Frequently Asked Questions

The Integrated National Board Dental Examination (INBDE) is a new written, cognitive examination for dental licensure scheduled to replace the current National Board Dental Examination (NBDE) Part I and Part II examinations no sooner than August 2020.

It is referred to as an “integrated” exam because it combines content from several disciplines, and test takers must integrate their knowledge of science with the clinical know-how involved in the safe practice of dentistry to answer many of the test items.

The INBDE has the same overall purpose as the NBDE Part I and Part II: to assist state boards of dentistry in evaluating candidates for dental licensure. By integrating content covering the basic, behavioral, and clinical sciences, the INBDE is expected to be more relevant than the current NBDE Part I and Part II examinations.

The INBDE launched August 1, 2020. The NBDE Part I will be discontinued December 31, 2020; the NBDE Part II will be discontinued July 31, 2022.

The Joint Commission on National Dental Examinations (JCNDE) is developing the new examination because of changes in educational curricula and instructional methods. The JCNDE appointed the Committee for an Integrated Examination in 2009 to begin developing a new exam instrument for dentistry that would integrate basic, behavioral, and clinical sciences.

Specific opportunities were seen to:

• increase the appropriateness of test content
• improve the examination experience for candidates
• better assist regulatory agencies

 The INBDE launched August 1, 2020. The NBDE Part I will be discontinued December 31, 2020; the NBDE Part II will be discontinued July 31, 2022.

The new test relies less on rote knowledge and information recall than the current NBDE examinations do, and instead it emphasizes the relevance of the basic sciences through test items that link science and clinical application.

Test items on the INBDE will require candidates to draw from their knowledge of basic science, behavioral science, and clinical competencies to answer them correctly. For example, INBDE questions will ask about patient care, how dentists approach the practice of dentistry, and how dentists keep up with advances in the profession.

The INBDE will include 500 items, compared with a total of 900 questions on the NBDE Part I and Part II. The INBDE is expected to take one and a half days to complete.

The purpose of an examination is foundational, and drives all aspects of its development. The integrated examination retains the same fundamental examination purpose as the NBDE Part I and Part II. The INBDE is a cognitive examination, exclusive of the demonstration of clinical skills, that is intended to be used by regulatory agencies (state boards) in making valid decisions regarding the licensure of dentists. The INBDE is designed to provide information concerning whether an individual has the entry-level knowledge and cognitive skills necessary to safely practice dentistry.

The INBDE is a 500-item examination which will be administered via computer at test centers throughout the United States and US territories. It will take one and a half days to complete.

Current dental students are expected to test on the NBDE Part I and Part II, because the INBDE will not be implemented until 2020. 
 
Any student who applies for Part II and is approved as eligible by their school will also receive an eligibility email for the INBDE, which can be used for a field test.

Scores from field tests are not reported to state boards or dental schools. Instead, the field tests are used to determine how well the drafted items are meeting the intended objectives so adjustments can be made before the official examination is administered in 2020.

College students who expect to enroll in dental school in 2017 or later could be eligible to take the INBDE instead of the NBDE Part II in 2020.

Students who expect to enroll in dental school in 2019 or later could be eligible to take the INBDE instead of the NBDE Part I. Most likely the NBDE Part II won’t be available after July 31, 2022, so these students might be required to take the INBDE for certification.

After students take the INBDE, they will no longer be allowed to take the NBDE Part I or Part II. Each student must qualify to take the National Board Examinations. Most often eligibility is provided through verification from the dean of an accredited dental program. Additional information on eligibility is available in the Guides for the NBDE Part I and NBDE Part II.

To help future candidates understand their options during the transition period, please consider the following paths:

I prefer to take the NBDE Part I and Part II. How should I proceed?

You must receive eligibility from your dental program to take the NBDE, and you must pass the NBDE Part I before administration of the exam ceases, which is expected to occur around August 1, 2020. After you pass the NBDE Part I, you must successfully complete the NBDE Part II before administration ceases around August 1, 2022. To take the NBDE Part II, you must receive eligibility from your dental school. However, if time runs out for either NBDE administration and you are eligible for the INBDE, you would be eligible for five attempts on the INBDE.

I prefer to take the INBDE. How should I plan ahead?

INBDE administration is expected to begin in 2020, and candidates will have five attempts in five years to complete the exam successfully. You must receive eligibility from your dental school to take the INBDE. After you take the INBDE, you will not be permitted to take the NBDE Part I and Part II exams.

I’m not sure if I should take the NBDE Part II or the INBDE. What should I consider?

If you have passed the NBDE Part I, and you have received eligibility from your dental school to take the NBDE Part II, you may take the Part II until administration ceases in 2022 or until you take the INBDE. If you forgo the NBDE Part II and test on the INBDE, you will have five test attempts on the INBDE. If you are unsuccessful on the INBDE, you will not be permitted to test on the NBDE Part II.

NBDE Part I administration is slated to cease at the end of July 2020, about the same time implementation of the official, scored INBDE is expected to start. NBDE Part II administration is expected to continue until July 31, 2022.
 
Eligible candidates who test between August 1, 2020, and July 31, 2022, may take the NBDE Part II if they have successfully passed the NBDE Part I, or they may choose to take the INBDE. After candidates have tested on the INBDE, they are not permitted to take the NBDE Part I or Part II.

Candidates who prefer to take the NBDE Part I and Part II examinations as the transition period approaches must pass the NBDE Part I before administration of the exam ceases, which is expected to occur around July 31, 2020. To take the NBDE exams, students must receive eligibility from their dental schools. After successfully completing NBDE Part I, candidates choosing to take the NBDE Part II must pass the Part II before administration ceases around August 1, 2022. However, if time runs out, candidates would still be eligible for five attempts on the INBDE.

Students who have taken the NBDE Part I and who will still be in dental school when the INBDE is officially implemented in 2020 will have the option of taking the NBDE Part II or the INBDE. The NBDE Part I will not be counted toward completion of the INBDE.
 
If students forgo the NBDE Part II and test on the INBDE, they will have five test attempts on the INBDE. If they are unsuccessful on the INBDE, they will not be permitted to test on the NBDE Part II. However, students who have successfully completed NBDE Part I and have not taken the INBDE will have the option of taking the NBDE Part II until 2022. Administration of the NBDE Part II is scheduled to cease on July 31, 2022.

All of the National Board Dental Examinations, including the INBDE, are written cognitive exams. They are not clinical exams. Each state board of dentistry has its own requirements for completing a clinical exam. For more information on clinical exam requirements, check with the state board in the state where you are most likely to practice. 

The Joint Commission recommends dental educators adjust their academic policies to reflect the INBDE’s scheduled replacement of NBDE Part I after August 1, 2020, and of the NBDE Part II after August 1, 2022. It also encourages dental educators to review the INBDE Implementation Plan and other information about the new examination so they can prepare to advise students about the upcoming changes to the National Board Examinations.
 
A Short Form Field Test of the INBDE, with about 120 items, was administered in fall 2016 to solicit additional feedback on the INBDE’s content and presentation. A Standard Form Field Test, with the same type and number of items as expected on the actual INBDE, is tentatively scheduled for 2017. The Joint Commission will not provide scores from field tests to state boards or dental schools. In 2018, the Joint Commission expects to provide notification of the dates for the first official INBDE administration and the final NBDE Part I administration, which is expected to approximately coincide with the start of INBDE administration.

At its June 10, 2016, annual meeting, the Joint Commission adopted several resolutions pertaining to INBDE implementation, including retest policies during the transition from the NBDE Part I and Part II to the new integrated examination. This is addressed in the question below.
 

As the replacement for the NBDE Part I and Part II, the Joint Commission on National Dental Examinations (JCNDE) intends the INBDE to be adopted as the written test component for state board licensure in all U.S. licensing jurisdictions that recognize NBDE results, including the 50 states, the District of Columbia, Puerto Rico, Guam, and the Virgin Islands of the United States.  

In May 2016, the Joint Commission provided four years’ notice of the INBDE’s expected implementation and included the following recommendations for state dental boards:

• Review and monitor INBDE information on the Joint Commission’s website.
• Attend the National Dental Examiners' Advisory Forum (NDEAF) annually.
• Review INBDE validity evidence and the results of field testing as these studies occur.
• Prepare to receive INBDE results on the first day of its availability.
• Consider whether any modifications to practice acts, rules, policies, or procedures will be required.
• Prepare to accept candidates who have successfully completed the National Boards. This could occur under either of the following sequences: 1) INBDE or 2) NBDE Part I and NBDE Part II.
• Communicate information concerning the acceptability of the INBDE to future licensure candidates.

The information in the answer to the question below, “How is the INBDE being developed and validated?” provides additional information for state boards and licensing agents.

The Joint Commission began developing the INBDE with the formation of an ad hoc committee known as the Committee for an Integrated Examination (CIE) in 2009 after a strategic planning committee recommended merging the NBDE Part I and Part II. This recommendation stemmed in part from changes in the dental education community that began after the American Dental Education Association (ADEA)’s Commission on Change and Innovation in 2005 recommended changes in curriculum, instructional methods, and assessment and outcome evaluation.

The CIE began work on an integrated examination in 2010. Construction of the test began with a review of the basic science areas and clinical competencies considered important for the safe practice of entry-level dentistry. In determining appropriate content, the CIE drew from the clinical competency areas ADEA regards as necessary for new dentists to master to perform successfully, and added two areas the Commission on Dental Accreditation considers important. Two science review panels confirmed the relevance of the content areas, and the CIE relied on results from a 2011 practice analysis and additional feedback from stakeholders and communities of interest to determine what proportion of questions to devote to each area. The practice analysis involved a survey that asked practicing dentists to rate how critical they considered certain competencies.

Test specifications

The practice analysis led to test specifications in 2012. The Joint Commission has approved INBDE test specifications based on a Model of the Domain of Dentistry, which includes 10 areas of Foundation Knowledge for the General Dentist based on science and 65 clinical content areas determined through the practice analysis to be at least “moderately important to patient care.” The clinical competencies are grouped into three sections: diagnosis and treatment planning, oral health management, and practice and profession.

For lists of the 10 Foundation Knowledge areas and 65 clinical content areas covered on the INBDE, please see the “INBDE Overview 2016” PowerPoint presentation for the Council on Dental Education and Licensure posted on the JCNDE website under “News and Resources.”

Test construction and review

Test construction committees began developing items for use on INBDE field tests in August 2014. A year later, NBDE Part II candidates were invited to review and comment on selected INBDE sample items in a model item survey that was briefly reopened in December 2015 to collect additional information. The survey responses indicated most participating dental students were able to apply their knowledge and clinical experiences to answer sample INBDE items. Most respondents said the test items were straightforward, clinically relevant, and required the integration of clinical know-how and knowledge of biomedical and other science disciplines.

Many liked the Patient Box item format (shown in the sample item below) with its side-by-side presentation and use of images. Patient Box items include case information about a particular patient and require test takers to use the case materials to answer test items. Respondents indicated the Patient Box format allowed them to easily extrapolate pertinent information and apply what they have learned in classes and clinical work to answer test items.


 


The CIE has accumulated evidence supporting the use of INBDE results for dental licensure through validity arguments confirming the examination uses appropriate content based on an accepted domain of dentistry and the clinical competencies considered important for safe entry-level dental practice.

Additional information, including sample questions, is available in the PowerPoint presentations posted on the ADA.org/JCNDE website under “News and Resources.” The JCNDE expects to provide additional sample questions from field tests to help state boards, dental schools, and other stakeholders understand the types of questions on the examination and to help students prepare for it.