How to Become a Dental Hygienist
The 5 steps to become a dental hygienist, how long it takes (about 3 years for most people), what school costs, and what varies by state.
To become a dental hygienist, you finish prerequisite college classes, graduate from an accredited dental hygiene program, pass the National Board Dental Hygiene Examination (NBDHE) and a clinical exam, and get a license from your state. For most people it takes about 3 years: roughly a year of prerequisites, then a program that averages 2 years (ADEA (opens in a new tab)).
This guide walks through each step, how long it takes, what school costs, and what changes from state to state. If you're still deciding whether the work suits you, read whether dental hygiene is a good career first.
What a dental hygienist does
A dental hygienist (RDH) is a licensed clinician who cleans teeth, removes plaque and tartar, takes X-rays, applies sealants and fluoride, checks patients' oral health for the dentist, and teaches patients how to care for their teeth at home. Most hygienists work in dental offices, and many work part time.
The U.S. had 225,300 dental hygienist jobs in 2025, and the median pay was $98,100 a year ($47.16 an hour) as of May 2025 (BLS (opens in a new tab)). Pay varies widely by state.
The 5 steps to become a dental hygienist
- Step 1: Finish your prerequisites. Science and general education classes, usually at a community college or university.
- Step 2: Complete an accredited dental hygiene program. Usually a 2-year associate degree, taken full time, with supervised clinic on real patients.
- Step 3: Pass the NBDHE. The national written exam.
- Step 4: Pass a clinical exam. A hands-on exam from a testing agency your state accepts.
- Step 5: Get your state license. Apply to the dental board where you'll work, then start practicing.
Step 1: Finish your prerequisites
Most programs want specific college classes done before you apply. Typical lists include anatomy and physiology, microbiology, chemistry, English, psychology, sociology, speech, and math. Programs may require up to 40 credit hours of prerequisite coursework (ADEA (opens in a new tab)). Each program sets its own list, minimum grades, and GPA, so pick your target programs before you register for classes. The full breakdown is in dental hygiene prerequisites.
Step 2: Complete an accredited dental hygiene program
Choose a program accredited by the Commission on Dental Accreditation (CODA). Most states require a degree from a CODA-accredited program for licensure. You can check any program's status in CODA's program finder (opens in a new tab).
Admission is often competitive. Some programs rank applicants with a points system, and some use a waitlist. Once you're in, expect a full-time schedule of lectures, lab, and clinic where you treat patients under supervision. For how to compare programs, read choosing a dental hygiene program.
Step 3: Pass the NBDHE
The NBDHE is the national written exam. As of the 2026 candidate guide, it has 350 multiple-choice questions, runs 7 hours 30 minutes of testing inside a 9-hour appointment, and costs $600 (JCNDE (opens in a new tab)). Most students take it near the end of their program. What's on it and how to study: dental hygiene board exam.
Step 4: Pass a clinical exam
Most states also require a hands-on clinical exam run by a testing agency such as ADEX or CRDTS. ADEX says its exam is required or recognized by law for licensure in nearly every U.S. jurisdiction (opens in a new tab). Which exams your state accepts varies, so confirm before you register.
Step 5: Get your state license
Apply to the dental board in the state where you plan to work. Expect to send transcripts and exam results and to pass a background check. Most states also require a jurisprudence exam on state dental law, and many jobs require CPR certification. The paperwork is covered in how to get a dental hygiene license.
How long does it take to become a dental hygienist?
About 3 years for most people. BLS says programs usually take 3 years to complete (BLS (opens in a new tab)). ADEA puts the average associate program itself at 2 years and 84 credit hours (ADEA (opens in a new tab)). The gap is prerequisites: most people spend about a year on them before the 2-year program starts.
| Your path | Before the program | Dental hygiene program | Total |
|---|---|---|---|
| Right after high school, associate degree | About 1 year of prerequisites | About 2 years | About 3 years |
| Career changer with college credits | Less, if your earlier classes count toward the prerequisites and haven't expired | About 2 years | About 2 to 3 years |
| Bachelor's degree in dental hygiene | Included in the degree | 4 years on average for the full degree (120 credit hours) | About 4 years |
| Program with a waitlist | Prerequisites plus time on the waitlist | About 2 years | Longer, by however long the wait is |
After graduation, add time for exam results and your license application. Processing times differ by state, so check with your state board before you plan a start date.
The fastest realistic route is to finish prerequisites before you apply and to target programs without long waitlists. The ADHA puts it this way: "In as few as two years, you could be on the job" (ADHA (opens in a new tab)). That assumes your prerequisites are already done.
How much does dental hygiene school cost?
It depends mostly on the type of school. Community colleges, where most associate programs are, usually charge much less than universities that offer a bachelor's, especially for in-district or in-state students. Out-of-state tuition is usually higher.
Tuition is only part of it. Programs also charge for instruments, uniforms, textbooks, lab fees, and exam and licensing fees. The NBDHE alone is $600.
Ask each program for its total estimated cost, and file the FAFSA to see what grants and loans you qualify for. To see school tuition for the programs in your area, browse dental hygiene schools by state.
Compare the programs you could actually attend. BrushNotes school search lets you find programs near you, see prerequisites and waitlist details where programs publish them, and save and compare your shortlist side by side.
Associate vs bachelor's degree
An associate degree is the typical entry-level education for dental hygienists (BLS). Graduates of accredited associate and bachelor's programs take the same board exams and apply for the same license. A bachelor's takes longer and usually costs more. It makes sense if you want to teach, work in public health or research, or earn a master's later.
| Compare | Associate degree | Bachelor's degree |
|---|---|---|
| Average length (ADEA) | 2 years, 84 credit hours | 4 years, 120 credit hours |
| Where it's offered | Mostly community and technical colleges | Universities |
| Leads to a license | Yes, from an accredited program | Yes, from an accredited program |
| Best for | Getting into clinical practice sooner and for less | Teaching, public health, research, or graduate school |
BLS doesn't report pay by degree level, so don't assume a bachelor's pays more for clinical work. You can also start with an associate degree and finish a bachelor's later through a degree-completion program.
Can you become a dental hygienist online?
Not fully. Clinical training is hands-on. You learn to clean teeth and take X-rays on real patients under supervision, so every entry-level program requires in-person lab and clinic time. Some programs deliver part of their classroom work online, and you may be able to take some prerequisites online if your programs accept them. Lab sciences are the ones most often required in person, so check first.
Fully online options are mainly for people who are already hygienists. Degree-completion programs, such as RDH to bachelor's, vary between on-campus and online or distance formats (ADEA (opens in a new tab)). If a program says you can become a hygienist entirely online, check its CODA accreditation before you pay anything.
Licensing varies by state
Every state requires dental hygienists to be licensed, and the requirements vary by state (BLS (opens in a new tab)). The core is nearly the same everywhere: an accredited degree, the NBDHE, and a clinical exam. (California, for example, doesn't require a separate clinical exam from recent graduates of its own approved programs.) The differences are in the details:
- Clinical exams accepted. Nearly every state accepts ADEX, and many also accept CRDTS.
- Jurisprudence exam. Many states test you on their dental laws before they issue a license.
- Permits. Many states require a separate permit or certificate to give local anesthesia or nitrous oxide.
- Moving later. Getting licensed in a second state usually means applying by credentials, and rules differ.
Check your state early, before you choose a program, so your clinical exam and any permits line up with where you want to work. Start with dental hygiene license requirements by state.
Your first step this week
- Find 2 or 3 accredited programs you could realistically attend, and bookmark their admissions pages.
- Write down each program's prerequisite list, minimum grades, and application deadline. Note whether it uses a waitlist or a points system.
- Compare that list against any college classes you've already taken, and see which ones still need to be done.
- Talk to a working hygienist, or ask your own hygienist a few questions at your next cleaning. Some programs ask for observation hours, so ask about shadowing too.
- If you're still in high school, take biology, chemistry, and math now. They make the college science prerequisites easier.
Frequently asked questions
How long does it take to become a dental hygienist?
About 3 years for most people: roughly a year of prerequisites, then an associate program that averages 2 years (ADEA). A bachelor's averages 4. A waitlist or missing prerequisites can add time.
How many years of college do you need to be a dental hygienist?
Usually about 3: roughly a year of prerequisites, then an associate program that averages 2 years and 84 credit hours (ADEA). A bachelor's averages 4 years and 120 credit hours, but you don't need one to get licensed.
Can I become a dental hygienist right after high school?
You can start right after high school by taking prerequisites at a community college or university. You can't practice until you finish an accredited program, pass your board exams, and get licensed, so most people finish about 3 years after high school. It can be closer to 2 if your prerequisites are done early (for example through dual enrollment).
How much does dental hygiene school cost?
It depends on the school. Community colleges, where most associate programs are, usually cost much less than universities that offer a bachelor's, especially for in-state students. Budget extra for instruments, uniforms, books, and fees, including $600 for the NBDHE. Ask each program for its full cost, and compare school tuition in dental hygiene schools by state.
Can you become a dental hygienist online?
Not fully. Clinical training happens in person, on real patients. Some classroom courses and prerequisites may be available online, and online degree-completion programs exist for hygienists who are already licensed.
Do I need a bachelor's degree to be a dental hygienist?
No. The typical entry-level education is an associate degree (BLS). A bachelor's helps if you want to teach, work in public health or research, or go on to a master's.
Is it hard to become a dental hygienist?
It takes steady work. Many programs are competitive, the science prerequisites are demanding, and the program is full time with clinic requirements. You also have to pass the NBDHE and a clinical exam. Planning ahead for prerequisites and deadlines makes it much more manageable.
How do I become a dental hygienist in my state?
The core steps are the same everywhere: prerequisites, an accredited program, the NBDHE, a clinical exam, and a state license. States differ on which clinical exams they accept, jurisprudence exams, and permits. Find your state's rules in license requirements by state.