Dental Licensure and Specialization

Because dentists are licensed by jurisdictions such as states, districts, or dependencies, and not at the national level, different licensing jurisdictions can have disparate requirements for licensure. But for the most part, the requirements are pretty similar:

  1. Education
  2. Written examination
  3. Clinical requirement

All jurisdictions accept graduates of ADA-accredited dental schools as fulfilling the educational requirement. Additionally, most jurisdictions also accept graduates of Canadian schools that are accredited by the Canadian Dental Association. The National Board Dental Examinations were created to fulfill, either completely or partially, the written examination requirement. That said, states can place limits on their acceptance of NBDE scores. For instance, some don’t accept scores from exams taken over 10 years ago. Currently, all U.S. licensing jurisdictions accept passing the NBDE exams as fulfilling the written exam requirement.

The NBDE: A Test In Two Parts

The NBDE is given in two parts—the first to be taken at the end of two years of dental school, and the second to be taken during the last year of school. The first part spans basic biomedical sciences, including:

  • Anatomic Sciences
  • Biochemistry-Physiology
  • Microbiology-Pathology
  • Dental Anatomy and Occlusion

The second part is a comprehensive, 1 1/2 day examination covering clinical dental sciences, and patient management. About 20% of the exam is based on patient cases. States may have different qualifying factors for the clinical requirement of licensure. Find out more from the jurisdiction that will license you.

Dental Specialization Spotlight

You’ve chosen a great time to get started! At a mean annual wage of $156,850, the U.S. Department of Labor Bureau of Labor Statistics predicts the employment of dentists will grow faster than that of all occupations and project an Increase of 16% over the next 10 years.
Why is the future smiling on dentistry? credits the number of retiring dentists as well as the aging of the baby boomers. As this significant portion of the population continues to get older, they will have a significant impact on several industries in this country, including insurance, financial services, healthcare, and even cosmetics. And as these folks continue to get older, they’ll require preventive and maintenance care for their teeth, as well as bridges and dentures.
There are plenty of great reasons to pursue a career as a dentist: A good salary, the on-going intellectual challenge, job autonomy and security, the opportunity for research, and working with people are just a few. But dentistry isn’t only about cleanings, x-rays, and cavities—while many dentists choose to be general practitioners, the American Dental Association recognizes several fields of specialization. Take a look at a few of the opportunities available to a DDS outside of general dentistry.


An endodontist steps in when damage has been done to the delicate root and pulp of a tooth, either from disease or injury. These specialists treat the inside of a tooth—the pulp that contains the nerves, blood vessels, and connective tissue.
Endodontics concentrates mainly on root canals, a procedure that removes the infected pulp of a tooth, fills it, and then seals it to prevent further infection. 95% of these procedures are performed with success.
Endodontic procedures also include treatment for cracked teeth, creating incisions to drain an infected tooth, and periradicular surgery—the removal of the root tip and surrounding infected tissue of an abscessed tooth. Basic training for these techniques is covered in dental school, but the more complicated cases require the attention of a dentist who has chosen to specialize in this area and has earned board certification.
Board-certified endodontists have not only fulfilled their general dental school requirements, but also put in an additional two to three years of training in the specialty. They must pass three additional exams—written, case history, and oral—to earn certification.
For more information on endodontics, check out the ADA or American Association of Endontics websites.

Oral and Maxillofacial Surgery

Oral and maxillofacial surgery (“OMFS”) is dentistry that goes far beyond cleanings and cavities. Practitioners of OMFS are generally thought only to deal with the extraction of wisdom teeth, but it’s about much more than impaction. The American Association of Oral and Maxillofacial Surgeons describes practitioners as those who “care for patients with problem wisdom teeth, facial pain, and misaligned jaws. They treat accident victims suffering facial injuries, place dental implants, care for patients with oral cancer, tumors and cysts of the jaws, and perform facial cosmetic surgery.”
Surgeons care for accident victims, perform reconstructive and dental implant surgery, treat jaw tumors and cysts, and have advanced training in pain control and anesthesia.
It is one of the most highly competitive specializations in dentistry—most schools only accept two or three candidates for residency per year, and look for NBDE Part I and Part II scores above the 90th percentile. Programs for OMFS range from four to six years (the six-year programs grant an MD). Students can pursue further specialization with another one or two years of training for fellowships ranging from treatment of cleft palates and head and neck cancer surgery to cosmetic surgeries like facelifts and nose jobs.


Yes: Orthodontists install braces and fit patients with retainers, but they also correct jaw position and jaw joint problems. Orthodontics literally means “tooth movement”, and is mainly concerned with crooked teeth (malocclusions) and facial development (dentofacial orthopedics).
Orthodontics is currently one of the most highly competitive dental specializations. It’s ideal for dentists who want to work with children, though the number of adults seeking orthodontic care is increasing every year. It’s a chance to not only improve a patient’s oral health, but also to boost their confidence by giving them a smile to be proud of.
Orthodontic dentistry requires additional schooling and residency—up to three years of full-time classes and clinical work, depending on the program. Classes include biomedical, behavioral and basic sciences; oral biology; and biomechanics.
To learn more about orthodontics, check out or the American Association of Orthodontists website.


Like working with kids? Consider specializing in pediatric dentistry, or pedodontics.
“First visit by first birthday” is the rule for when a child should start visiting a dentist. As a pedodontist, you have the unique opportunity to shape your patients’ attitude toward dentists—an attitude that will most likely prevail for the rest of the child’s life. To prepare for this significant task, pedodontic training includes child psychology, development, and growth.
Aside from preventing a life-long fear of dentists, a pedodontist’s most common tasks are dealing with cavities, tooth loss due to accident or injury, and preventive care to reduce the risk of future complications. The specialization also deals with surgery for cleft palates.
At 18 to 24 months, pedontotics has one of the shorter residencies of the dental specializations, but is a field of that offers some of the greatest personal rewards.


From crowns and bridges to dentures and implants, prosthodontists have an in-depth knowledge of healthy mouths and smiles.
The American College of Prosthodontics describes these practitioners as “dental specialists in the restoration and replacement of teeth.” Their advanced training prepares them to not only build dentures and fit patients with bridges, but also means they can provide help to people with TMD, jaw joint problems, and traumatic injuries to the mouth’s structure and/or teeth. They are also able to treat people with snoring or sleep disorders, as well as provide continuing care and reconstruction after oral cancer.
Prosthodontists must complete three additional years of advanced training in an ADA-accredited prosthodontic graduate program after completing dental school.
For more information about becoming a dentist, visit the American Dental Association website or