points by presenting the
patient free of:
• Remaining plaque.
• Remaining calculus on surfaces within
the Case Selection that are not a part
of the 12 surfaces of qualified calculus
assigned to evaluate removal skills.
• Remaining extrinsic stains.
• Other remaining residue or debris.
Infection Control
Candidates must follow the infection
control procedures recommended by the
Centers for Disease Control and
Prevention. See the testing agency
Supplemental Section of this Manual for
more detailed information.
15
Table of Evaluation Criteria
At least two out of three examiners must independently assess an error for points to be
withheld. The two tables below explain the criteria for scoring.
Judgment
Skills Section
Evaluation Criteria
Initial Case
Presentation
•
A full quadrant with at least six teeth and two posterior teeth from a second
quadrant
•
•
At least two natural, permanent molars
o
One must be located in the primary quadrant
o
One of the teeth in the second quadrant must be a molar
One of the molars must have both a mesial and a distal contact. Another molar
must have at least one contact.
o
Radiographs
Calculus
Requirements
Clinical Skills
Section
•
•
•
Periodontal pocket
measurement
•
•
•
•
Calculus removal
Tissue
management
Final case
presentation
from the molars.
Must be free of excessive soft debris
Radiographs of the teeth selected are of sufficient quality for a dentist to
accurately diagnose dental caries, periodontal health, or other dental diseases and
abnormalities.
Qualifying calculus is verified by at least two examiners on:
o
At least three surfaces on proximal surfaces of molars (M or D).
o
At least five surfaces on proximal surfaces of posterior teeth (M or D). These
can include the three from molars.
o
At least eight surfaces on posterior teeth (M, D, F, or L). These can include
the five from proximal surfaces.
Evaluation Criteria
•
Calculus detection
To be considered a contact, the adjacent surface must be no more than 2 mm
Candidate correctly detects the presence or the absence of readily detectable
qualifying subgingival calculus on a tooth surface.
The computerized scoring system compares the candidate’s assessment of the
presence or absence of calculus to the assessment made during pre-treatment
evaluation by three examiners on the same three teeth.
Candidate accurately records the sulcus/pocket depths of two assigned teeth.
The computerized scoring system compares the candidate’s measurements to
those made by three examiners on the same two teeth during pre-treatment
evaluation.
Measurements made by the candidate must be within ± 1 mm of the median of the
measurements of the three examiners.
•
•
•
No remaining calculus is found on surfaces chosen by examiners for evaluation.
No calculus is seen when tooth is dried with compressed air.
No calculus is felt with 11/12 explorer.
•
Candidate did not inflict any avoidable minor or major tissue damage during
calculus removal.
•
Patient is presented free of remaining calculus, plaque, stain, or prophy paste
residue in the treated area.
Anesthetic record is complete.
•
16
POINT SYSTEM
Criteria
Points
Possible
Point System
A full quadrant with at least six teeth and two posterior teeth from a second
1
quadrant
At least two natural, permanent molars
Initial case
presentation
1
One must be located in the primary quadrant
One of the teeth in the second quadrant must be a molar
One of the molars must have both a mesial and a distal contact. Another molar
1
must have at least one contact.
Must be free of excessive soft debris
Calculus
requirements
1
Qualifying calculus requirements met by teeth in the selection: (8-5-3)
Eight surfaces located on any surfaces of posterior teeth
Five surfaces located on M or D of posterior teeth
Three surfaces located on M or D of molars
5
Radiographs
Radiographs of the primary quadrant and any additional teeth are of diagnostic
quality.
Calculus detection
12 surfaces worth 1.5 points each, evaluated for the presence or absence of
readily detectable qualifying subgingival calculus.
Calculus removal
Periodontal
assessment
Minor tissue
trauma
Final case
presentation
8
18
12 surfaces of qualifying calculus worth 4.5 points each
If examiners verify four or more surfaces with remaining calculus, an additional
15 points are deducted.
54
If two examiners are unable to verify 12 surfaces of qualifying calculus in the
entire selection, points can be earned for removal only on the number of
surfaces with qualifying calculus verified by examiners.*
Six measurements worth one point each.
6
Three points awarded if no minor tissue trauma is present.
One point deducted for each site of minor tissue trauma, up to three sites.
The presence of four or more sites qualifies as major tissue trauma and
automatic failure.
Treated selection is presented free of calculus, visible plaque, extrinsic stains,
prophy paste, and any other visible debris in the treated area. Anesthesia
record is complete.
Total
Major tissue trauma or major infection control
violation**
100-point deduction = automatic failure
3
2
100
-100
removal only on those ten surfaces, for a
maximum total of 45 points for removal. If
examiners verify only eight surfaces of
qualifying calculus, points for removal are
awarded only on those eight surfaces for a
maximum of 36 points. Only when two
*For example, if, after thorough
examination of both the quadrant and any
additional teeth selected by the
candidate, two examiners independently
identify only ten surfaces with qualifying
calculus, the candidate can earn points for
17
Points are assigned in accordance with the
nationwide task analysis survey conducted
every five years. Results from this survey
of practicing dental hygienists allows the
testing agencies to determine which
clinical skills are performed most
frequently, and which clinical skills are
considered more important to protect the
public. Skills that rate highest (most points
earned) are weighted more heavily than
skills that rate lower.
examiners verify 12 surfaces of qualifying
calculus in the selection can the candidate
earn the maximum of 54 points for
calculus removal.
**Examples of major infection control
violations include, but are not limited to,
use of non-sterile instruments; uncapped
needles; and other violations that put the
patient, candidate, examiner, or staff
members at risk for injury or exposure.
2
POINTS SYSTEM EXPLANATION
Initial Case Presentation: 4 points
There are four criteria under Initial Case Presentation. If the case does not meet one of more
criteria, four points are lost. There are not individual points assigned to each of the four criteria.
Four points are lost if one, two, three or all four criteria are not met.
Calculus Requirements: 5 points
There are four criteria under Calculus Requirements. If the case does not meet one or more
criteria, five points are lost There are not individual points assigned to each of the four criteria.
Five points are lost if one, two, three or all four criteria are not met.
Radiographs: 8 points
Radiographs of the candidate’s selected teeth are evaluated as diagnostic or non-diagnostic This
is also a one-time point deduction.
Calculus Detection: 18 points
Twelve surfaces are evaluated. Each surface is worth 1.5 points. Points are earned when the
candidate correctly identifies the presence or absence of calculus on the M, D, L and F surfaces of
three teeth. The candidate’s answer must match that of two out of three examiners.
Calculus Removal: 54 points
Twelve surfaces are evaluated for calculus removal. Each surface is worth 4.5 points each. Points
are earned when the candidate successfully removes all calculus from the surface. If examiners
verify four or more surfaces with remaining calculus, an additional 15 points are deducted.
Periodontal Assessment: 6 points
Three surfaces (ML, L and DL) on two teeth are measured for a total of six measurements. Each
measurement is worth one point. Points are awarded when the measurement made by the
candidate is within +/- 1 mm of the median measurement recorded by the three examiners.
Minor Tissue Trauma: 3 points
If no minor tissue trauma is verified, the candidate earns three points. If one area of minor tissue
trauma is verified, one point is lost. If two or three areas of minor tissue trauma are verified the
candidate loses two or three points respectively. If four or more are verified, the trauma is
elevated to “major” tissue trauma and results in a 100 point deduction and failure of the
examination. “Minor” and “Major’ trauma are defined in the Manual.
Final Case Presentation: 2 points
There are five criteria under Final Case Presentation. If the case does not meet one or more
criteria, two points are lost. There are no individual points assigned to each of the five criteria.
Two points are lost if one, two, three four or all five criteria are not met.
18
COMPUTER SIMULATED EXAM
Content
Computer Simulated Clinical Examination (CSCE)
Medical/Dental Assessment
Intra and Extra Oral Examination
Format
Clinically based questions
presented on a computer
Dental and Periodontal Charting and Assessment
Soft Tissue, Bone and Tooth Abnormalities
Radiography/Imaging
Dental Hygiene Care Planning
Periodontal Procedures
The CSCE is the Computer Simulated
Clinical Examination with clinically based
questions that utilize a multiple-choice
format to indicate examinees’ responses.
It is an integral component of the ADEX
Clinical Examination and differs from the
National Board Dental Hygiene
Examination, which is a comprehensive
achievement examination in the theory
of dental hygiene. Note: the local
anesthesia computer-based examination
is not required as part of the 2016
examinations.
or greater is passing. There are an
additional 15 questions being tested for
possible future use, but they are not part
of the examination grade.
The CSCE is approximately two hours in
length.
The CSCE is given, by appointment, at
a testing center. Contact the testing
agency of your choice for information
concerning testing centers.
Standards for the CSCE
The CSCE is designed to assess more
complex levels of diagnosis and
treatment planning knowledge, skills,
and abilities.
•
Clinically based questions are utilized
through computer-enhanced
photographs, radiographs, optical
images of study and working models,
laboratory data and other clinical
digitized reproductions.
•
The CSCE consists of 100 graded
questions. Scoring for this examination is
based on the percent of questions
answered correctly. A final score of 75
19
Extraneous materials (textbooks or
study materials) are n o t
permitted at the testing center at
any time. Only those materials
distributed or authorized by the
testing center may be brought to
the examination. Use of
unauthorized materials will result
in failure of the entire examination.
Time schedule: A specific total
amount of time is allowed for the
CSCE. Once a candidate has
completed and locked out of the
CSCE, the candidate may not reenter the CSCE.
•
•
•
Timely arrival: The date and
appointment schedule
established by the testing center
must be adhered to as confirmed.
Failure to do so will result in
forfeiture of the examination fee.
Behavior at the testing center:
Unseemly behavior of the
candidate or improper behavior
toward personnel at the testing
center will result in failure of the
CSCE and forfeiture of the
examination fee.
Examination security: Security
measures established by the
testing agency and testing center
must be followed. Failure to do
so may result in failure of the
examination.
•
•
•
•
•
•
The candidate may skip or mark items to
be considered later. Once the CSCE is
completed and the candidate locks out of
the examination, she/he will not be able to
return to the examination. The time
indicated on the computer screen is the
amount of time for the examination.
There is no specific time limitation for
each item.
The CSCE is administered at testing
centers by appointment after eligibility
authorization is granted to the examinee
by the testing agency. Approximately two
hours are allotted for this examination.
No study materials may be brought to
the center and recording of test items is
prohibited. Violation of these rules
constitutes a violation of the Standards for
the CSCE and may result in failure of the
examination. The rules of conduct of
the examination as established by testing
center must be followed.
Disciplines and Subject Matter
Addressed in the CSCE
•
•
•
•
•
Dental Hygiene Care Planning
Periodontal Procedures
Infection Control
Medical Emergency Management
Dental Specialties
Applied Pharmacology
Medical/Dental Assessment
Intra and Extra Oral Examination
Dental and Periodontal Charting
and Assessment
Soft Tissue, Bone and Tooth
Abnormalities
Radiography/Imaging
1
SUPPLEMENTAL
TESTING
AGENCY INFORMATION
of the examination should be directed to
the testing agency selected by the
candidate. While all testing agencies
administering the ADEX Dental Hygiene
Examination must adhere to the patient
eligibility, criteria and scoring system
explained in this Manual, other details
regarding administration are unique to
each testing agency.
Additional information regarding
application, schedules, testing sites, fees,
forms, policies, and procedures are found
in the Supplemental Section of this
Manual. This section is produced and
included in the Manual by the individual
testing agency or state that chooses to use
the licensure examination provided by
ADEX.
Please refer to the following supplemental
section of this Manual for further details.
All questions regarding the administration
21
Glossary
Abrasion
Abnormal wearing of tooth substance or restoration by mechanical factors other than
tooth contact.
Apical
The tip or apex of a root of a tooth and its immediate surroundings.
Calculus
A hard deposit attached to the teeth, usually consisting of mineralized bacterial plaque.
Caries
An infectious microbiological disease that results in localized dissolution and destruction
of the calcified tissues of the teeth.
Case Selection
Entire selection of the teeth chosen by the candidate, which includes a primary
quadrant plus two posterior teeth in a second quadrant.
Cemento-enamel junction – CEJ
Line formed by the junction of the enamel and cementum of a tooth.
Complete treatment
Removal of all supra and subgingival deposits including coronal plaque and stain.
Contact area
The area where two adjacent teeth are no more than two millimeters from each other.
Debride
Complete removal of all calculus, plaque, soft debris, food, and prophy paste.
Defective restoration
Ditching, poor marginal integrity, recurrent caries, or fractured.
Deposits, subgingival
Deposits thatare apical to the gingival margin.
Deposits, supragingival
Deposits coronal to the gingival margin.
Diagnostic quality radiographs
Radiographs of sufficient quality for a dentist to accurately diagnose caries, periodontal
health, or other dental diseases and abnormalities.
Gross (excessive) caries
Decay that has deteriorated three of the four axial walls and involves the cervical third
of the tooth.
22
Interproximal contact
The area of contact between two adjacent teeth. Also called proximal contact.
Line angle
The angle formed by the junction of two surfaces.
Long axis
An imaginary straight line passing through the center of the whole tooth occlusoapically.
Mobility
The degree of looseness of a tooth.
Optional additional Teeth
Up to two posterior teeth, premolars or molars, within 2mm of each other in a second
quadrant used to satisfy tooth and surface selection criteria not met in the quadrant of
the Case.
Pass/fail rule
Candidate must have a score of 75 or greater to pass.
Periapical
Area around the root end of a tooth.
Pocket depth measurements
Pockets depths accurately assessed and recorded on the two examiner assigned teeth –
one posterior and one anterior.
Posterior teeth
Premolars and molars
Primary dentition
The first set of teeth (deciduous).
Proximal surfaces
Mesial and Distal surfaces.
Psychometric validity
Test validity: the degree to which evidence and theory support the interpretations of
test scores.
Quadrant
A quarter of the oral cavity with six to eight teeth, upper right, lower right, upper left,
lower left.
Qualifying calculus
Explorer detectable subgingival calculus, which is distinct and easily detected with an
#11/12 explorer.
Qualifying surfaces
Twelve surfaces with subgingival qualifying calculus. (eight surfaces on posterior teeth,
five surfaces on posterior teeth on mesial and distal surfaces, three on mesial and distal
surfaces of molars, four on any other sub gingival surfaces.)
23
Stain, extrinsic
Stain that forms on and can become incorporated into the surface of a tooth after
development and eruption. These stains can be caused by a number of developmental
and environmental factors.
Sonic scaler
An instrument tip attached to a transducer through which high frequency current causes
sonic vibrations (approximately 6,000 cps). These vibrations, usually accompanied by
the use of a stream of water, produce a turbulence, which in turn removes adherent
deposits from the teeth.
Tissue trauma
Unwarranted iatrogenic damage to extra/intraoral tissues resulting in significant injury
to the patient, such as lacerations, burns, amputated papillae, or large tissue tags.
Triple blind scoring
Three examiners independently evaluate and score.
Ultrasonic scaler
An instrument tip attached to a transducer through which high frequency current
causes ultrasonic vibrations (approximately 30,000 cps). These vibrations, usually
accompanied by the use of a stream of water, produce a turbulence, which in turn
removes adherent deposits from the teeth.
Validate
To be sound and just while supported by fact.
Veneers
A restoration that covers the facial, mesial, distal, and incisal surfaces of a tooth,
usually porcelain.
Acronyms
AADB
American Association of Dental Boards
ADEX
American Board of Dental Examiners
APA
American Psychological Association
CDCA
Commission of Dental Competency Assessments
CODA
Commission on Dental Accreditation
CSCE
Computer Simulated Clinical Examination
DHEC
Dental Hygiene Examination Committee
OSHA
Occupational Safety and Health Act
PTCE
Patient Treatment Clinical Examination
24
2016
Policies and Procedures
Supplement
for the
ADEX Dental Hygiene Examination
as administered by:
The North East Regional Board of Dental Examiners
is now the CDCA
The Commission on Dental Competency Assessments, Inc.
1304 Concourse Drive, Suite 100
Linthicum, MD 21090
www.cdcaexams.org
Copyright © 2014 American Board of Dental Examiners, Inc.
Copyright © 2014 North East Regional Board of Dental Examiners, Inc.
The CDCA Supplement Table of Contents
I.
GENERAL INFORMATION..1
VII.
Examination results ....................... 1
Eligibility…………………………….……………2
Application ................................... 2
Applying for re-examination ........... 5
II.
SITES, DATES, AND FEES..5
Dates and Sites……………………..……….5
Site Selection………………………….………5
Computer Simulated Examination.…5
Fees………………………………………….….….6
III.
PREPARING FOR THE
EXAMINATION…………... .. 8
Pre-examination preparation .......... 8
Exam materials ............................. 8
Registration ................................. 8
IV.
PROCEDURES………….…. .. 9
Exam schedule and Overview ……. . 10
Cubicle set-up............................. 12
Pre-treatment evaluation ............. 13
Clinical treatment time................. 14
Use of local anesthesia................. 15
Shared patients .......................... 16
POLICIES……………….…..30
1.
Anonymity .........................30
2.
Candidate accessibility ........31
3.
Change of name………………….31
4.
Confidentiality………………………31
5.
Dismissal from examination .31
6.
Electronic equipment ..........32
7.
Examination placement &
limitations .........................32
8.
Examination results ............32
9.
Equipment .........................33
10.
Ineligible candidates ...........33
11.
Infection control .................34
12.
Instruments .......................37
13.
Interpreters .......................37
14.
Jurisprudence ....................37
15.
Malpractice Insurance .........38
16.
Patients.............................38
17.
Patient privacy statement ....38
18.
Professional standards ........38
19.
Questions ..........................38
20.
Re-examination ..................38
21.
Refunds ............................40
22.
Restrictions .......................40
Post operative evaluation ............. 17
23.
Retake Requirements ..........40
FORMS…………………….... 18
24.
Scheduling confilicts ...........40
Dental Hygiene Progress Form ...... 18
Calculus detection ....................... 19
25.
26
Sharing equipment….…….41
Special testing provisions41
Probing Measurements ................. 20
27.
State-only examinations ......42
V.
Calculus removal………………………....20
Trtmt Selection Worksheet.……….…21
Progress Form……………………………...22
Medical History Form ................... 25
Post-Operative Care Agreement .... 28
Patient Consent, Disclosure and
Assumption of Respnsibility Form .. 29
VI.
APPEALS…………………... 29
28. Unethical conduct……….……42
VIII.
FAQs.............................. 42
IX.
EXAM CHECKLIST…….…..46
X.
ONLINE REVIEW
CERTIFICATION …….…...51
GRADUATION WITHIN
45 DAYS……………….……52
XI.
GENERAL INFORMATION
Welcome to the Commission on Dental Competency and Assessments
(CDCA)administration of the ADEX Dental Hygiene Examination. The CDCA
provides this Candidate Manual so candidates may become familiar with the
procedures and policies for the ADEX Dental Hygiene Examination administered
by CDCA. The ADEX section of this Manual covers the core requirements
for the criteria and scoring needed to pass the examination. This
section covers the administrative procedures including how to apply,
testing site information, fees, schedules, and forms required by the
CDCA. Please be aware that by registering for this examination, that you agree
that the CDCA, and its examiners, volunteers, and employees will have no
liability to you in the event you suffer an injury during the examination as a
result of your actions or actions of your patient.
Examination results
The performance of the candidate is evaluated according to the ADEX criteria
and standards published in the Candidate Manual
Scores are automatically reported to each CDCA participating jurisdiction.
Scores are also made available to candidates for each individual ADEX Dental
Hygiene Examination. Scores are posted for each candidate in their profile
following the examination.
The CSCE scores are reported at the end of the first full week of the month
following the month in which the CSCE was taken. The Patient Treatment
Clinical Examination scores are generally reported within three days of the date
of the candidate’s examination, if the examination is administered
electronically. You will receive an email notifying you that your scores have
been posted to your profile.
A critique of performance in each clinical examination of the ADEX Dental
Hygiene Examination is provided to the candidate together with the
examination score. In order to maintain the security of the examinations, this
critique is issued in lieu of a review of actual examination papers or clinical
evaluation forms.
Scores are not released to candidates or their representatives by telephone,
facsimile or email. The individual scores of a candidate are not released by the
CDCA to the school of graduation unless authorized by the candidate upon
application for examination. Scores are not released at any time, except to the
candidate and the CDCA participating licensing jurisdictions unless authorization
is received from the candidate.
1
Scores will be provided to other licensing jurisdictions upon receipt of a request
signed by the candidate and sent to the CDCA. Such request must include the
following:
1.
2.
3.
4.
5.
Candidate’s name, mailing address and telephone number,
Candidate’s name at time of examination,
Year in which the CDCA Clinical Examinations were completed,
Address to which the results are to be sent,
Money order in the sum of $30 per each address to which the scores are
to be forwarded.
Eligibility for the Clinical Exam
The following are those categories of individuals qualified to take this
examination. Others may qualify upon the specific request of a state dental
board. (These are called State-only examinations).
Graduates of dental hygiene programs accredited by the American Dental
Association Commission on Dental Accreditation (ADA/CODA) or by the
Commission on Dental Accreditation of Canada (CDAC) or other specified
national dental commissions are eligible to apply to take the ADEX Dental
Hygiene Examination administered by the CDCA upon presentation of proof of
graduation.
Senior students of record attending a dental hygiene program accredited by the
ADA/CODA are eligible to apply to take the ADEX Dental Hygiene Examination
when the Program Director (or designated school official) certifies, in writing,
that the candidate is expected to complete all academic requirements and
receive a dental hygiene degree within 45 days of the scheduled Patient
Treatment Clinical Examination and that the candidate is sufficiently prepared
to participate in the examinations.
Application
Online Registration Process
Applying online is a multi-stage process:
1. Go to http://www.cdcaexams.org/apply. Click the fill out a
basic profile link and complete the form.
The email address you enter will become your username to
login to your profile and will be used to communicate your site
assignment and notify you when results are available for
2
release. Double check your email address, all other information
and choose a secure password.
After completing the online form, click the Apply button.
2. The next page that is displayed is the one you will see each
time you login to your profile. The Dashboard tab is displayed
by default. Here you will find a list of current items and their
status:
Check Mark = completed item
Exclamation Mark = item requires attention
3. On your Dashboard page, you will be prompted to upload a
photo. Click the Upload link and follow the instructions. A
photo is required. All photos will be reviewed by the CDCA and may
be rejected if they are not acceptable for identification purposes.
Submitting an unacceptable photo will delay your registration.
•
Photos must be in one of the following formats: JPG/JPEG,
GIF, or PNG.
•
Photos must be square and have a minimum resolution of
200 x 200 and a maximum resolution of 500 x 500.
•
Your photo must be a front facing headshot in the format
that would be used for a passport and your name must not
be visible on your photo.
•
Photos must not display written information, such as on a
driver’s license or school identification number.
•
Do not submit scans of photo IDs such as a driver’s license.
4. Your graduation status must be validated before you can
register for exams. Verification can take several weeks
depending on the method used:
•
•
Graduating senior at a school in a CDCA state:
o
A designated school official may login to the CDCA
website to verify eligible candidates online.
o
Your school may provide the CDCA with a list of its
graduating class.
Graduating senior NOT in a CDCA state:
o
Upload a scan of the signed Certification of Completion of
Requirements to Graduate Within 45 Days Form located in at the
end of this Manual. To upload a scan, login to your profile, then
click the Profile tab followed by the Proof of Graduation link at the
top of the screen.
3
•
Graduate:
o
Upload a scan of your diploma. To upload a scan, login to your
profile, then click the Profile tab followed by the Proof of
Graduation link at the top of the screen.
5. After your profile, photo and graduation status are validated,
you will be able to click the link on your Dashboard to register
for examinations.
6. Submit payment for examination fees. The CDCA accepts U.S. VISA
and MasterCards only. Debit cards may be used if allowable by
the issuing bank and if they bear the VISA or MasterCard logo.
All payments are drawn immediately and must be paid in full.
Failure to pay the registration fee at the time of registration
may forfeit your ability to sit for the examination. Registrations
that are not paid within 72 hours are automatically cancelled from your
profile.
CDCA Online Profile Tabs
Dashboard. Under this tab you will find a find a list of items you must
submit for your CDCA profile and the status of each item.
Check Mark = completed item
Exclamation Mark = item requires attention
Apply Once all profile information has been uploaded and your profile
has been verified you may use this tab to apply for examinations.
Detailed instructions will be presented based on the available
examinations. This tab is also where your clinical assignment will be
listed once the site schedule is finalized.
Documents Candidates must visit this tab prior to the examination to
download and possibly fill out any required forms and documents.
Instructions about each document will be given.
Profile Under this tab you can view and edit your personal information
and upload your photo, proof of graduation, etc.
Results
Your results will also be posted under this tab once they are finalized and
released.
Social Security Number
A Social Security Number is not required to register and take the examination
but may be required by a state for purposes of licensure.
4
Applying for re-examination
For candidates who need to retake the examination, it is not necessary to
create another profile. Simply log back into your profile and click on “Apply” at
the top of the screen. Follow the instructions on the screen.
SITES, DATES and FEES
Dates and Sites
You should refer to the CDCA website (www.cdcaexams.org) for a current and
complete listing of the dates and sites at which the Patient Treatment Clinical
Examinations will be offered. These can be found under the tab Dental
Hygiene, menu choice Dental Hygiene Exam Calendar. Clicking on an individual
site will give you specific site information.
A current listing of the locations of Prometric Centers at which the CSCE is
offered throughout the year can be accessed at Prometric’s website
(www.prometric.com).
Site Selection
-Patient Treatment Clinical Exam
When applying online, applicants must indicate the site at which they wish to be
examined. Applicants from the school where the examination is administered
receive priority. Other applicants will be accepted on a first-come, first-served
space available basis. In some cases, if a site is full, the candidate may be
assigned to an alternate site with their permission.
Schools designated as closed sites accept only students or graduates of their
school.
Candidates who did not attend the school serving as their test site are
encouraged to visit the site prior to the time of the examination.
Site
information is available on the Dental Hygiene Exam Calendar on the CDCA
website as the host school makes it available. This should provide candidates
from outside a school the information they need to take the examination at that
institution. It is the responsibility of the candidate to find out the specific
requirements for their scheduled test site. Some sites require that all
instruments be supplied by the school. The candidate must make arrangements
with the school for the provision of instruments, if required. The school may
charge a rental fee for use of instruments, clinical facilities, supplies, and
disposables. A rental charge or deposit imposed by the facility must be
remitted directly to the school.
This fee is independent of the ADEX
examination fee and is not collected by the CDCA.
5
Computer Simulated Clinical Exam (CSCE)
The CSCE is administered at Prometric Testing Centers by appointment. The
locations of Prometric Testing Centers can be found on the website:
www.prometric.com. CDCA will instruct you on how to make an appointment
for your examination, either by calling Prometric’s National Registration Center
or via their website.
To cancel or reschedule an appointment, call the National Prometric
Registration Center (1-800-797-1813). Do not call your local Prometric
Testing Center.
If you wish to cancel or reschedule, you must call at least 30
consecutive days prior to the test date. If you call 5 to 29 consecutive
days prior to the exam date, you will be charged a $25 fee by Prometric. If you
call less than 5 consecutive days prior to the test date or are more than 15
minutes late for the examination, the examination will be cancelled and your
fee will be forfeited.
When scheduling an appointment for the CSCE with Prometric, an email
confirming the examination date and time may be requested.
It is
recommended that a copy be made and retained for future reference.
If the CSCE was failed, a new application for re-examination is required prior to
receiving authorization to schedule an appointment with Prometric for the
retake. All CDCA rules for application procedures apply.
Fees
Current fees are listed on the CDCA website; www.cdcaexams.org under tab
“About” and then select “Exam Fees.”
Refund of Fee
A request for a refund must be in writing and received by the CDCA on or
before the published application deadline date for the current examination
series for which the fee was submitted. Requests received after the published
application deadline date will not be granted.
The deadline date for the CSCE retake application is the date the retake
application is received by the CDCA. Requests for refund are not granted after
the date the CSCE retake application is received by the CDCA.
6
Failure to appear for any individual examination of the ADEX Examinations in
Dental Hygiene results in forfeiture of the entire examination fee. A refund or
partial refund is not granted for any reason.
Fee Deferral:
Under extenuating circumstances a request for the examination fee to be
deferred to another series will be considered on an individual basis when
received by the CDCA on or before the scheduled examination date and no later
than 30 days after the scheduled examination date. Requests must be made in
writing to the Director of Finance and Administration of the CDCA and must
include original documentation in support of the request. Notification will be
sent immediately after a determination is made by the CDCA. If a fee deferral
is granted, the terms and conditions for future examination as set by the CDCA
will be included. If the deferral is due to academic reasons, see the separate
section on Academic Disqualification.
Requests for fee deferral received more than 30 days after the date of the
scheduled examination will be denied and the fee will be forfeited.
Administrative Fee:
A non-refundable administrative processing fee of $100 is applicable for any
refund or fee deferral.
7
PREPARING FOR THE EXAMINATION
Pre-examination preparation
On the day of the exam, candidates must provide their own instruments or rent
them from the examination site. The site information sheet will explain which
sites do or do not rent instruments. The candidates must also provide an
acceptable patient, a full-mouth series of diagnostic-quality radiographs (or
panoramic film and bitewings) of the patient presented, and appropriate
paperwork.
Exam materials
Each testing site will send a site information sheet explaining what materials
will be available. Candidates should contact the testing site directly to
determine whether the equipment available onsite is compatible with the
candidates’ equipment.
EXAM FORMS
After the candidate’s application is completed and verified, he/she should
download and print all forms from the website www.cdcaexams.org by going to
the Dental Hygiene tab and selecting menu choice Dental Hygiene Exam Forms.
Candidates may use copies of forms for pre-screening patients and to aid in
patient preparation. If errors are made on forms in ink during the examination,
the candidate should make a single line striking through the incorrect entry,
make the correction, and initial the correction using the candidate number.
Note that in addition to the Medical History Form required for all patients, some
patients with sensitive medical conditions may require an additional physician’s
statement clearing them for treatment. If the patient has a condition that
requires a physician’s written clearance, candidates must present the
physician’s letter during the pre-treatment evaluation; if no letter is presented,
the patient will not be allowed to participate..
Candidates should develop a list of teeth and surfaces that meet the
requirements for Case Selection and record this this information on the
Treatment Selection Worksheet, then enter it into the scoring system online up
until 48 hours before the start of the scheduled examination. Alternatively, the
Case Selection may be entered into the scoring system by the DSM on the day
of the examination. Bring a copy of the Case Selection entry or the Treatment
Selection Worksheet when meeting with the DSM All Case Selection
information, whether entered online or on site, must be reviewed with the DSM
for Candidate confirmation before Pre-Treatment Evaluation.
8
Forms Required on Examination Day
Forms/Materials Presented at PreTreatment Evaluation
Forms Presented at Registration
Two candidate IDs- one photo
and two with the candidate’s
signature. Acceptable forms
include current driver’s license,
Passport, Military ID, School ID,
voter registration card. A credit
card is acceptable as a secondary
form of ID
•
Patient Medical History Form
(and physician’s statement, if
needed)
•
Dental Hygiene Progress Form
•
Patient Consent, Disclosure and
Assumption of Liability Form
•
•
Certification of Review of the
Online Orientation
Radiographs
•
Cubicle card
•
Application form that contains
the Candidate sequential number
•
PROCEDURES
Required ID
When candidates apply for the examination, they electronically submit a
recent photograph. This is applied to an Identification Card which the
candidate receives on the day of the examination. Besides the photograph,
the ID card includes the candidate’s sequential number, ID number, test site
and date. The ID card is to be cut from the sheet it is printed on and worn
in a badge holder provided the day of Orientation. This ID is to be worn at
all times during the examination. Prior to Registration, candidates must go
to their online profile, where they originally applied to take the examination,
and under the Apply Tab, find their assigned Sequential Number. In order
to enter and pick up their examination materials, candidates must print off
and bring this number with them to the Registration along with 2 other
forms of personal identification. Both of these additional IDs must contain
the candidate’s signature and one must have a recent photograph.
Acceptable forms of ID include: Current driver’s License, Passport, Military
ID, Employee ID, School ID or voter registration card. A national credit card
is an acceptable secondary form of ID. An expired Driver’s License is not
acceptable as an ID for this examination.
If the name on the documentation presented differs at all from the name
currently used on the application, official documentation or authorization of
a name change must be presented for admittance to the examination. If
not admitted for lack of this documentation the fee will be forfeited.
Note:
An identification card is not issued for the CSCE, however 2 forms of ID
9
with the name identical to that on the candidate’s registration are required
for admittance to test at the Prometric Testing Center.
Clinical Examination Schedule
Candidate Orientation is done online prior to the examination day.
AM Session
6:45 - 7:15
7:15 - 7:45
7:45
10:00
12:00
Candidate Registration
Set Up in Clinic
CFE’s can begin checking medical histories when the
candidates are ready
Exam Start: Patients who are checked in can be sent to
the Evaluation Area
Deadline for sign-in to the Evaluation Area
Exam ends
PM Session
11:45 - 12:15
12:15 - 12:45
12:45
3:00
5:00
Candidate Registration
Set Up in Clinic
CFEs can begin checking M o the Evaluation Area
Exam Start: Patients who are checked in can be sent to
the Evaluation Area
Deadline for sign in to the Evaluation Area
Exam Ends
Overview of the examination day
On the day of the examination, Candidates must attend registration. Due to
the number of sites at which the CDCA administers the examination, site
specific information may not be provided until 2 weeks before the
examination. It is the responsibility of each candidate to contact the site
prior to the date of the examination to verify that all handpieces and
sonic/ultrasonic scalers are compatible with school equipment. It is
advisable to visit the site prior to the examination date to become familiar
with the clinic. The candidate must arrange directly with school officials,
as the CDCA does not arrange tours of sites.
What
•
•
•
to bring to Registration:
Radiographs
Medical History, Consent and Treatment Selection Worksheet form
Certification of Review of the Online Orientation form from the
Candidate Manual
• Candidate Manual
• Your Sequential Number from the Apply Tab on your Profile
10
Registration Session:
• IDs will be checked and examination forms will be distributed in
envelopes
• Specific site information will be provided by the Chief Examiner
• Candidates will have the opportunity to ask questions about the
examination and/or the site
• Receive candidate badge and form for interpreter registration
• Candidates will turn in a signed form (found at the back of this
Manual) attesting that they have viewed and understood the on-line
Examination Orientation
• Receive candidate badges and badges for interpreters
• Peel-off ID labels are affixed to all required forms
Medical History forms, Consent forms and Treatment Selection
Worksheets that have been printed from the website and completed by
the Candidate and/or the patient may be used during the examination.
Bring the completed forms to Registration and affix an ID label on them.
New forms are provided at Registration if needed. The Progress Form
provided at Registration must be used during the examination.
Candidates who fail to attend registration will not receive individual
instructions.
Registration is for candidates only.
If a candidate will be using an interpreter, the interpreter should submit the
interpreter authorization form and two forms of ID to the Chief Examiner.
Clinic Floor Examiner (CFE): A dentist who supervises
the clinic floor during the examination. The CFE evaluates the patient’s
health history to determine whether it is safe for the patient to participate
in the examination and receive local anesthesia. The CFE serves as a liaison
between the candidate and examiners, but does not evaluate the
candidate’s performance.
Data Systems Manager (DSM): The DSM assists candidates with entering
examination data into the computer scoring system. DSM does not
evaluate candidate performance.
Candidates should review/enter the Case Selection with the DSM or CFE to
insure its accuracy. Examination paperwork is reviewed by a CFE and when
approved, the patient proceeds to a separate Evaluation Area where three
examiners independently evaluate the patient during the Pre-Treatment
Evaluation process. The patient is then returned to the candidate to begin
clinical treatment. When the 2 hour clinical treatment time ends or if the
candidate is ready before that time, the candidate escorts the patient to the
11
Evaluation Area and meets with the DSM to enter the Calculus Detection
findings and Periodontal Probe readings and then the patient enters the
Evaluation Area where three examiners evaluate the candidate’s work. When
the final evaluation is complete, the patient returns to the candidate, the
candidate dismisses the patient and cleans the cubicle. Only one patient
may be presented for the Patient Treatment Clinical Examination. Once a
patient’s medical history and other examination forms have been submitted
to a CFE for approval, the exam has begun and a back up patient may not
be presented.
If, before the patient is presented to the CFE, the candidate determines that
the patient is ineligible, a back-up patient may be presented. The work-up
of back-up patients is at the expense of the total time allowed for the
examination process. Candidates begin the Patient Treatment Clinical
Examination at either 7:45 a.m. or 12:45 p.m. as assigned by group.
Cubicle set-up
During set up candidates check that the air, water, light, and chair are
working properly, and notify the CFE of equipment failure. Locate the
disposable supplies provided by the school. They need to set up and arrange
instruments and paperwork take the patient’s blood pressure and record it
on the Medical History. (No treatment may be provided if the systolic
pressure is 160 and/or the disastolic is 100 mm Hg or above.) The CFE
Checks the Medical History and enters appropriate information on the
Progress Form. Anesthesia is provided if approved by the CFE. When ready,
the candidate brings the patient to the Evaluation Area sign in desk and
meets with the DSM to enter or confirm the previously submitted Case
Selection into the scoring system. After you have checked in with the CFE
you can set up the ultrasonic cleaner and make sure it works properly.
QUICK TIP
REQUIRED MATERIALS
• 11/12 explorer and a probe with markings 1 mm apart
• A blood pressure measuring device
• Syringes / supplies for local anesthesia administration, if applicable. Testing sites
provide cartridges of anesthetic.
• A tray for the patient to transport the instruments to the designated area Sterile
instruments (choice of the candidate)
• Ultrasonic/sonic scaling instruments. At some schools, ultrasonic units may be available
for rent. Contact the school directly to see if this service is available. CDCA does not
assist in equipment rental issues
• A hand-piece compatible with the examination site’s equipment
12
Pre-Treatment Evaluation
Pre-treatment evaluation is the procedure during which three examiners in
the Evaluation Area:
If the patient is sitting for more than one examination on the same day, the
blood pressure must be taken prior to each examination and recorded on a
separate Medical History Form for each candidate.
Pre-Treatment Evaluation
Pre-Treatment Evaluation is the procedure during which three examiners in the
Evaluation Area:
•
•
•
•
•
•
Evaluate the Case Selection according to the examination criteria
Assign teeth for calculus detection and periodontal assessment
exercises
Assign two additional surfaces of qualifying calculus
Document where calculus is found on the teeth assigned for detection
Measure and record the periodontal pocket depths on the teeth
assigned for the periodontal assessment
Validate 12 surfaces of qualifying calculus from the 12 surfaces
selected by the candidate and the 2 surfaces added by the examiners.
The 12 surfaces validated for the Calculus Removal exercise may be a
combination of surfaces selected by the Candidate and those selected
by the examiners.
Pre-Treatment Evaluation may take 35 minutes once the evaluation process
has begun in the Evaluation Area. Patients should remain in the candidate’s
treatment chair until advised by a CFE that space is available in the
Evaluation Area. Patients may use books, magazines or other non-electronic
devices. The use of all electronic devices by both patients and candidates is
prohibited during the examination. To facilitate the pre-treatment evaluation
process, patients must be plaque-free, with no evidence of soft debris, food
matter, etc. Candidates who present patients with excessive soft debris will
not earn points for initial case presentation.
13
The following items must always accompany the patient to the Evaluation Area:
Paperwork
• Required radiographs
• Color coded cublcle card
• Consent Form
• Completed, signed and dated Medical History Form, current within 30 days of
examination date. Attach a physician’s statement, if needed.
• Dental Hygiene Progress Form, with the following information completed:
 Candidate information
 Anesthesia record
 Quadrant and additional teeth selected for the partial debridement
o These must be the same as entered into the website, if the exam is
administered electronically
 Teeth and surfaces where qualifying calculus is located
o These must be the same as entered into the website, if the exam is
administered electronically
 Comments to examiners
Instruments
•
•
•
11/12 explorer for calculus detection
Periodontal probe for periodontal assessment with markings of 1-2-3-4-5-6-78-9-10. The probe may be single or double ended
Reflective front surface mirror, which may be one or two sided
Other Materials
•
•
•
A tray for the patient, to transport the instruments and required paperwork to
the designated area for pre-treatment evaluation
Eyewear for the patient
Barcode on a clean patient napkin
Clinical treatment time
The clinical skills section of the ADEX Dental Hygiene Examination evaluates the
candidate’s ability to detect calculus, remove calculus without damaging the
surrounding tissue, and accurately measure periodontal pocket depths.
Candidates have 2 hours to complete the calculus detection, periodontal pocket
measurements, and calculus removal exercises. Perform calculus detection and
periodontal measurements before beginning calculus removal, in order to
ensure accurate detection and measurements.
Clinical treatment time begins and ends as noted on the Progress Form by the
examiners. Stop-time is exactly 2 hours after the start-time. Post-treatment
evaluation begins when the patient returns to the Evaluation Station. However,
any candidate wishing to proceed to post-treatment evaluation prior to the end
of the 2 hour deadline may do so.
14
Use of local anesthesia
The use of injectable local anesthesia will be permitted at the discretion of the
examination sites. Candidates should check with the school prior to the
examination, to determine whether the use of injectable local anesthesia is
allowed.
The use of injectable local anesthetic is permitted, if allowed by the
examination site, by candidates who are:
• students at the host school and who have successfully completed the
required anesthetic course work and have been certified on the day of
the examination by the program director or other authorized school
official at the exam site.
• student candidates from schools external to the school hosting the
examination, including unlicensed graduates of schools external to the
host school, and who provide a letter from their program director or the
authorized school official certifying successful completion of the required
anesthetic course work.
• graduates who are authorized by a state to use injectable local
anesthetics, and who provide documentation, on the day of the
examination, from their state dental board, authorizing them to utilize
injectable local anesthesia (copies of active state certificates that permit
the use of injectable local anesthetic are acceptable documentation).
This documentation must be provided to the Chief examiner at registration.
•
•
Candidates must provide all syringes and supplies for anesthetic
administration. Cartridges may or may not be provided at the site for
injectable local anesthesia but all local anesthetics must be used before
their expiration date.
After the CFE approves the Medical History and Anesthetic Request, the
candidate may anesthetize the patient before going into the evaluation
area or at any time during the clinical examination. The CFE will tell you
when to anesthetize based on when a chair will be available in the
Evaluation Area for your patient.
All candidates who utilize local anesthesia for their patients are required to
complete the appropriate documentation. When deciding whether to administer
anesthesia, keep in mind that three examiners will examine the patient using
the explorer and probe subgingivally during Pre-Treatment Evaluation. It is
recommended to anesthetize the patient before Pre-Treatment Evaluation for
better patient comfort and time utilization. The Progress Form in this Manual
gives an example of a completed anesthesia record.
Candidates wanting to utilize topical and/or injectable anesthesia must
complete the anesthesia record on the Progress Form and have it approved by
the CFE at Check-in. Permission for the use of any anesthetic agent must be
15
granted by the CFE, prior to administration, at the start of the examination and
properly documented on the Progress Form. The candidate may choose not to
use an injectable local anesthetic agent. Combination agents such as lidocaine
and prilocaine periodontal gel 2.5%/2.5% are considered topical anesthetics.
Examiners do not evaluate the technique and/or actual administration of local
anesthetic.
Candidates may be observed by the CFE regarding proper
technique, in order to ensure patient safety and comfort.
Inhalation anesthesia is not permitted for the examination. Violation of this
standard will result in failure of the affected examination.
If more than 2 cartridges of anesthetic are needed during the examination, the
candidate must request approval from the CFE who will document and initial the
request.
This protocol must be followed for each subsequent cartridge.
Anesthetic solution may only be administered following approval of the CFE. An
aspirating syringe and proper aspirating technique must be used for the
administration of local anesthetic.
Candidates who are not qualified to administer local anesthetics may
use topical anesthetics or anesthesia patches (Oraqix, etc.). The CDCA does not
permit a third party, whether an examiner, dentist or licensed dental hygienist
to administer local anesthetic for a candidate.
Shared Patients
For patient safety, no more than half the maximum anesthetic dose may be
utilized for a patient who will be treated by two candidates on the same day.
16
Post Treatment Evaluation
Examiners perform the Post Treatment Evaluation once all treatment is
completed. Candidates escort their patients to the Sign In desk. Candidates
meet with the DSM to enter the Perio Probing Measurement, Calculus Detection
findings and Anesthesia record then the patients are taken into the Evaluation
Area for Post Treatment Evaluation.
Before the patient is signed in for post-treatment evaluation, candidates meet
with the DSM to enter their detection findings, periodontal probe
measurements, and information from the anesthetic record on the Progress
Form into the computer-scoring system.
Notes for Post-Treatment Evaluation
Patient Preparation For Post-Treatment Evaluation
Wearing safety glasses
Clean patient napkin
with ID label attached
• Patient carries the tray of instruments and required
Required Instruments & Paperwork
•
•
• Mirror
• 11/12 explorer
• Dental Hygiene Progress Form
• Medical History Form
• Consent Form
• Radiographs
• Color coded cubicle card
Information for Patient
•
•
•
Three examiners will complete the final evaluation.
No electronic devices can be used by patients
Patients may use books, magazines, and any other non-electronic means of
passing time.
Cubicle clean-up
While patients are in the Evaluation Area for Post Treatment Evaluation,
candidates can clean and disinfect their units. When patients return, the Medical
History and Consent Form should be signed by the candidate, and the Post
Operative Care Agreement should be signed by the patient and then the patient
can be dismissed. Candidates must check out with the CFE and return all
examination forms in the white envelope.
17
DENTAL HYGIENE PROGRESS FORM
The Dental Hygiene Progress Form has three purposes:
 Examiners use it to track the examination process for each candidate and
serve as an anesthetic record.
 Candidates use it to document periodontal pocket measurements,
presence or absence of calculus on assigned teeth and to communicate
patient care issues and pre-existing conditions to examiners.
 Candidates also use it as a communication method with the examiners.
The following description explains each section and provides instructions for
completing the form. The following pages show a blank Progress Form, a
sample form with the candidate sections completed, and another sample
showing how the Progress Form will appear after pre-treatment evaluation.
At the top of the form, attach a peel-off ID label from the white envelope
provided at Registration. Then complete the form in ink.
Choose a primary quadrant that meets criteria to demonstrate calculus removal
skills and two additional teeth in a second quadrant. This is called the Case
Selection. If you are not able to fulfill the calculus requirements from within the
primary quadrant, you may choose surfaces on up to two additional posterior
teeth from the secondary quadrant, to fulfill the requirement. Examiners will
assign two additional surfaces from within the Case Selection. All surfaces of
every tooth within the Case Selection must be treated. You must also indicate if
the third molar in the primary quadrant is included in the Case Selection.
Next complete the anesthetic record. This includes
• Name of anesthetic, both topical and injectable
• Type of injection(s) planned
• Dosage, form and strength
• Quantity of anesthetic expected
• Percentage of vasoconstrictor
• If the patient has received other anesthetic the same day
If candidates do not intend or are not eligible to use injectable local anesthesia,
they may enter the name and type of a topical anesthetic intended to be used.
However, no anesthetic needs to be used and if not, no anesthetic needs to be
recorded on the Progress Form. A CFE must review the Medical History and
approve the use of an anesthetic before it is administered. If the candidate is
eligible for the use of injectable local anesthesia (ILA) and has provided the
needed documentation to the Chief at Registration, the Chief will place a red
ILA stamp on the Progress Form. If the patient is sitting for a second candidate
the same day, only half the maximum anesthetic dose may be administered by
the first candidate.
18
Also list any premedication if applicable. Candidates who are sharing a patient
with a need for antibiotic prophylaxis must treat the patient the same clinical
day. Do not initially write anything in the section labeled “Probing
Measurements.” During pre-treatment evaluation, examiners assign two teeth
for the probing measurement exercise. That assignment will be recorded by the
examiners in this section. Once assigned, the candidate will measure and record
pocket depths on the two assigned teeth, prior to scaling.
At the bottom right in the section labeled “Calculus Detection Findings” again do
not initially write anything in this area. During pre-treatment evaluation the
examiners will assign three teeth for calculus detection evaluation. Once
assigned, the candidate will determine if calculus is (Yes) or is not present (N0)
on each of the four indicated surfaces.
On the back of the form describe any dental treatment or surgeries that
occurred since the radiographs were exposed and/or any pre-existing tissue
injuries or conditions that might affect treatment or evaluation of the patient.
For example:
• Severe hyperplasia
• Gingivitis
• Excessive decay
• Pre-existing tissue conditions that might be construed by examiners as
minor tissue trauma
• Unavoidable reasons why radiographs are less than diagnostic, e.g., narrow
palate, lingual tori, etc.
• Any restorative or surgical treatment, which the patient has undergone since
the radiographs were taken.
Calculus detection
During the Pre-Treatment Evaluation, examiners assign three teeth for the
calculus detection exercise, indicating the selected teeth on the Progress Form.
There are spaces for candidates to indicate whether or not calculus is present
on each surface.
During clinical treatment time, candidates evaluate these teeth and surfaces
and mark “Yes” if qualifying calculus is present or “No” if no qualifying calculus
is found on that surface. This clinical skills section demonstrates that a
candidate can recognize the presence of
readily detectable calculus (moderate to
QUICK TIP
heavy calculus)—on a variety of tooth
Complete the periodontal
surfaces and can recognize when a surface
measurements and calculus
is free of calculus.
detection exercise before
beginning calculus removal.
19
Candidates earn points for each surface where the candidate’s findings match
those of two out of three examiners. If examiners find calculus on a surface,
and the candidate finds calculus on the same surface, the candidate earns
points. If 2 examiners find no calculus on a surface, and the candidate also
finds no calculus on the surface, the candidate also earns points. Candidates
earn no points if they do not select an answer at all or if they select both “Yes”
and “No.”
Probing Measurements
During Pre-Treatment Evaluation, examiners assign two teeth (one anterior and one
posterior) for the periodontal assessment exercise, and write the selected tooth
numbers on the Progress Form.
During clinical treatment time and prior to any calculus removal, candidates
measure and record the three pocket depths on each of the two assigned teeth on the
Progress Form, for a total of six measurements. The candidates’ measurements must
be no more than ± 1 mm of at least 2 of the three examiners’ measurements. Because
pocket depths could change after calculus removal, candidates must complete
periodontal measurements before removing calculus. Prior to post-treatment
evaluation, the candidates assist the DSM in entering their periodontal pocket depth
measurements into the computer scoring system.
Calculus removal
If fewer than 12 surfaces of qualifying calculus are verified in the selection, including
all teeth in the quadrant and any additional teeth chosen by the candidate, points will
be awarded only for calculus removal on the surfaces verified by two examiners as
having qualifying calculus. For example, if examiners are able to verify only eight
surfaces with qualifying calculus, the candidate will have only eight opportunities to
earn points for calculus removal, rather than 12 opportunities, and will automatically
lose points for removal on four surfaces.
Treatment Selection Worksheet
This is used in developing the selection of teeth and surfaces for the Case Selection and
to provide to the DSM so the selected teeth and surfaces can be entered into the tablet
at the beginning of the examination. It also includes a designation of the primary
quadrant and extra tooth selections plus whether or not the 3rd molar is included.
20
-
21
Blank Dental Hygiene Progress Form
22
Progress Form as Completed by the Candidate for CFE Check-in
23
Progress Form after Pre-Treatment evaluation is completed
24
Medical History Form
Patients complete the Medical History Form in ink prior to the day of the examination.
Patients should complete this form no more than 30 days prior to the day of the
examination. The information on this form should be reviewed with the patient on the
day of the examination.
1. Place a peel-off ID label in the area labeled“ PLACE ID LABEL HERE” at the top left.
2. Enter the Candidate Number in the area labeled “Candidate Sequential” at the top
right.
3. Enter the Cubicle Number during set up at the top right.
4. Do not complete the “Blood Pressure-Required- Must Be Taken Day of Examination”
blank until set up. Complete this area after patient is seated and BP is taken.
Complete “Date/Time Taken” after you record the patient’s BP on the day of the
examination.
5. CFE will enter their examiner number in the area labeled “Examiner Confirms BP
Taken Day of Exam” during set up. This indicates that the CFE has reviewed the
form and the patient is approved to participate in the examination.
6. Patient answers questions 1 through 13, including questions 8.A through FF, within
30 days of the examination, signs, and dates the form in the area indicated.
7. At the bottom of page two, enter the ASA Classification of the patient.
8. Candidates initial and date the form but do not enter a signature until after the
examination is completed, in order to preserve anonymity.
9. Present this form completed except for the candidate signature, with other forms at
pre-treatment evaluation.
On the day of the examination, the candidate must document on the Medical History Form all
medications or supplements taken by the patient within the last 24 hours. Candidates should
document antibiotic premedication on the appropriate Progress Form, as well as on the
Medical History Form.
In order to participate in the examination, patients must meet the following criteria:
1. The patient’s blood pressure taken on the day of the exam must be below 160
(systolic) and/or 100 (diastolic). The patient's health status must be acceptable for
treatment.
2. Candidates who are sharing a patient requiring antibiotic prophylaxis must treat the
patient the same day. Treatment of the same patient on subsequent clinical days will
not be permitted.
3. Patients must have no history of heart attack (myocardial infarction), stroke or cardiac
surgery within the last six months.
4. Patients may not have active tuberculosis. A patient who has tested positive for
tuberculosis or who is being treated for tuberculosis but does not have the clinical
signs is acceptable.
5. Patients may not have undergone chemotherapy for cancer within the last six
months.
6. Patients may not have a history of taking IV or orally administered bisphosphonate
medications.
7. Patients may not have active incidence of bisphosphonate osteonecrosis of the jaw
(BON) also known as osteochemonecrosis or osteonecrosis of the jaw (ONJ).
8. Not in the first or third trimesters of pregnancy.
25
9. Patients with latex allergies may not participate
10. Candidates must follow the current American Heart Association antibiotic
premedication recommendations when treating patients at potential risk of infective
endocarditis following dental treatment. A medical clearance may be indicated to
determine the patient’s potential risk of endocarditis.
11. If the patient answers “yes’” to any of the questions on the Medical History, the
candidate must explore the item further and determine whether a medical clearance
from a licensed physician would be appropriate. A medical clearance is required if
the finding could affect the patient’s suitability for elective dental treatment during
the examination.
The candidate must have the form available during set up so the CFE can verify that:
•
•
•
All sections are complete
When required, a proper physician’s statement is provided
Administration of injectable local anesthesia is appropriate
Patient Medical Clearance: If the patient indicates a medical history that could affect their
suitability for treatment, the candidate must receive written medical clearance from a licensed
physician indicating that the patient may participate in the examination. The medical
clearance, if necessary, must include
•
A clearly legible statement from a licensed physician written within 30 days prior to the
examination on official letterhead
•
A positive statement of how the patient should be medically managed
•
The physician’s clearly legible name, address and phone number
•
A telephone number where the physician may be reached on the day of the
examination if a question arises regarding the patient’s health
The Medical History Form and medical clearance will be reviewed by a CFE and must
accompany the patient when the treatment selection is submitted for evaluation (pre-treatment
evaluation /case acceptance). If the patient sits for more than one candidate, a separate
Medical History Form and Patient Consent Form must be completed for each examination.
If a patient presents with an active oral herpetic lesion, the CFE must evaluate the
lesion and will decide if it is safe for the patient, candidate, and examiners to proceed
with the examination using that patient. If the CFE determines that it will be unsafe for
the patient to be treated, the CFE will dismiss the patient and the candidate from the
examination and the candidate fails. The candidate may reapply for the earliest
available examination.
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Blank Medical History Form
27
Post-Operative Care Agreement
Complete this form in ink. Please ensure the information is legible. Provide it to the
patient at the end of the examinations.
Both the patient and candidate must sign the form.
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Patient Consent, Disclosure and Assumption of Responsibility
Form
The patient completes this form in ink, prior to registration/orientation. The patient
must sign and date the form.
This form requires a peel-off label, the candidate’s Sequential Number and Cubicle
Number. On the back of the form the patient’s name, address, sex, age and contact
information is entered along with the patient’s signature. The candidate’s name is only
added at the end of the exam before the records are turned in. This form must
accompany the patient when the treatment procedure is submitted for evaluation.
APPEALS
SCORE CERTIFICATION PROCEDURE
Score Certification is a procedure whereby the electronic evaluation and accompanying
documents from which the examination score were generated are re-checked for any
irregularities or errors which may have occurred in establishing the score. Irregularities
or errors in scoring include duplicate entries, missing or extraneous marks on
accompanying documents that could have been misread prior to grading or a
mathematical error. Score Certification is not a review of the examination process or
candidate performance and a listing of specific candidate errors is not included.
29
For information on how to submit a request for a Score Certification, go to
www.cdacexams.org click on “Scores” and then menu item Score Certification and
Appeals.
CANDIDATE APPEALS PROCEDURE
A Candidate Appeal may be generated if the candidate believes that their examination
results was/were adversely affected by extraordinary conditions during the
examination, which affected the final outcome of the candidate’s examination. Appeals
are reviewed on the basis of facts surrounding the decision during the examination.
Appeals based on patient behavior, tardiness or failure to appear will not be considered.
The appeals process is the final review authority and if the appeal is denied there is no
further review process within the CDCA.
All reviews of Candidate Appeals include the Score Certification Procedure described
above, and are based on a reassessment of the documentation of the candidate’s
performance on the examination. The review is limited to a determination of whether
there exists substantial evidence to support the judgment of the examiners at the time
of the examination. The review will not take into consideration other documentation
that is not part of the examination process. Opinions of the candidate, faculty
members, patients, colleagues, examiners acting outside of the area of their
assignment and records of academic achievement are not considered in determining the
results of the examination and do not constitute a factual basis for an appeal.
Consideration can only be given to the electronic scoring, documents, radiographs or
other materials that were created/submitted during the examination and remain in the
possession of the CDCA. Any other information such as radiographs, photographs or
models of a patient taken after the completion of the examination will not be considered
in the appeals process. Any candidate receiving a failing score on an ADEX examination
may, on one’s own behalf, submit a candidate appeal of that failing score. For
information on how to submit an Appeal and the Appeal Process itself, go to
www.cdcaexams.org click on “Scores” and select “Score Certification and Appeals.”
POLICIES
1.
Anonymity
The CDCA conducts all examinations anonymously. All examination materials are
identified by the candidate’s ID number assigned prior to the examination. The
candidate’s name and school information do not appear on any material reviewed by
the examiners. The examiners at all sites are experienced practitioners with diverse
backgrounds. The examiners are trained and standardized prior to each examination
and are evaluated to ensure grading to established criteria. The examiners are
separated from the candidates and remain in a separate area of the facility. The
candidates must observe all signs and follow instructions so as not to breach
anonymity. Anonymity is preserved between the scoring examiners and the candidates
and nearly always among the examiners themselves. However there are rare instances
where fairness or patient safety requires consultation among examiners.
30
2.
Candidate accessibility
The CDCA makes every effort to accommodate and comply with ADA legislation for any
candidate with a documented physical and/or learning disability that impairs sensory,
Manual, or speaking skills and that requires a reasonable deviation from the normal
administration of the examination. The candidate must present a written statement
from a qualified physician or appropriate health care provider at the time of application.
The statement must clearly define the limitation(s) and must detail the assistance
required to ensure appropriate accommodations. Requests are evaluated on a case-bycase basis. Accommodations/deviations are not allowed for those components/skills the
examination measures. Information regarding the physical/learning challenges of a
candidate will remain confidential except in the case of disabilities that may require
emergency treatment. In such cases, onsite safety personnel will be advised.
3.
Change of name
After creation of an online profile under one name, notification of a name change should
be emailed to director@cdcaexams.org along with appropriate documentation such as a
marriage certificate or court order.
4.
Confidentiality
The CDCA office staff or examiners will not discuss candidate scores, appeals, concerns,
or questions with a candidate’s spouse, parent, faculty member, family member, or
friend.
5.
Dismissal from examination
This listing is not all-inclusive of the reasons for which a candidate may receive a failing
evaluation or dismissal. Some procedures may be deemed unsatisfactory for other
reasons. Additionally, a combination of several unsatisfactory evaluations may result in
failure. Reexamination may be denied for one year from the date of dismissal from the
examination. Infractions that may lead to dismissal or failure include:
•
Evidence of dishonesty or misrepresentation during the application process,
including false or misleading statements or false documentation presented by
the candidate or on the candidate’s behalf
•
Evidence of dishonesty or misrepresentation during candidate registration or
during the course of the examination
•
Rude, abusive, or uncooperative behavior exhibited by the candidate and/or
those accompanying the candidate to the examination site
•
Failure of the candidate to carry out a directive of the Chief Examiner or
continuing to work after published cut-off time
•
Failure to complete the examination within the allotted time (No make-up time,
grace period or second effort is allowed for any part of this examination).
•
Alteration of preoperative radiographs
•
Receiving assistance from a dentist, another candidate, faculty member, etc.
The CDCA understands that different programs will support candidates in
different ways, but patient selection must be an independent decision made only
by the candidate.
•
Thievery during the course of the examination
31
•
•
•
•
•
•
•
6.
Performance of any unauthorized work outside of designated areas at the test
site
Noncompliance with anonymity requirements for pre-treatment evaluation
and/or examiner scoring. Candidates must not enter the Evaluation Area
beyond the sign in desk.
Noncompliance with established guidelines for asepsis and infectious disease
control
Disregard for the oral structures or welfare of the patient or lack of skill to
perform assigned clinical procedures
Charging patients for services performed
Failing to complete or refusing to provide a Post-Operative Care form
Attempting to use a patient who is a dentist, dental hygienist, junior or senior
dental student, or dental hygiene student
Electronic equipment
The CDCA prohibits the use of cellular telephones, pagers, cameras, electronic readers
or other electronic equipment by candidates and/or patients within the clinic/scoring
areas. Violation of this policy is a reason for dismissal from the examination.
7.
Examination placement & limitations
When the application is processed, the CDCA assigns a group and exam time for each
candidate after the examination’s published registration deadline. The CDCA policy does
not allow transfer to another testing date or location once an examination site
assignment has been made. However, in cases of a medical emergency, the CDCA may
consider transfers on a case-by-case basis. The candidate must fully document the
nature of the emergency in writing. The CDCA office must receive notification prior to
the examination, or the request will not be considered and the candidate will be
deemed a “no-show.”
Priority seating for the examination is given for the exam site’s current students and
former students, then on a first come, first served basis for all other candidates. An
exam site may become full prior to the application deadline and the CDCA cannot
guarantee placement at any exam site. Applying early may increase the probability of
placement in the preferred site.
The CDCA reserves the right to cancel an exam and reassign candidates to other testing
sites in the event there are too few candidates scheduled for any examination.
8.
Examination results
Candidates must pass the clinical examination with a score of at least 75. Candidates
who fail may retake the examination and can login to their profile on the CDCA website
to see a critique of the errors assessed.
Results are available online within three business days after completion of the
examination if administered electronically. Results from exams administered on paper
take longer to report. An unofficial results report from each examination will be
available to view/download online under the ‘Results’ tab of the candidates’ profile.
32
The CDCA automatically sends the examination record of each candidate to the CDCA
participating state boards of dentistry.
Some state boards of dentistry may require a notarized copy of the final report, which
the CDCA will provide for a nominal fee. Please contact our office to request this
additional service.
In addition to the CDCA’s participating boards, other states accept the CDCA/ADEX
results for licensure. Candidates should contact the individual state board of dentistry
where they are applying for licensure to verify acceptance of the CDCA/ADEX scores
and to learn of other state-specific requirements.
The CDCA supplies the examination results to the participating state boards but does
not analyze or interpret the records and makes no recommendations on the way the
states use the scores. Individual state boards determine acceptance of the regional
examination scores.
9.
Equipment
Providing the necessary equipment is the responsibility of each candidate or in some
cases, some equipment may be rented from the host school. Contact the individual
school for specific information. Each testing site charges an additional fee for the use of
facilities and incidental materials. This fee is charged by each school separately from
the ADEX examination fee. TheCDCA strongly advises candidates to visit the
examination site at a suitable time prior to examination to familiarize themselves with
the facilities and available equipment and to ensure that their hand-pieces and
ultrasonic/sonic equipment can be adapted to the unit available at the testing site.
These arrangements must be made directly with the school. The use of ultrasonic/sonic
instruments is permitted; however, it is the candidate's responsibility to provide
equipment that is compatible with testing site attachments. Some additional equipment
may be available from certain schools/testing sites if candidates arrange in advance
with the school. The school/testing site provides the operating chair and unit.
The CDCA is not responsible for the malfunction of the facility’s or the candidate’s
equipment and may not allot additional time due to the malfunction of any equipment.
Equipment maintenance personnel are onsite during each examination to ensure the
equipment and the water are in working order. At the site, should an equipment
malfunction occur prior to or during the examination, the candidate must immediately
notify the CFE or DSM so the appropriate personnel may be contacted.
10.
Ineligible candidates
A candidate may be disqualified from taking the ADEX Dental Hygiene Examination by
the program director of the dental hygiene program the candidate attends even after
acceptance of the application. Disqualification means that graduation is no longer
expected to occur within 45 days of the scheduled Patient Treatment Clinical
Examination.
Disqualification does not apply to the Computer Simulated Clinical
Examination (CSCE).
Notification of disqualification by the program director (or designated school official) for
the Patient Treatment Clinical Examination must be received by the CDCA, in writing or
33
by facsimile, FOURTEEN (14) CALENDAR DAYS OR MORE IN ADVANCE OF THE START
DATE OF THE CURRENTLY SCHEDULED PATIENT TREATMENT CLINICAL EXAMINATION.
Notification by any other source or in any other manner is not recognized or accepted.
Facsimiles must be immediately followed by a letter to the CDCA with the required
signature of the program director (or designated school official).
Acceptance of disqualification by the CDCA is considered final. Once disqualified from
any given series, a candidate will not be reinstated for examination during the series for
which disqualification was received and accepted.
Fees paid by candidates who are disqualified shall be applied, less $100 processing fee,
to the next examination series for which they are eligible and/or certified. A new online
application must be submitted with all required documentation, including the processing
fee, for the series desired. The balance of the fee will be forfeited if the examination is
not taken during the next examination series or if the candidate withdraws at any time
after having been disqualified.
If the Computer Simulated Clinical Examination (CSCE) is failed during the series for
which disqualification was received for the Patient Treatment Clinical Examination, the
candidate will be notified of the CSCE results. In the event the candidate wishes to
retake the failed CSCE prior to the Patient Treatment Clinical Examination, a new
application must be completed together with appropriate documentation and the
payment of the application fee in addition to the $100 processing fee for the Patient
Treatment Clinical Examination.
If the official notification by the dental hygiene program is received by the CDCA in
writing or facsimile less than 14 days prior to the date published for the Patient
Treatment Clinical Examination, the notice of academic disqualification is not accepted
and the candidate’s fee is forfeited.
All applicants will be notified by the CDCA when official notification of academic
disqualification has been received and recorded.
11.
Infection control
The current recommended infection control procedures as published by the Centers for
Disease Control and Prevention must be followed for the Patient Treatment Clinical
Examination. These procedures must begin with the initial setting up of the unit,
continue throughout the Patient Treatment Clinical Examination and include the final
cleanup of the operatory. Failure to comply will result in the loss of points and any
violation that could lead to direct patient harm will result in termination of the
examination and loss of all points.
To the extent possible, dental professionals must prevent the spread of infectious
diseases. Because many infectious patients are asymptomatic, all patients shall be
treated as if they are, in fact infectious. Use of standard precautions including barriers,
disposables whenever possible, and proper disinfection and sterilization is required.
The following infection control procedures shall be strictly adhered to:
34
1.
Personal Protective Equipment/barriers.
a.
Gloves, masks and eye protection must be worn when setting up or
performing any intra-oral procedures and when cleaning up after any
treatment. If rips or tears occur, new gloves must be donned. Gloves
are not to be worn outside the operatory. Patients with known allergies
to latex will NOT be allowed to participate for the examination. Hand
washing must occur prior to patient treatment, during patient treatment
if glove(s) are compromised and when gloves are removed. Alcohol hand
sanitizer (60% alcohol or greater) is permitted in place of hand washing
only if hands are not visibly soiled. No rings that can tear gloves or wrist
jewelry except a watch is permitted.
b.
Clean long sleeved uniforms, gowns, or laboratory coats are to be worn
and must be changed if they become visibly soiled. Gowns or laboratory
coats are to be removed before leaving the clinic area.
c.
Face masks and protective eyewear with side shields must be worn
during all procedures in which splashing of any body fluids is likely to
occur. Masks are to be discarded after each patient or sooner if the
masks become damp or soiled.
d.
Footwear may not include sandals, perforated clogs or open-toed shoes
(a safety issue rather than strictly infection control).
e.
Impervious-backed paper, aluminum foil or plastic wrap may be used to
cover surfaces that may become contaminated. The coverings must be
removed (while gloved), discarded, and replaced (after removing gloves)
between patients.
f.
A clean patient napkin must be worn by the patient when he/she goes to
the Evaluation Station.
g.
Patients must wear protective eyewear during all clinical procedures and
are required to bring protective eyewear with them to the Evaluation
Station for use during the evaluation of clinical procedures.
STERILIZATION AND DISINFECTION
Instruments, gloves and other materials, which become contaminated, must be placed
in appropriate receptacles.
Instruments: Any instrument that penetrates soft or hard tissue shall be disposed of
or sterilized before and after each use. Instruments that do not penetrate hard of soft
tissues, but do come in contact with oral tissues, shall be a single use disposable item
and properly discarded or sterilized when appropriate.
a.
Surfaces and counter tops if not barrier wrapped, surfaces and counter
tops shall be pre-cleaned & disinfected with hospital level disinfectant.
35
b.
Handpieces, prophy angles, air/water syringes shall be sterilized before
and after use or properly disposed of after use.
Used sharps are to be placed in a spill proof, puncture resistant container. Needles are
to be recapped with a one-handed method or with special devices designed to prevent
needle-stick injuries and disposed of properly.
All waste and disposable items shall be considered potentially infectious and shall be
disposed of as is customary at the testing site in accordance with federal, state and
local regulations.
Exposure to Blood Pathogens: An exposure incident is defined as contact with blood
and/or other potentially infectious materials (OPIM) through:
a.
Needlestick, sharp or other percutaneous exposure,
b.
Non-intact skin exposure such as an open cut, burn or abrasion, or
c.
Contact with a mucous membrane (e.g. inside nose, eye or mouth).
Since maximum benefit of therapy is most likely to occur with prompt treatment, the
following policy has been established:
a.
Immediately following the exposure incident, puncture wounds or other
percutaneous exposures should be cleaned with soap and water. Mucous
membrane exposed to blood or OPIM should be extensively rinsed.
b.
All percutaneous exposures and other exposures to blood and OPIM
should be reported immediately to the Chief Examiner and the person in
authority at the examination site so that appropriate measures can be
initiated and the exposure incident documented.
c.
If possible, post-exposure prophylactic treatment should be initiated at
the examination site if appropriate, as determined by the U.S.
Department of Health and Human Services recommendations or
appropriate referral made.
At the completion of all clinical examinations performed in operatories, it is the
responsibility of candidates to thoroughly clean the operatory utilizing accepted
infection control procedures.
Emergency Medical Equipment: Automatic External Defibrillator (AED) equipment,
pocket masks, resuscitation bags, or other ventilation devices will likely be provided by
the school in strategic locations. Candidates should be familiar with their location and
use.
36
12.
Instruments
Candidates must provide these instruments for the examiners during pre-treatment an
post-treatment evaluation:
•
A probe with markings of 1-2-3-4-5-6-7-8-9-10. The probe may be single ended
or double ended. Candidates may use the brand or manufacturer of their choice
but the UNC probe is the recommended instrument.
•
An 11/12 explorer for calculus detection at pre-treatment and post-treatment
evaluation of calculus removal
•
A reflective front surface mouth mirror, which may be one or two sided
All other instruments are the choice of the candidate. Candidates must provide a blood
pressure measuring device and supplies for anesthetic administration, including
syringes. The school may or may not supply anesthetic cartridges. The only
requirement is that the cartridge be within its “use by” date. Candidates may choose
the type of anesthetic used.
If the candidate does not provide the appropriate instruments, examiners cannot
evaluate the patient at pre-treatment evaluation and the candidate loses the time
necessary to provide the missing item(s). If the candidate cannot obtain the required
instruments, he/she will be unable to take the examination and will fail the
examination.
Candidates are encouraged to secure and provide additional instruments for the
examination. Candidates will not be allowed additional time for instruments dropped or
for autoclaving instruments. The candidate should provide an additional sterile
mirror,11/12 explorer, and correct periodontal probe in case an instrument is dropped.
13.
Interpreters
Candidates should utilize the services of an interpreter when their patient does not
speak English or is hearing impaired and their hearing loss cannot be corrected. (This is
particularly important when the patient has a history of medical problems or is on
medications.) Faculty members, dentists and dental hygienists (licensed or unlicensed),
third or fourth year dental students, and final year dental hygiene students may not act
as interpreter during the Patient Treatment Clinical Examination. If an interpreter is
utilized, the candidate must notify the Chief Examiner following registration and the
Chief will provide the needed Interpreter Disclosure Statement and Interpreter ID Form.
The candidate must bring two separate 2” x 2” photos of the interpreter, one to be
attached to the top of the Interpreter Disclosure Statement and one attached to the
bottom of the form which serves as the interpreter’s ID. During the clinical examination,
the interpreter must wear a photo identifying badge provided by the CDCA at all times
when on the clinic floor. Candidates are responsible for the registration of the
interpreter and for the conduct of the interpreter during the examination.
14.
Jurisprudence
The CDCA does not administer the jurisprudence examination for the participating
boards of dentistry, except for the State of Florida. The respective boards of dentistry
develop, administer, and score their own jurisprudence examinations. The CDCA does
not have access to nor can we provide jurisprudence study materials. Candidates
should contact the boardof dentistry in the statein which licensure is sought to arrange
to take the jurisprudence examination.
37
15.
Malpractice Insurance
Insurance in the amount of $1,000,000 / $3,000,000 is required. CNA, through the
Professional Protector Plan, administered by Brown and Brown, Inc., Tampa, Florida, in
cooperation with the Commission on Dental Competency Assessments, will provide
complimentary professional liability coverage required for the examination for all
candidates taking the human subject based portion of the CDCA/ADEX Clinical
Examination in Dental Hygiene during the calendar year 2016. The limit amount of
$1,000,000 / $3,000,000 will apply. To facilitate this consideration, the CDCA will
forward to Brown and Brown, Inc., agents for CNA, the names, addresses and
telephone numbers of all applicants for the CDCA/ADEX Dental Hygiene Examination
during the calendar year 2016.
16.
Patients
Candidates must procure their own patient and is responsible for the patient’s arrival
and return. The CDCA is not responsible for procuring patients used in examinations.
Candidates must advise their patients of the time required to participate in this
examination. Pre and Post-Treatment Evaluation may take up to more than 35 minutes
each. Patients should expect to spend a minimum of five hours participating in the
exam.
Case presentation (that is, identifying a patient whose dental condition meets the
criteria for the examination) is a scored part of the examination and must be completed
independently. It is the candidate’s responsibility to critically analyze patient data. The
candidate cannot request the recommendation of a licensed dental or dental hygiene
professional for patient selection.
Patients must be at least 18 years of age. No patient may be a dentist, dental
hygienist, junior/senior dental student, or final year dental hygiene student. A dental
assistant, whether a student or a practicing assistant, may be a patient. No one with a
latex allergy may be a patient. A woman in her first or third trimester of pregnancy is
not acceptable as a patient. Patients who have received oral, intravenous (IV),
intramuscular (IM), or subcutaneous bisphosphonate medications may not participate in
the examination. Patients presented with radiographs that are of such poor quality that
examiners cannot determine whether they are an accurate depiction of the patient will
be dismissed as ineligible
All written and oral communication must be in English. Candidates may communicate
with their patients in another language. (See Interpreter Policy.)
Patients, their teeth and oral cavity may be photographed by designated examiners
during the examination. The CDCA uses the images to revise the examiner
standardization.
17.
Patient privacy statement
At the conclusion of the CDCA/ADEX Examination, the examiners collect all patient
information. The CDCA uses patient information only for examiner reference during
the examination or during the appeal process.
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18.
Professional standards
The purpose of this examination is to assess professional competency. The CDCA
expects the candidates to maintain professional standards in the following areas:
•
Suitable operating attire, inclusive of the Personal Protective Equipment.
Patients must wear protective eyewear; candidates must follow OSHA and CDC
Guidelines.
•
Consideration for patients and cooperation with examiners, test site personnel,
and other candidates.
•
Aseptic techniques and general cleanliness of the cubicle during all procedures.
Candidates must maintain proper infection control throughout the entire
examination.
•
Protection of and concern for tooth structure and supporting tissue during
patient treatment. The unwarranted occurrence of major tissue trauma will
result in automatic failure of the entire examination.
Violation of any of these standards is grounds for immediate dismissal from the
examination. The CDCA may deny reexamination for 12 months.
19.
Questions
Direct all questions concerning jurisprudence, licensing, reciprocity, and licensure by
credentials to the appropriate state board where licensure is sought.
Questions concerning testing facilities, equipment, and facility fees can usually be
answered by checking the appropriate examination site information sheet which is
made available to candidates prior to each exam. If necessary, please contact the
school/testing site after thoroughly reading this sheet, if you have further questions.
Email general questions and questions relating to the dental hygiene examination to
director@cdcaexams.org. Once an application has been processed for a particular site,
all questions for both pre-examination and post-examination must be initiated by the
candidate only. To preserve candidate confidentiality, the CDCA staff and examiners
will not discuss candidate concerns and questions with a candidate’s spouse, parent,
faculty member, family member, or friend.
20.
Re-examination
After three unsuccessful examination attempts, the candidate should contact the state
in which licensure is sought to determine if it is possible to be licensed in that state
because some states do not permit more than four exam attempts. Some states require
remedial training after the second or third attempt. Passing a subsequent exam
attempts does not negate the required remedial training.
21.
Remediation
The CDCA does not require remedial education prior to re-examination of any clinical
examination in Dental Hygiene. However, the CDCA and ADEX strongly encourage
remediation prior to retaking any portion of the examination. Licensing jurisdictions
may require remedial education prior to retaking the ADEX Dental Hygiene Examination
after failing one or more examinations a second or third time.
39
It is the responsibility of the candidate to obtain and complete all requirements for
remedial education in accordance with the requirements of the licensing jurisdictions.
The CDCA does not assume any responsibility in providing this information or in
monitoring the completion of such requirements prior to examination.
22.
Refunds
CDCA will not refund examination fees for candidates who fail to appear for a scheduled
examination unless the CDCA has received written notification prior to the application
deadline date. The CDCA does not provide refunds if the candidate is unable to secure
a patient for the examination or if a patient fails to appear or is deemed ineligible by
the examiners. Please call the CDCA office for information on transfer of application
fees.
23.
Restrictions
Candidates may not use
•
Nitrous oxide
•
Air-abrasive instruments
•
Assistants
•
Disclosing Solution
No written materials may be taken into the operating area other than a copy of the
Candidate Manual (with notes written in) and the ADEX examination forms.
Candidates must wear suitable operating room attire. No personal identification of the
candidate may appear on candidate clinical attire. Photo identification cards, received
at registration/orientation must be worn at all times during the clinical examination by
the candidate and interpreter (if present).
24.
Retake requirements
The computer-based and patient based examinations must be completed successfully
within 18 months after the first of the two component exams is initiated. If both
examinations are not successfully completed within the 18-month period described,
regardless of the reason, both examinations in Dental Hygiene must be retaken. A new
registration must be initiated including appropriate documentation and applicable fees.
25.
Scheduling conflicts
The examination assignment schedule is considered final when issued to the candidate.
Request for change will not be considered or made by the CDCA personnel once the
schedule has been distributed.
School personnel do not have the authority to accept a candidate for examination at
their site or to make assignment changes within an examination series.
Such
arrangements concluded between school personnel and candidate may preclude the
candidate from being admitted to the examination as well as forfeiture of fee.
The Chief Examiner is the only authorized individual who may consider a request for
schedule change. If unusual circumstances warrant such change and space is available
it is the decision of the Chief Examiner to approve such a request. This decision is
made on site on the day of examination. Prior requests are not accepted or considered.
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26.
Sharing equipment
The CDCA discourages sharing sonic and ultrasonic scalers, handpieces, and other
equipment because it is possible that candidates who are sharing equipment could be
placed in the same testing group and would need to use the shared equipment
simultaneously.
27.
Special Testing Provisions
The CDCA will administer the ADEX Dental Hygiene Examination to an individual with a
documented physical and/or learning disability, which impairs sensory, manual or
speaking skills in a place and manner accessible to persons with a disability or will offer
alternative accessible arrangements for such individuals. Efforts will be made to ensure
that the examination results accurately reflect the individual’s aptitude or achievement
level rather than reflecting the individual’s impaired sensory, manual or speaking skills,
except where those skills are factors the examination purports to measure.
The CDCA will provide appropriate auxiliary aids for such persons with impaired
sensory, manual or speaking skills unless providing such auxiliary aids would
fundamentally alter the measurement of the skills or knowledge the examination is
intended to test. To ensure that auxiliary aids or other requested modifications exist
and can be provided, candidates with a disability requesting such modification or
auxiliary aid must:
1.
Submit, in writing, a request for the auxiliary aid or modification stating the
exact auxiliary aid or modifications needed.
Requests received after the
application date or retroactive requests will not be considered.
2.
Provide documentation of the need for the auxiliary aid or modification,
indicating any portion of the dental hygiene examination for which such auxiliary
aid or modification will be needed.
3.
Provide a letter from the appropriate health care professional
documenting the disability. This letter must be received no later than 45days
prior to the date of examination.
In providing such auxiliary aids or modifications, the CDCA reserves the ultimate
discretion to choose between effective auxiliary aids or modifications and reserves the
right to maintain the security of the examination. All information obtained regarding
any physical and/or learning disability of a candidate will be kept confidential with the
following exceptions:
1.
Authorized individuals administering the examination may be informed regarding
any auxiliary aid or modification; and
2.
First aid and safety personnel at the test site may be informed if the disability
might require emergency treatment.
Requests for Special Accommodations due to Religious Constraints: Candidates
requesting special accommodation due to religious constraints must request a separate
Application for Religious Accommodations from the CDCA Director of Examinations and
submit it to the CDCA by the examination deadline date.
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28.
State-only Examinations
Certain candidates may be required to take one or more of the two clinical examinations
in Dental Hygiene at the request of an individual state. These individuals who take only
part of the examination or do not meet all eligibility requirements of the standard ADEX
Dental Hygiene Examination (such as graduates of dental schools outside the U.S. or
Canada) are not eligible for CDCA or ADEX Status and their scores will be sent only to
the jurisdiction requesting this special examination. It is the sole responsibility of the
candidate to contact the individual state dental board to determine the requirements of
that state and have the state board provide the CDCA a written request. Candidates for
the State-only Examinations must indicate that information when registering by
checking the category titled “State-only Examination” and the state for which the
examination was requested.
29.
Unethical conduct
Professional behavior is a critical quality in the practice of dental hygiene. Candidates
found guilty of unethical conduct, as defined by the guidelines, automatically fail the
examination. Examples of unethical conduct include, but are not limited to
•
•
•
•
•
•
•
Using unauthorized equipment at any time during the exam
Using unauthorized patients
Altering patient records or radiographs
Treating patients outside clinic hours or receiving assistance from another
practitioner during clinical treatment time
Engaging in dishonesty
Altering candidate worksheet or treatment notes
Any other behavior that compromises the standards of professional behavior
FAQs
1.
What is the best method to find out what I have to do to pass the exam?
Read this Candidate Manual multiple times. Each time through, you will better
understand the processes and procedures. Mark important sections with
highlighters or Post-it Notes. Bring this Candidate Manual to the examination for
quick reference. There is also a helpful examination overview presentation on the
CDCA website.
2.
Where do I get the forms?
All forms are available on the CDCA website, www.cdcaexams.org, under Dental
Hygiene Exam Forms. Make multiple copies in case you make errors. Ensure
current year examination forms are completed in ink.
3.
Which forms do I complete prior to the day of the exam?
Complete the Medical History Form, Treatment Selection Worksheet, and Consent,
Disclosure and Assumption of Responsibility Form in full prior to the day of the exam
and bring them with you to registration. The Post Operative Care Agreement form is
filled out on the day of the examination.
4.
Can I use a different explorer than the ODU 11/12?
Yes. Examiners will want to use an 11/12 or equivalent explorer to score calculus
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detection and removal. You need to provide this type of explorer. You may use any
scalers or explorers to complete the calculus detection and removal exercises, but
examiners will need to use an 11/12 explorer for pre-treatment and post-treatment
evaluation.
5.
Can I use any probe I choose?
No. The CDCA requires a probe with markings of 1-2-3-4-5-6-7-8-9-10. If you do
not provide the correct probe, the examiners will not be able to check in the patient,
and you will fail the examination. The UNC probe is recommended.
6.
What is “qualifying calculus?”
See the ADEX Section of this Manual for the definition of qualifying calculus. It must
be easily detectable with an 11/12 explorer and cause a definite “bump” when
explored. On all teeth, calculus must be subgingival to qualify. Examiners
determine whether a surface of calculus qualifies. Only surfaces of qualifying
calculus in the primary quadrant and any additional teeth selected by the candidate
will be eligible for calculus removal points.
7.
Why do I need to do the calculus detection exercise before I start to scale?
During Pre-Treatment Evaluation, examiners determine the presence or absence of
calculus on the four surfaces of three assigned teeth. If you remove calculus prior
to completing the detection exercise, you will be unable to document the presence
or absence of calculus on the assigned teeth.
8.
Why do I need to complete the periodontal assessment (probing
measurement) before starting the periodontal debridement?
Examiners record their own measurements during pre-treatment evaluation.
Removing calculus prior to recording pocket depths could result in periodontal
errors, as your readings may vary by more than ± 1 mm from those recorded by
examiners while calculus was still present on the surface. In addition, it is quite
common for candidates to become so involved in the calculus removal exercise that
they run out of time or forget to do the periodontal assessment.
9.
What radiograph criteria do examiners evaluate?
Examiners check to see that the mount has the appropriate information, that
radiographs are of sufficient diagnostic quality that they can be determined to
belong to the patient presented, that radiographs are mounted correctly and
marking left and right. Indicate your candidate number, the date the radiographs
were exposed, and the patient's name on the mount or digital printout. (The same
information should be available for radiographs viewed on a monitor.)
Radiographs of the selected teeth must be of sufficient quality to accurately
diagnose caries, periodontal health, or other dental diseases and abnormalities.
Examiners evaluate only the radiographs of the primary quadrant and any additional
teeth selected by the candidate. Examiners dismiss patients as ineligible if the
radiographs are not of sufficient quality for examiners to determine that they are an
accurate depiction of the patient’s mouth. If this happens you will fail the
examination.
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10.
What materials do the examiners need for Pre and Post-Treatment
Evaluation?
For both Pre and Post-Treatment Evaluation: Barcode label on a clean patient
napkin, Dental Hygiene Progress Form, Medical History Form, Consent Form,
radiographs, color-coded cubicle ID card, patient eyewear, 11/12 explorer,
periodontal probe, mirror, and air-water syringe tip.
For both pre-treatment and post-treatment evaluation, place the instruments on a
tray, cover with a clean patient napkin and place the required forms on top. The
patient, wearing a clean bib, carries the tray into and out of the Evaluation Area.
11.
What should I tell the patient about what will happen when they go to the
Evaluation Area?
Inform the patient that they will be taken into a separate evaluation area and
evaluated by three examiners. The Pre and Post-Treatment Evaluation could each
take as long as 45 minutes. The CDCA prohibits electronic devices. Patients using
electronic devices, especially any device with a camera, will be dismissed from the
examination.
12.
What type of disclosing agents may I use?
The use of a disclosing agent is not permitted.
13.
What materials do the schools supply? (for candidates from outside the
school)
Most schools provide disposable paper products and anesthetic cartridge. It is your
responsibility to make sure you have the required instruments and supplies. You will
receive a site information sheet by email regarding the testing site prior to the
examination explaining what supplies they do and do not provide. If the information
is not on the site information sheet, you need to call the examination site for specific
questions regarding supplies that are or are not furnished.
14.
Can I use an assistant?
No.
15.
Can I administer local anesthesia to my patient?
Yes, if you are a student at the host school and your program director has notified
the Chief Examiner that you are qualified, or you are a student from an outside
school and your program director has provided written approval to the Chief
Examiner on the day of the examination. In addition, graduates who hold
certification to administer injectable local anesthesia from their state, may also
provide injectable local anesthesia if such certification is approved by the Chief
Examiner on the day of the examination. No third party is permitted to provide
injectable local anesthesia for this exam.
If you have not completed a local anesthesia course, you may use topical
anesthesia, including Oraqix or other non-injectable anesthetic agents.
16.
If my patient does not show up, can I present a different patient?
If a patient does not show up or if, prior to checking with the CFE, the candidate
realizes that the patient is ineligible, a different patient may be presented if the
44
required radiographs and paperwork are available. After a patient has been
presented to a CFE, no patient substitutions are allowed.
17.
Are ultrasonic scalers provided by the schools?
It depends on the site. Check the site information sheet for the site where you will
be taking the examination to determine if ultrasonic scalers will be provided. CDCA
does not arrange for rental equipment.
18.
Can I take radiographs on the day of the examination?
No, you must bring any radiographs needed for the examination with you on the day
of the examination.
19.
Does the calculus for the Calculus Detection exercise have to meet the
same criteria as the qualifying calculus for the Calculus Removal exercise?
Yes, the requirements are the same for both exercises.
20.
If I select surfaces of calculus on a third tooth in the second quadrant to
fulfill the calculus requirement, where do I list this tooth on the Treatment
Selection Worksheet?
As part of the 12 surfaces requirement, the tooth from the second quadrant will be
listed within the column of twelve boxes listing the teeth and surfaces selected for
Calculus Removal. The teeth should be listed in ascending order.
Additional questions?
Contact the CDCA at:
Email: director@cdcaexams.org
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IX.
QUICK EXAMINATION CHECKLIST
Patient
 At least 18 years old
 No latex allergy
 No history of bisphosphonate therapy
 Not in first or third trimester of pregnancy
 No history of myocardial infarction, stroke or cardiac surgery within 6 months
 No chemotherapy for cancer within 6 months
 No active tuberculosis
 Not a dentist, hygienist, junior or senior dental student, hygiene student in
the last year
 Is presented with diagnostic-quality radiographs
 Has a physician’s written clearance to participate, if any “Yes” answers on the
Medical History indicate a significant problem
Bring to registraton
 Two forms of ID, both with your signature and one with a recent photo
 A copy of the Candidate Application Form with the 3-digit sequential
candidate number
 Any forms that you have completed: i.e. Medical History, Consent
 A signed copy of The Review of the Online Orientation Form
 Radiographs
Cubicle set-up
 Check equipment, air, water, light, and chair to ensure proper functioning.
Contact the CFE if any problems are found.
 Take patient’s blood pressure. Record readings on the Medical History Form.
 If anesthesia is planned, enter the type of injection(s) planned and the name
of the anesthetic with percentage of vasoconstrictor on the Progress Form;
administer anesthetic prior to pre-treatment evaluation, if approved by a
CFE. When deciding whether the patient needs anesthesia prior to pretreatment evaluation, remember that three examiners will be using the
explorer and probe on the patient. Enter quantity of anesthesia on the
Progress Form prior to post-treatment evaluation.
 Verify the accuracy of case and surface selections, if entered prior to the
examination date. Last minute changes can be made, if needed. The DSM
and CFE will assist with this process.
Preparing for Pre-Treatment Evaluation
 Place clean mirror, 11/12 explorer, and probe on the tray and cover them
with an impermeable barrier.
 Place Progress Form, patient’s Medical History Form, Consent Form , Cubicle
card and radiographs on top of the barriered instruments .
 Make sure the CFE enters their examiner number on the Med. History Form.
 Have patient wear safety glasses and clean patient napkin with a candidate
label on the upper right side of the napkin.
 Ensure that patient is free of gross soft debris.
46
Clinical treatment time
 Complete detection exercise. Blanks are assessed as errors.
 Complete periodontal measurements and recording. Blanks are assessed as
errors.
 Perform oral debridement on all teeth in primary quadrant and additional
teeth.
Preparing for Post-Treatment Evaluation
 Place clean patient napkin on patient.
 Place clean mirror, 11/12 explorer, and probe on the tray covered with an
impermeable barrier.
 Place Progress Form, patient’s Medical History Form, Consent Form , Cubicle
card and radiographs on top of the instruments.
 If ILA is used, verify that the quantity is recorded on the Progress Form.
 Verify that all periodontal probing measurements and detection findings are
recorded on Progress Form.
 Ensure that the patient’s teeth are free of calculus, visible plaque, stain, and
prophy paste.
 Have patient wear safety glasses and clean patient napkin with candidate ID
label affixed.
Before post-treatment evaluation
 Make sure that all calculus detection findings and periodontal probe
measurements have been entered into the computer scoring program with
the assistance of the DSM.
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Exam Flow
Prior to the Exam Day
Review the online Candidate Orientation Materials
Enter Case Selection online up to 48 hours before your exam
Candidate Exam Day Flow
Attend Registration (6:45 am or 11:45 am) Bring:
Medical History, Consent Form and Treatment Selection Worksheet
Radiographs
Form that you completed the online Calibration
Candidate Manual
Bring your Sequential Number downloaded from the Apply Tab on your Profile
Clinic Set UP (7:15 am or 12:45 am)
Set up to seat patient and take blood Pressure, Review Medical History and do an oral exam
Confirm surfaces of calculus if needed
Sign up on the CFE Check-in form (in the clinic) when you are ready to present your patient to begin
the exam. You have 4 hours to complete the exam.
Present Patient to the CFE. Medical History, Progress Form (with anesthesia record fill out), Consent
Form and radiographs. Provide a Medical Clearance if needed.
Anesthetize the patient shortly before your turn to bring your patient to Pre-Treatment Evaluation.
CFEs will tell you when there is an Operatory available for your patient. Keep patient in the candidate
clinic with you until notified by the CFE.
Escort your patient to the Evaluation Area Sign In Desk and meet with the DSM to enter and/or
confirm our Case Selection into the grading system.
Patient will be returned from Evaluation Area by a runner. The Progress Form will indicate your 2 teeth
for Perio Probing, the 3 teeth for Calculus Detection assignment and your Finish ‘time. You will have 2
hours of Treatment Time.
Complete the probing and calculus detection and write your findings on the Progress Form.
Treat the patient and finish before the “Finish Time”
Put on a clean patient napkin with an ID label and escort the patient to the Sign In Desk.
Patient has to be signed in by the Finish Time.
Meet with the DSM to enter your Probing readings. Calculus Detection findings and Anesthetic record
into the grading system.
While patient is in Post Treatment Evaluation clean the unit, pack your instruments and belongings.
When patient returns, complete the Post Operative Care Agreement with the patient and then dismiss
the patient
Sign the Medical History and Consent Form.
Gather all your forms and check out with the CFE. You are finished.
48
Check-Off List
 I have read the entire ADEX Manual for the Examination in Dental Hygiene.
APPLICATION
 I have completed the online application by following the instructions above
PROMETRIC TESTING CENTERS:
 I have selected the location of the Prometric Testing Center where I have
elected to take the Computer Simulated Clinical Exercise. After my application
has been processed and the CDCA has sent an authorization letter, I have
called and made an appointment with Prometric at the national scheduling
number or schedule an appointment.
 I will take 2 forms of personal identification: one with a recent photo, and both
with my signature, with me to the Prometric Testing Center. Acceptable ID’s
include: valid current Driver’s License, Passport, and Military ID. A credit card
will be acceptable as a secondary form of ID. If my name has recently
changed due to marriage, divorce, or other legal reasons, I will bring a copy of
the marriage certificate or court document so stating to the Prometric Center
to assure entry.
I WILL TAKE TO THE CLINICAL EXAMINATION SITE AND REGISTRATION:
 Two forms of identification, both with my signature and 1 with a recent
photograph. Acceptable ID’s included: valid current Driver’s License, Passport,
Military ID, and Employee ID. A credit card with signature will be acceptable
as a secondary form of ID.





The name on the IDs is identical to the name under which I applied take the
examination.
I have printed the page from my online profile under the Apply tab that
indicates my assigned site, time, and Candidate ID number.
a ball point pen to be used on the Progress Forms, Medical History, Consent
Form and Post Operative Agreement Form.
two #2 lead pencils, to be used on all scannable evaluation sheets.
all necessary materials and instruments.
the ADEX Manual for the Examination in Dental Hygiene.
SCHOOL/SITE:
 I have paid any school facility use fee or equipment rental fee if required to
the school.
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CONCERNING MY PATIENTS (IF APPLICABLE):
 I have paid any school facility use fee or equipment rental fee if required to
the school.
 appropriate forms have been completed for each patient.
 the patient meets the ADEX requirements as published in the Dental Hygiene
Candidate Manual.
 I have all necessary radiographs.
 I have reviewed all the criteria that are to be evaluated in the Clinical
Exercises of the examination.
 I have informed my patient that this exercise is not a complete oral care
treatment.
ONLINE TRAINING:
 I have signed the form that I have viewed and understand the Online
Orientation prior to coming to the examination. (See the next page.)
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Certification of Review of the Online Orientation
By signing this form I certify that I have viewed the online Orientation for
this examination which is available on the CDCA website:
www.cdcaexams.org. I also certify that I understand the examination content
and process as explained in the online Orientation.
________________________________
Candidate Name (printed)
______________________
Date
________________________________
Candidate Name (Signed)
Certification of Completion of Requirements to Graduate
within 45 Days.
51
(For all candidates who have NOT graduated
and are NOT from a school in a CDCA state)
If you have not yet graduated and received your certificate or diploma, you need to
have this form signed by the Program Director or designated school official as
certification that you are expected to complete all academic requirements and
graduate within 45 days of the Patient Treatment Clinical Examination. Once signed,
scan it and submit it with your online application. Instructions will be provided
online.
Submit this form along with the application.
Student’s
Name:
Last Name
Student’s SS#:
-
First Name
Middle Name
-
School:
This letter certifies that the student listed above is a senior student of record and is
expected to complete all academic requirements to graduate within 45 days of the
scheduled Patient Treatment Clinical Examination and that the candidate is
sufficiently prepared to participate in the examination.
Signature of Program Director or
designated school official
Date
52