DANB ICE Exam 2026: Build Infection-Control Confidence Fast
The DANB Infection Control (ICE) exam is a core credential component for CDA and NELDA pathways and a high-value proof point for safe clinical practice in dental settings. The exam is short, but it tests protocol accuracy at a level where careless shortcuts fail quickly.
Candidates who struggle usually do not lack knowledge. They lack decision structure: what comes first, what comes next, and what documentation or corrective action is required when something goes wrong.
This 2026 guide is designed to fix that by combining domain-weighted prep, timed drills, and high-yield scenario practice.
Exam Format & Structure
| Component | Details |
|---|---|
| Total Questions | 75 multiple-choice questions |
| Time Limit | 60 minutes |
| Passing Score | DANB scaled score model (100-900 range, 400 passing scaled score per component exam outlines) |
| Pass Rate | 73% in DANB 2024 exam performance reporting |
| Cost | $270 |
| Testing Format | Pearson VUE, in-person or online proctoring |
| Testing Window | 60-day testing window |
| Eligibility | No eligibility requirements to take ICE |
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ICE Domain Breakdown (Use This to Prioritize Study Time)
DANB ICE publishes four weighted domains:
| ICE Domain | Weight | Focus |
|---|---|---|
| Prevention of Disease Transmission | 20% | Infectious disease pathways, hand hygiene, PPE decisions |
| Prevention of Cross-contamination | 34% | Treatment area disinfection, barriers, waterline and surface control |
| Process Instruments and Devices | 26% | Instrument transport, sterilization workflow, monitoring and storage |
| Occupational Safety and Administration Protocols | 20% | OSHA standards, sharps safety, post-exposure and documentation |
High-value insight
Most candidates should invest the largest study share in Cross-contamination (34%) and Process Instruments and Devices (26%). Together they make up 60% of the exam and include many sequence-sensitive questions.
Domain 1: Prevention of Disease Transmission (20%)
What to master
| Topic | Why It Matters |
|---|---|
| Modes of disease transmission | Foundation for selecting the right prevention controls. |
| Hand hygiene protocols | Frequent testing point and common real-world failure area. |
| PPE selection and use sequence | High-probability exam content tied to safety outcomes. |
| Aerosol and spatter mitigation | Core concept for procedure-room risk reduction. |
Study move
Practice quick-case prompts where you identify exposure risk and choose immediate control steps.
Domain 2: Prevention of Cross-contamination (34%)
This is the largest ICE domain and should receive the largest share of your prep calendar.
High-yield categories
| Category | Core Skill Tested |
|---|---|
| Operatory and lab disinfection | Selecting and sequencing proper cleanup workflow |
| Surface barriers and tray setup | Preventing contamination transfer during setup and turnover |
| Waterline and evacuation maintenance | Correct maintenance and monitoring procedures |
| Impression and appliance disinfection | Proper handling between clinical and lab phases |
| Biohazard disposal | Safe and compliant waste decisions |
Why candidates miss this area
They know definitions but miss sequence and “best next action” logic. ICE often rewards procedural order more than isolated fact recall.
Domain 3: Process Instruments and Devices (26%)
Focus points
- Transport and handling of contaminated instruments.
- Sterilization selection, packaging, loading, and storage standards.
- Biological/chemical monitoring interpretation.
- Equipment malfunction response and documentation.
Score boost tactic
For every sterilization scenario, force yourself to answer four questions: what happened, what failed, what action now, what documentation next.
Domain 4: Occupational Safety and Administration Protocols (20%)
This domain tests your ability to apply OSHA-oriented safety standards in realistic dental workflows.
Core tested themes
| Theme | Practical Exam Angle |
|---|---|
| Bloodborne Pathogens Standard | Sharps protocol, exposure response, and prevention controls |
| Hazard Communication Standard | SDS use, chemical labeling, and first-aid awareness |
| Exposure control programs | Documentation and policy maintenance expectations |
| Quality and training records | Operational compliance habits in busy clinics |
Candidates often rush this section because it feels policy-heavy. In reality, these are reliable scoring opportunities when studied with scenario context.
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8-Week DANB ICE Study Schedule
| Week | Focus | Target Hours | Goal |
|---|---|---|---|
| 1 | Baseline + plan setup | 4-6 | Identify weakest domains and pacing gap |
| 2 | Disease transmission + PPE | 6-8 | Master hand hygiene and transmission control logic |
| 3 | Cross-contamination fundamentals | 6-8 | Solid operatory/lab turnover workflow |
| 4 | Cross-contamination advanced scenarios | 6-8 | Faster sequence decisions under timing |
| 5 | Instrument processing workflows | 6-8 | Sterilization and monitoring confidence |
| 6 | Occupational safety/OSHA protocols | 6-8 | Exposure-response and documentation readiness |
| 7 | Mixed timed simulations | 6-8 | Integrate all domains and improve speed |
| 8 | Final remediation + logistics | 4-6 | Correct weak trends and lock test-day plan |
Recommended study-hour split
| Domain | Study Share |
|---|---|
| Prevention of Cross-contamination | 34% |
| Process Instruments and Devices | 26% |
| Prevention of Disease Transmission | 20% |
| Occupational Safety and Administration Protocols | 20% |
Test-Taking Strategies for ICE
1) Think sequence, not trivia
Most high-difficulty ICE items test order and response selection. If you only memorize terms, you will miss sequence traps.
2) Use elimination by risk
Discard answers that create unnecessary exposure risk first. Then choose the option that best aligns with CDC/OSHA-informed workflow.
3) Do timed protocol drills
Because ICE is 75 questions in 60 minutes, speed matters. Run short timed sets and immediately review why each wrong answer failed.
4) Build a “failure-response” notebook
Track sterilization failures, sharps incidents, and contamination events as action templates. These patterns repeat on exam items.
5) Protect easy points
Hand hygiene, PPE sequence, and basic disinfection decisions should be near-automatic by exam week.
Hardest ICE Topics (Ranked)
| Rank | Topic | Why It Is Missed | Better Method |
|---|---|---|---|
| 1 | Instrument processing and sterilization monitoring | Detail-heavy and sequence-sensitive | Drill with workflow maps and failure scenarios |
| 2 | Cross-contamination prevention in complex setups | Multiple simultaneous contamination risks | Use room-turnover checklists and timed case practice |
| 3 | OSHA BBP and hazard communication application | Policy language can feel abstract | Translate standards into chairside actions |
| 4 | PPE sequencing in varied scenarios | Overconfidence causes careless errors | Practice scenario-specific PPE decisions |
| 5 | Pacing for one-minute average per question | Overthinking early items burns time | Use two-pass timing plan with flagged review |
21-Day ICE Final Drill Plan
Use the final three weeks to convert knowledge into repeatable exam performance.
| Days | Priority | Daily Execution |
|---|---|---|
| 21-15 | Cross-contamination and instrument flow | 30-question targeted blocks + sequence review |
| 14-10 | OSHA and exposure response | Scenario drills focused on policy-to-action translation |
| 9-6 | Full timed ICE sets | Two 75-question timed sessions with deep rationale review |
| 5-3 | Weak-topic repair | Rework only recurring miss clusters |
| 2-1 | Light review and logistics | Short confidence sets and appointment prep |
ICE exam-day checklist
- Confirm your identification and check-in plan in advance.
- Review one-page summaries for PPE sequence, sterilization monitoring, and post-exposure response.
- Start with high-confidence questions to build pace and reduce early anxiety.
- Flag difficult items instead of getting stuck; recover them in the second pass.
If Your First Attempt Misses the Target
Many candidates improve quickly after one well-structured correction cycle. Use this 4-step reset:
- Classify misses by domain and error type (knowledge, sequence, or timing).
- Build a 3-week remediation block focused only on high-frequency miss types.
- Run timed sets twice weekly to restore pacing confidence.
- Reschedule only after weak-domain accuracy stabilizes at a clearly higher level than baseline.
A data-driven reset is usually faster and less stressful than repeating broad review.
Career & Salary Information
Infection-control competency is one of the most employer-sensitive skill areas in dental practice. From a career standpoint:
- BLS reports $51,550 median pay (2024) for dental assistants.
- BLS projects 7% employment growth (2024-2034) with 55,100 openings per year.
- DANB salary reporting indicates certificants earn about 15% more than non-certified peers.
ICE alone is not the end goal for many candidates, but it is a strong credential step that supports pathway progression and greater responsibility in the operatory.
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