100+ Free ADEX Dental Hygiene Practice Questions

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An SPTCE final case shows calculus remaining on 1 assigned key surface in the mandibular quadrant. The point deduction is:

-10 points

-3 points

-6 points

-1 point

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2026 Statistics

Key Facts: ADEX Dental Hygiene Exam

ADEX Dental Hygiene is the practical/clinical licensure exam for dental hygienists, accepted by ~85% of U.S. jurisdictions and administered by the American Board of Dental Examiners (the merged CDCA-WREB-CITA/ADEX entity, finalized August 2025). It pairs a ~100-item Computer Simulated Clinical Examination (CSCE OSCE) with a live-patient Simulated Patient Treatment Clinical Examination (SPTCE) requiring calculus detection on 16 surfaces of 4 maxillary teeth and removal across 12 assigned mandibular surfaces. Minimum passing score is 75 reported as Pass/Fail. This 100-question free practice bank covers the CSCE content blueprint and the SPTCE criteria sheets - it does not replace hands-on patient practice.

Sample ADEX Dental Hygiene Practice Questions

Try these sample questions to test your ADEX Dental Hygiene exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Approximately what percentage of U.S. dental hygiene licensure jurisdictions accept the ADEX Dental Hygiene Examination as of 2026?

A.55%

B.70%

C.85%

D.100%

Explanation: ABDE reports that the merged CDCA-WREB-CITA/ADEX organization serves approximately 85% of U.S. dental hygiene licensure candidates. ADEX Dental (dentist) acceptance is higher at ~98%.

2The ADEX Dental Hygiene Examination Series consists of which two components?

A.Written board exam (NBDHE) and clinical patient procedure

B.Simulated Patient Treatment Clinical Examination (SPTCE) and Computer Simulated Clinical Examination (CSCE OSCE)

C.Manikin-only typodont scaling and panoramic radiographic interpretation

D.Single live patient with full-mouth scaling and root planing only

Explanation: The ADEX Dental Hygiene Examination series has two required components: the SPTCE (live-patient clinical examination focused on calculus detection, probing, and quadrant scaling) and the CSCE OSCE (computer-based exam with ~100 scored items across 6 content areas).

3Approximately how many scored items does the ADEX Dental Hygiene CSCE OSCE contain?

A.30 items

B.65 items

C.100 items

D.200 items

Explanation: The CSCE OSCE has roughly 100 scored items plus a varying number of unscored pilot questions. The actual exam time is 1 hour 55 minutes within an approximately 2.5-hour session that includes a tutorial and post-exam survey.

4Per the CSCE OSCE blueprint, which content area has the LARGEST weight on the exam?

A.Medical/Dental Assessment (12%)

B.Intra and Extra Oral Assessment and Charting (27%)

C.Radiology/Imaging (15%)

D.Patient Care including Periodontal Procedures (19%)

Explanation: Intra and Extra Oral Assessment and Charting is the largest CSCE blueprint domain at 27% of items. The full blueprint is: Medical/Dental Assessment 12%, IEO Assessment & Charting 27%, Radiology/Imaging 15%, Care Planning 13%, Patient Care 19%, Specialties & Pharmacology 14%.

5What is the minimum scaled score required to pass the CSCE OSCE and the SPTCE?

A.60

B.70

C.75

D.80

Explanation: A minimum scaled score of 75 is required to pass each component. Results are reported to candidates and licensing jurisdictions as Pass/Fail. Both components must be successfully completed within 18 months of the first attempt of any component.

6What is the 2026 full ADEX Dental Hygiene Examination fee (excluding facility fees)?

A.$450

B.$795

C.$1,150

D.$2,795

Explanation: The 2026 full ADEX Dental Hygiene Examination fee is $1,150 plus a facility fee that varies by clinical location. This includes one complimentary clinical retake. The CSCE OSCE alone is $450 ($275 retake); clinical retake-only is $795.

7Per the SPTCE patient selection requirements, what is the minimum number of qualifying subgingival calculus surfaces a patient must present?

A.6 surfaces

B.8 surfaces

C.12 surfaces

D.20 surfaces

Explanation: Candidates must present 6-10 teeth with at least 12 qualifying subgingival calculus surfaces. Of those 12 qualifying surfaces, at least 8 must be on posterior teeth, at least 3 must be on molars, and no more than 4 may be on anterior teeth.

8Per SPTCE patient selection, the maximum number of qualifying calculus surfaces that may be on anterior teeth is:

A.1

B.4

C.8

D.All 12

Explanation: Of the 12 qualifying subgingival calculus surfaces, no more than 4 may be on anterior teeth. The remainder must be posterior, with at least 8 surfaces on posterior teeth and at least 3 of those on molars.

9Per SPTCE patient selection, calculus detection scoring evaluates how many tooth surfaces?

A.12 surfaces on a mandibular quadrant

B.16 surfaces (M, D, F, L) on 4 assigned maxillary teeth

C.32 surfaces on the full dentition

D.Only the 4 surfaces of one assigned tooth

Explanation: Calculus detection is evaluated on 4 surfaces (mesial, distal, facial, lingual) of 4 assigned maxillary teeth - 16 surfaces total. These are evaluated for presence or absence of subgingival calculus and compared to examiner findings.

10How many surfaces are evaluated for the SPTCE calculus REMOVAL portion of scoring, and how is point value distributed?

A.8 surfaces worth 12.5 points each in the maxillary quadrant

B.12 assigned key surfaces worth 5.5 points each in one mandibular quadrant

C.16 surfaces worth 6.25 points each across both quadrants

D.All surfaces of all teeth, equally weighted

Explanation: Calculus removal is graded on 12 assigned key surfaces in one mandibular quadrant, worth 5.5 points each. Calculus remaining on 1 surface results in -3 points; calculus remaining on 2 or more surfaces results in -6 points.

About the ADEX Dental Hygiene Exam

The ADEX Dental Hygiene Clinical Examination is the practical licensure exam accepted by approximately 85% of U.S. dental hygiene licensure jurisdictions. It has two components: a computer-based Computer Simulated Clinical Examination (CSCE OSCE, ~100 scored items, 2.5 hours) and the Simulated Patient Treatment Clinical Examination (SPTCE), in which candidates demonstrate calculus detection, periodontal probing, and quadrant scaling/root planing on a live patient. The CSCE weights are Medical/Dental Assessment 12%, Intra/Extra Oral Assessment & Charting 27%, Radiology/Imaging 15%, Care Planning 13%, Patient Care 19%, and Specialties & Pharmacology 14%. This 100-question Q-bank targets the cognitive knowledge tested by the OSCE plus the scoring criteria used to grade the patient-treatment section.

Questions

100 scored questions

Time Limit

CSCE OSCE ~2.5 hours total (1h55m actual exam time); SPTCE scheduled per testing site

Passing Score

Minimum scaled score of 75 (reported as Pass/Fail)

Exam Fee

Full exam $1,150 + facility fee; clinical retake $795; CSCE OSCE $450 ($275 retake); typodont $150 (American Board of Dental Examiners (ABDE/ADEX) - formed by the August 2025 merger of CDCA-WREB-CITA and ADEX)

ADEX Dental Hygiene Exam Content Outline

12%

Medical and Dental Assessment

Medical history, vital signs, ASA classification, drug-disease interactions, allergies, informed consent, and red-flag systemic findings (uncontrolled DM, recent MI, anticoagulants, bisphosphonates, pregnancy)

27%

Intra and Extra Oral Assessment and Charting

Heaviest-weighted CSCE domain. Lesion description (location, size, color, consistency), TMJ and lymph-node exam, dental charting, periodontal charting (PD, recession, CAL, BoP, mobility, furcation), and 2017 AAP staging and grading

15%

Radiology and Imaging

FMX and bitewing prescription, radiographic interpretation (caries, calculus, vertical/horizontal bone loss, periapical pathology), exposure factors, ALARA, lead apron and thyroid collar use, and digital sensor infection control

13%

Dental Hygiene Care Planning

Treatment-need prioritization, prophylaxis vs SRP vs periodontal maintenance decision rules, recall intervals, patient education, and re-evaluation timing

19%

Patient Care

Instrumentation (Gracey area-specific vs universal curettes, sickle scalers, ultrasonic vs hand), modified pen grasp, lateral pressure, fulcrum technique, fluoride therapy, sealants, local anesthesia infiltration where in scope, and medical emergency protocols

14%

Dental Specialties and Applied Pharmacology

Pediatric, orthodontic, prosthodontic, periodontic, endodontic, and oral surgery considerations plus pharmacology relevant to hygiene (analgesics, antibiotics for prophylaxis per AHA/ADA, anesthetics, fluorides)

How to Pass the ADEX Dental Hygiene Exam

What You Need to Know

Passing score: Minimum scaled score of 75 (reported as Pass/Fail)
Exam length: 100 questions
Time limit: CSCE OSCE ~2.5 hours total (1h55m actual exam time); SPTCE scheduled per testing site
Exam fee: Full exam $1,150 + facility fee; clinical retake $795; CSCE OSCE $450 ($275 retake); typodont $150

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ADEX Dental Hygiene Study Tips from Top Performers

1Drill the CSCE blueprint by weight - Intra/Extra Oral Assessment & Charting is 27% and the single largest source of test items

2Memorize the 2017 AAP periodontal staging (I-IV) and grading (A-C) - it appears throughout charting and care-planning items

3Learn the SPTCE patient selection rules cold: 6-10 teeth, ≥12 qualifying subgingival surfaces, ≥8 posterior, ≥3 on molars, ≤4 anterior

4Practice Gracey area-specific assignments (1/2 anteriors; 7/8 facial/lingual posteriors; 11/12 mesial posteriors; 13/14 distal posteriors)

5Know CDC dental infection control: critical/semi-critical/non-critical instrument categories and heat sterilization for critical items

6Review radiographic interpretation: horizontal vs vertical bone loss patterns, calculus on bitewings, and root-tip vs PDL widening

7Drill antibiotic prophylaxis indications per AHA (prosthetic valve, prior IE, certain congenital heart disease) - amoxicillin 2g 1 hour before

8Practice mock SPTCE patient screening with peers using the official ADEX assignment form (ACF) so you know what disqualifies a patient

Frequently Asked Questions

Is the ADEX Dental Hygiene Exam a written or practical exam?

Both. It has a computer-based Computer Simulated Clinical Examination (CSCE OSCE, ~100 items, 2.5 hours) plus a live-patient Simulated Patient Treatment Clinical Examination (SPTCE) for calculus detection, probing, and quadrant scaling.

Who administers the ADEX Hygiene Exam in 2026?

The American Board of Dental Examiners (ABDE), formed by the August 2025 merger of CDCA-WREB-CITA with the ADEX exam-development consortium. The unified entity serves approximately 85% of U.S. dental hygiene licensure jurisdictions.

What are the SPTCE patient selection requirements?

Candidates must present 6-10 teeth with at least 12 qualifying subgingival calculus surfaces. At least 8 surfaces must be on posterior teeth, at least 3 on molars, and no more than 4 on anterior teeth. The patient supplies one mandibular quadrant for assigned scaling.

How is calculus detection scored?

Calculus detection is evaluated on 16 surfaces - the mesial, distal, facial, and lingual of 4 assigned maxillary teeth. Calculus removal is scored on 12 assigned key surfaces in one mandibular quadrant, worth 5.5 points each. Missing 1 surface costs -3 points; 2+ costs -6.

What instruments are allowed for the SPTCE?

Universal curettes, area-specific Gracey curettes, sickle scalers, and ultrasonic/sonic scalers are all permitted. Candidates select the appropriate instrument for each surface and area; correct selection and proper technique factor into the technical evaluation.

What is the passing score?

75 minimum scaled score on both the CSCE and the SPTCE. Results are reported to candidates and licensing jurisdictions as Pass/Fail rather than a numerical score, and both components must pass within 18 months of the first attempt.

How much does the ADEX Hygiene Exam cost?

Full examination is $1,150 plus a facility fee that varies by clinical location, and includes one complimentary clinical retake. Clinical-only retake is $795. The CSCE OSCE alone is $450 ($275 retake). Typodont fee is $150.

Does the CSCE cover local anesthesia?

Yes, as part of the Patient Care domain in scope-of-practice jurisdictions. ADEX also administers a separate Local Anesthesia exam used by many states to add local anesthesia to the hygiene scope of practice.