How to Get a Dental Hygienist License in California
Last updated: March 12, 2026
Quick Facts
Education
0 hrs
Total Cost
$22,500
Governing Body
Dental Hygiene Board of California (DHBC)
California is one of the best states in the country to build a career as a dental hygienist. With nearly 40 million residents and approximately 25,000 practicing Registered Dental Hygienists (RDHs), California offers strong demand, competitive salaries averaging $118,330 per year, and diverse practice settings ranging from private offices to community health clinics. Licensing is overseen by the Dental Hygiene Board of California (DHBC), which grants the Registered Dental Hygienist (RDH) credential.
To earn your California RDH license, you must graduate from a CODA-accredited dental hygiene program (California has approximately 25 approved programs), pass the National Board Dental Hygiene Examination (NBDHE), pass a clinical licensing exam (ADEX), and pass the California Law and Ethics Examination. The full process from enrollment to licensure typically takes 2.5 to 4 years, with total costs ranging from $20,000 to $25,000 depending on your chosen program. A recent law change (AB 1257, effective January 2024) allows graduates of California programs who apply within three years of graduation to bypass the clinical exam, streamlining the path to licensure.
CaliforniaDental Hygienist License Requirements
| Requirement | Details |
|---|---|
| Minimum Age | 18 years old |
| Pre-License Education | 0 hours |
| Degree Required | Yes |
| Exam Required | Yes — NBDHE + Clinical Licensing Examination + California Law and Ethics Exam |
| Passing Score | 75 on NBDHE (scaled); Pass on ADEX clinical; 75% on Law and Ethics |
| Background Check | Yes |
| Broker Sponsorship | Not required |
| Application Fee | $100 |
| Exam Fee | $1,750 |
| Governing Body | Dental Hygiene Board of California (DHBC) |
| License Reciprocity | Partial |
Reciprocity:California offers a Licensure by Credential (LBC) pathway for dental hygienists who have held an active RDH license in another state for at least five years. LBC applicants must still pass the California Law and Ethics Examination but may be exempt from the clinical exam.
Steps to Get Your Dental Hygienist License in California
- 1
Graduate from a CODA-Accredited Dental Hygiene Program
Enroll in and complete a dental hygiene program accredited by the Commission on Dental Accreditation (CODA). California has approximately 25 accredited programs at community colleges and universities, including programs at Pasadena City College, Chabot College, Fresno City College, Foothill College, Sacramento City College, Oxnard College, and Southwestern College. Most are associate degree programs that take 2-3 years to complete. Programs include classroom instruction, lab work, and supervised clinical rotations. You must also complete DHBC-approved courses in local anesthesia administration, nitrous oxide-oxygen analgesia, and soft tissue curettage before applying for licensure.
Time: 2-3 years (associate) or 4 years (bachelor's) Cost: $20,000 - 2
Pass the National Board Dental Hygiene Examination (NBDHE)
Register with the Joint Commission on National Dental Examinations (JCNDE) and pass the NBDHE. This is a comprehensive computer-based written exam with 350 multiple-choice questions covering dental hygiene science, clinical dental hygiene, and community health. The exam is administered at Prometric testing centers throughout California including Los Angeles, San Francisco, San Diego, and Sacramento. You must obtain a DENTPIN (Dental Personal Identification Number) before registering. The exam fee is $600, which includes your DENTPIN registration. Most dental hygiene programs schedule students to take the NBDHE during their final semester.
Time: 1-2 months to schedule and take Cost: $600 - 3
Pass a Clinical Licensing Examination (ADEX)
Pass a board-approved clinical examination. California accepts the ADEX dental hygiene examination, administered by CDCA-WREB-CITA. The ADEX exam consists of a computer-based simulation component and a Simulated Patient Treatment Clinical Examination (SPTCE) that evaluates your clinical skills including calculus detection and removal, periodontal probing, and tissue management using a manikin. The exam fee is approximately $1,150 plus a facility fee that varies by testing location. Important: As of January 1, 2024, graduates of California CODA-accredited programs who apply for licensure within three years of graduation may be exempt from the clinical examination requirement under AB 1257.
Time: 1-3 months to schedule and complete Cost: $1,150 - 4
Pass the California Law and Ethics Examination
Once your application is deemed complete by the DHBC, you will receive eligibility information for the California RDH Law and Ethics Examination. This computer-based exam is administered by PSI (Psychological Services Incorporated) at testing centers throughout California. The exam covers California Dental Practice Act, licensing requirements (30% of the exam), patient confidentiality (10%), mandated reporting (4%), and telehealth regulations (4%). You must score at least 75% to pass. Study the current DHBC Laws and Regulations book, available free on the DHBC website, to prepare.
Time: 2-4 weeks to schedule and take - 5
Submit Your RDH License Application to the DHBC
Apply for your Registered Dental Hygienist (RDH) license through the DHBC's online BreEZe portal at breeze.ca.gov. Your application must include proof of graduation from a CODA-accredited program, passing NBDHE scores, passing clinical exam scores (or proof of exemption for recent California graduates), completion of local anesthesia, nitrous oxide, and soft tissue curettage courses, current CPR/BLS certification from an approved provider, and the $100 application fee. You will also need to submit fingerprints for a background check through Live Scan. The initial license issuance fee is $100. Processing typically takes 30-60 days once all documents are received.
Time: 4-8 weeks for processing Cost: $200 - 6
Begin Your Career as a California RDH
Once the DHBC issues your RDH license, you are authorized to practice dental hygiene in California. California employs approximately 25,000 dental hygienists, one of the highest totals in the nation. Most RDHs work in private dental practices, but opportunities also exist in community health clinics, hospitals, school-based programs, corporate dental chains, and public health departments. Major employment hubs include the Los Angeles, San Francisco Bay Area, San Diego, and Sacramento metro areas. California RDHs earn an average annual salary of approximately $118,000, among the highest in the country. After gaining experience, you may pursue an RDHAP (Registered Dental Hygienist in Alternative Practice) license to practice in underserved settings without direct dentist supervision.
Time: Immediate once licensed
Key Things to Know
- Education from a CODA-accredited program is mandatory: California requires graduation from a dental hygiene program accredited by the Commission on Dental Accreditation. The state has approximately 25 programs, mostly at community colleges like Pasadena City College, Chabot College, Fresno City College, Foothill College, Sacramento City College, and Oxnard College. Associate degree programs take 2-3 years; bachelor's programs take 4 years.
- Three exams are required for licensure: You must pass the NBDHE (national written exam, $600), the ADEX clinical examination ($1,150), and the California Law and Ethics Exam (administered by PSI). Recent California graduates may qualify for a clinical exam exemption under AB 1257 if they apply within three years of graduation.
- Background check and fingerprinting required: All applicants must submit Live Scan fingerprints for a DOJ and FBI background check. A criminal record does not automatically disqualify you — the DHBC evaluates each case individually under California's fair chance licensing laws.
- Apply online through BreEZe: California processes all RDH applications through the BreEZe online portal (breeze.ca.gov). You can upload documents, pay fees, and track your application status online. Processing typically takes 30-60 days.
- Additional required courses: Beyond your dental hygiene degree, you must complete DHBC-approved courses in local anesthesia administration, nitrous oxide-oxygen analgesia, and soft tissue curettage before applying for licensure.
- Ongoing CE and renewal: Your RDH license must be renewed every two years by the last day of your birthday month. You need 25 hours of continuing education per renewal cycle, including mandatory hours in infection control and the California Dental Practice Act.
How California Compares
California dental hygienists earn an average of $118,330 per year — significantly above the national average of approximately $87,530. The state employs roughly 25,000 RDHs, the highest total in the nation, and job growth is projected at 7% through 2034. California's cost of education is moderate compared to other states: community college programs range from $17,000 to $23,000 total, which is competitive given the state's high earning potential. The average RDH in California can recoup their education investment within the first year of full-time practice.
How Much Does a Dental Hygienist License Cost in California?
| Cost Item | Estimated Range |
|---|---|
| Pre-License Education | $300 - $700 |
| Application Fee | $100 |
| Exam Fee | $1,750 |
| Total Estimated Cost | $20,000 - $25,000 |
License Renewal
- Renewal Period: Every 2 years
- Continuing Education:25 hours
- CE Details:Licensees must complete 25 hours of continuing education every two years. Up to 12.5 hours may be completed through home study. A minimum of 2 hours must be in infection control and 2 hours in the California Dental Practice Act. CE courses must be from providers approved by the Dental Board of California, the ADA's Continuing Education Recognition Program (CERP), or the Academy of General Dentistry's PACE program. No CE is required for the first renewal period after initial licensure.
- Renewal Fee: $300
Tips for Success
- Apply to multiple dental hygiene programs: With only about 25 CODA-accredited programs serving the entire state, admission is competitive. Most programs accept 20-30 students per cohort. Apply to several schools and complete all prerequisite courses (anatomy, chemistry, microbiology) before applying to strengthen your candidacy.
- Take advantage of the clinical exam exemption: If you graduate from a California CODA-accredited program, you may be exempt from the ADEX clinical exam if you apply for licensure within three years of graduation (under AB 1257, effective January 2024). This saves approximately $1,150 in exam fees and several months of preparation time.
- Prepare strategically for the NBDHE: The NBDHE is a 350-question computer-based exam covering dental hygiene science and clinical practice. Popular study resources include Mosby's Review for the NBDHE, StudentRDH, and DentalDecks. Most programs schedule students to take it during their final semester while the material is fresh.
- Start your patient search early for the ADEX clinical exam: If you need to take the ADEX clinical exam, begin preparing well in advance. The manikin-based format requires precision in calculus removal, periodontal probing, and tissue management. Practice consistently in your program's clinic and use ADEX-specific prep materials from adextesting.org.
- Study the California Dental Practice Act: The California Law and Ethics Exam (administered by PSI) covers state-specific regulations. Download the free DHBC Laws and Regulations book from dhbc.ca.gov and focus on licensing requirements (30% of the exam), patient confidentiality (10%), mandated reporting, and telehealth regulations.
- Consider your career path beyond the RDH: California offers an advanced credential — the Registered Dental Hygienist in Alternative Practice (RDHAP) — which allows you to practice in underserved communities, nursing homes, and schools without direct dentist supervision. An RDHAP license requires additional education and clinical experience but significantly expands your practice scope and autonomy.
- Budget for the full licensing process: Plan for $20,000-$25,000 total, including tuition ($17,000-$23,000), NBDHE ($600), ADEX ($1,150), DHBC application ($100), initial license fee ($100), Live Scan fingerprinting ($50-$80), and CPR certification ($50-$75). Financial aid, scholarships, and payment plans are available at most community college programs.
Frequently Asked Questions
What are the California dental hygienist license requirements?
To become a Registered Dental Hygienist (RDH) in California, you must: (1) graduate from a CODA-accredited dental hygiene program, (2) pass the National Board Dental Hygiene Examination (NBDHE), (3) pass a clinical licensing exam such as the ADEX (or qualify for the clinical exam exemption as a recent California graduate), (4) pass the California Law and Ethics Examination administered by PSI, (5) complete approved courses in local anesthesia, nitrous oxide, and soft tissue curettage, and (6) submit an application with fingerprints and fees to the Dental Hygiene Board of California (DHBC) through the BreEZe online portal.
How long does it take to become a dental hygienist in California?
The entire process typically takes 2.5 to 4 years. An associate degree program at a California community college takes 2-3 years (including prerequisites), while a bachelor's program takes about 4 years. After graduating, the exam and licensing process adds approximately 2-4 months. Many students complete prerequisite courses like anatomy and chemistry before entering the dental hygiene program, so total time may vary depending on how quickly you fulfill prerequisites.
How much does it cost to get a dental hygienist license in California?
Total costs range from approximately $20,000 to $25,000. The major expense is tuition for a CODA-accredited dental hygiene program, which ranges from roughly $17,000 to $23,000 at California community colleges (including instruments, supplies, and fees). Exam fees add approximately $1,750 total: $600 for the NBDHE and $1,150 for the ADEX clinical exam. The DHBC application fee is $100 and the initial license issuance fee is $100. You will also need to budget for CPR certification, Live Scan fingerprinting, and study materials.
Can I become a dental hygienist in California with an out-of-state license?
Yes. California offers a Licensure by Credential (LBC) pathway for dental hygienists who have held an active RDH license in another state for at least five years with no disciplinary actions. LBC applicants must still pass the California Law and Ethics Examination but may be exempt from taking a clinical exam. You must apply through the DHBC and provide verification of your out-of-state license, proof of education from a CODA-accredited program, and passing NBDHE scores. Contact the DHBC at (916) 263-1978 for specific eligibility questions.
Do I need a bachelor's degree to become a dental hygienist in California?
No, a bachelor's degree is not required. An associate degree from a CODA-accredited dental hygiene program is the minimum educational requirement for RDH licensure in California. However, a bachelor's degree can open doors to careers in education, public health, research, and management. Several California universities offer bachelor's completion programs for RDHs who already hold an associate degree, including programs at the University of the Pacific and West Coast University.
What is the ADEX clinical exam for California dental hygienists?
The ADEX dental hygiene examination is the clinical licensing exam accepted by California. Administered by CDCA-WREB-CITA, it consists of a computer-based simulation component and a Simulated Patient Treatment Clinical Examination (SPTCE) that tests your clinical skills on a manikin, including calculus detection and removal, periodontal probing accuracy, and tissue management. The exam fee is approximately $1,150 plus a facility fee. Important: As of January 1, 2024 (under AB 1257), graduates of California CODA-accredited programs who apply for licensure within three years of graduation may be exempt from this clinical examination.
How much do dental hygienists make in California?
California dental hygienists earn among the highest salaries in the nation. According to the Bureau of Labor Statistics, the average annual salary for RDHs in California is approximately $118,330 (about $56.89 per hour). Salaries vary by region: the San Francisco Bay Area and San Jose metros tend to pay the highest, while areas like the Central Valley average closer to $89,000-$95,000 per year. With approximately 25,000 employed dental hygienists and projected 7% job growth through 2034, California offers strong earning potential and job security for RDHs.
What are the continuing education requirements for California dental hygienists?
California RDHs must complete 25 hours of continuing education (CE) every two years to renew their license. Up to 12.5 hours may be completed through home study or online courses. At minimum, 2 hours must cover infection control and 2 hours must cover the California Dental Practice Act. CE courses must be from providers approved by the Dental Board of California, the ADA's CERP program, or the AGD's PACE program. No CE is required for your first renewal period after initial licensure. The biennial renewal fee is approximately $300.
Sources
- https://www.dhbc.ca.gov/applicants/index.shtml
- https://www.dhbc.ca.gov/applicants/rdh_clincial.shtml
- https://www.dhbc.ca.gov/applicants/becomelicensed_rdh_wreb.shtml
- https://www.dhbc.ca.gov/applicants/rdh_credential.shtml
- https://www.dhbc.ca.gov/licensees/renewals.shtml
- https://www.dhbc.ca.gov/licensees/cont_ed.shtml
- https://jcnde.ada.org/nbdhe
- https://coda.ada.org/find-a-program
- https://www.bls.gov/oes/current/oes291292.htm
- Official website: Dental Hygiene Board of California (DHBC)
- O*NET OnLine — Dental Hygienist (29-1292)
- Bureau of Labor Statistics — Occupational Employment and Wages (29-1292)
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