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200+ Free NBDHE Practice Questions

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Case 001 (Head & Neck Anatomy): A patient reports persistent lower-lip paresthesia after a prior mandibular block at another clinic during the first appointment. Which step is most appropriate before attempting another inferior alveolar injection?

A
B
C
D
to track
2026 Statistics

Key Facts: NBDHE Exam

350

Scored Questions

JCNDE NBDHE Candidate Guide 2026

9h

Total Testing Time

JCNDE NBDHE Candidate Guide 2026

75

Passing Scaled Score

JCNDE NBDHE Candidate Guide 2026

$600

Exam Fee

JCNDE NBDHE Candidate Guide 2026

12-15

Case-Based Patient Scenarios

JCNDE NBDHE Candidate Guide 2026

221,600

Dental Hygienist Jobs (US)

BLS OOH May 2024 employment estimate

JCNDE's 2026 candidate guide lists the NBDHE at 350 scored questions, a 9-hour total testing time, a scaled passing score of 75, and a $600 exam fee. For exams scheduled on or after the anticipated October 2026 blueprint update, JCNDE lists 56 scientific-basis questions, 124 clinical-services questions, 20 research/community-health questions, and 150 case-based questions (12 to 15 patient cases), with added emphasis on local anesthesia and emerging technologies.

Sample NBDHE Practice Questions

Try these sample questions to test your NBDHE exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1Case 001 (Head & Neck Anatomy): A patient reports persistent lower-lip paresthesia after a prior mandibular block at another clinic during the first appointment. Which step is most appropriate before attempting another inferior alveolar injection?
A.Reconfirm pterygomandibular-space landmarks and needle path relative to the mandibular foramen before reinjection.
B.Switch to a maxillary PSA approach because lower-lip symptoms indicate posterior superior alveolar involvement.
C.Inject directly into the lingual frenum to improve anesthetic diffusion.
D.Skip landmarking and deliver a rapid full-cartridge injection without aspiration.
Explanation: For mandibular block safety and predictability, landmark verification and controlled, aspirated technique come before reinjection.
2Case 002 (Head & Neck Anatomy): A patient reports persistent lower-lip paresthesia after a prior mandibular block at another clinic while planning today's care. Which step is most appropriate before attempting another inferior alveolar injection?
A.Switch to a maxillary PSA approach because lower-lip symptoms indicate posterior superior alveolar involvement.
B.Reconfirm pterygomandibular-space landmarks and needle path relative to the mandibular foramen before reinjection.
C.Inject directly into the lingual frenum to improve anesthetic diffusion.
D.Skip landmarking and deliver a rapid full-cartridge injection without aspiration.
Explanation: For mandibular block safety and predictability, landmark verification and controlled, aspirated technique come before reinjection.
3Case 003 (Head & Neck Anatomy): A patient reports persistent lower-lip paresthesia after a prior mandibular block at another clinic when deciding whether to continue instrumentation. Which step is most appropriate before attempting another inferior alveolar injection?
A.Switch to a maxillary PSA approach because lower-lip symptoms indicate posterior superior alveolar involvement.
B.Inject directly into the lingual frenum to improve anesthetic diffusion.
C.Reconfirm pterygomandibular-space landmarks and needle path relative to the mandibular foramen before reinjection.
D.Skip landmarking and deliver a rapid full-cartridge injection without aspiration.
Explanation: For mandibular block safety and predictability, landmark verification and controlled, aspirated technique come before reinjection.
4Case 004 (Head & Neck Anatomy): A patient reports persistent lower-lip paresthesia after a prior mandibular block at another clinic during final chart review before checkout. Which step is most appropriate before attempting another inferior alveolar injection?
A.Switch to a maxillary PSA approach because lower-lip symptoms indicate posterior superior alveolar involvement.
B.Inject directly into the lingual frenum to improve anesthetic diffusion.
C.Skip landmarking and deliver a rapid full-cartridge injection without aspiration.
D.Reconfirm pterygomandibular-space landmarks and needle path relative to the mandibular foramen before reinjection.
Explanation: For mandibular block safety and predictability, landmark verification and controlled, aspirated technique come before reinjection.
5Case 005 (Head & Neck Anatomy): A patient reports persistent lower-lip paresthesia after a prior mandibular block at another clinic while preparing the home-care plan. Which step is most appropriate before attempting another inferior alveolar injection?
A.Reconfirm pterygomandibular-space landmarks and needle path relative to the mandibular foramen before reinjection.
B.Switch to a maxillary PSA approach because lower-lip symptoms indicate posterior superior alveolar involvement.
C.Inject directly into the lingual frenum to improve anesthetic diffusion.
D.Skip landmarking and deliver a rapid full-cartridge injection without aspiration.
Explanation: For mandibular block safety and predictability, landmark verification and controlled, aspirated technique come before reinjection.
6Case 006 (Oral Pathology): You observe a unilateral ulcer with indurated borders that has persisted longer than two weeks during the first appointment. What is the best next action by the hygienist?
A.Delay action and recheck in three months because traumatic ulcers always self-resolve.
B.Document lesion characteristics thoroughly and arrange prompt evaluation/biopsy referral while informing the supervising dentist.
C.Prescribe topical corticosteroids independently and continue routine care only.
D.Remove the lesion with an ultrasonic insert during debridement.
Explanation: Persistent suspicious lesions require timely referral and complete documentation; watchful waiting alone is unsafe.
7Case 007 (Oral Pathology): You observe a unilateral ulcer with indurated borders that has persisted longer than two weeks while planning today's care. What is the best next action by the hygienist?
A.Delay action and recheck in three months because traumatic ulcers always self-resolve.
B.Prescribe topical corticosteroids independently and continue routine care only.
C.Document lesion characteristics thoroughly and arrange prompt evaluation/biopsy referral while informing the supervising dentist.
D.Remove the lesion with an ultrasonic insert during debridement.
Explanation: Persistent suspicious lesions require timely referral and complete documentation; watchful waiting alone is unsafe.
8Case 008 (Oral Pathology): You observe a unilateral ulcer with indurated borders that has persisted longer than two weeks when deciding whether to continue instrumentation. What is the best next action by the hygienist?
A.Delay action and recheck in three months because traumatic ulcers always self-resolve.
B.Prescribe topical corticosteroids independently and continue routine care only.
C.Remove the lesion with an ultrasonic insert during debridement.
D.Document lesion characteristics thoroughly and arrange prompt evaluation/biopsy referral while informing the supervising dentist.
Explanation: Persistent suspicious lesions require timely referral and complete documentation; watchful waiting alone is unsafe.
9Case 009 (Oral Pathology): You observe a unilateral ulcer with indurated borders that has persisted longer than two weeks during final chart review before checkout. What is the best next action by the hygienist?
A.Document lesion characteristics thoroughly and arrange prompt evaluation/biopsy referral while informing the supervising dentist.
B.Delay action and recheck in three months because traumatic ulcers always self-resolve.
C.Prescribe topical corticosteroids independently and continue routine care only.
D.Remove the lesion with an ultrasonic insert during debridement.
Explanation: Persistent suspicious lesions require timely referral and complete documentation; watchful waiting alone is unsafe.
10Case 010 (Oral Pathology): You observe a unilateral ulcer with indurated borders that has persisted longer than two weeks while preparing the home-care plan. What is the best next action by the hygienist?
A.Delay action and recheck in three months because traumatic ulcers always self-resolve.
B.Document lesion characteristics thoroughly and arrange prompt evaluation/biopsy referral while informing the supervising dentist.
C.Prescribe topical corticosteroids independently and continue routine care only.
D.Remove the lesion with an ultrasonic insert during debridement.
Explanation: Persistent suspicious lesions require timely referral and complete documentation; watchful waiting alone is unsafe.

About the NBDHE Exam

The NBDHE is the national written board exam used for dental hygiene licensure decisions across all U.S. jurisdictions. The test includes discipline-based items and case-based patient scenarios focused on clinical judgment, safety, and evidence-based care.

Questions

350 scored questions

Time Limit

9 hours total testing time

Passing Score

Scaled score 75

Exam Fee

$600 (JCNDE / ADA DTS / Pearson VUE)

NBDHE Exam Content Outline

16%

Scientific Basis (56/350)

Biomedical sciences, oral pathology, pharmacology, infection prevention, and foundational risk concepts

35%

Provision of Clinical Services (124/350)

Assessment, radiography, care planning, preventive services, and periodontal/implant maintenance decisions

6%

Research Principles & Community Health (20/350)

Epidemiology, screening indices, appraisal of evidence, and population oral-health program planning

43%

Case-Based Component (150/350)

Integrated clinical judgment across 12-15 patient cases, including medically complex and ethical scenarios

How to Pass the NBDHE Exam

What You Need to Know

  • Passing score: Scaled score 75
  • Exam length: 350 questions
  • Time limit: 9 hours total testing time
  • Exam fee: $600

Keys to Passing

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

NBDHE Study Tips from Top Performers

1Practice in mixed sets that mirror both discipline-based and case-based items; do not study these in isolation
2Use a formal risk-assessment routine on every case: medical history, vitals, medications, radiographic findings, and periodontal charting
3Train pacing for a 9-hour exam day with timed blocks and planned mental resets
4Prioritize evidence-based prevention and maintenance decisions (fluoride, biofilm control, recall interval logic) rather than memorization alone
5Drill emergency and infection-control protocols until first-step actions are automatic
6Review October 2026 blueprint updates, especially local anesthesia and emerging-technology items

Frequently Asked Questions

How many questions are on the NBDHE?

The current JCNDE guide lists 350 scored questions for the NBDHE. The exam combines discipline-based questions with case-based patient scenarios.

How long is the NBDHE exam?

JCNDE lists total testing time at 9 hours. Candidates should train for endurance and pacing, not only content recall.

What is the passing score for NBDHE?

NBDHE results are reported on a scaled score system, and the published passing point is 75.

What is the NBDHE exam fee in 2026?

The 2026 candidate guide lists the NBDHE fee as $600, with scheduling handled through Pearson VUE after eligibility is approved via ADA DTS/JCNDE workflows.

What NBDHE content changes are expected in October 2026?

JCNDE's 2026 guide describes an anticipated blueprint update for exams scheduled on or after October 2026, including explicit weighting for research/community-health content and added emphasis on local anesthesia and emerging technologies.

Is NBDHE accepted for licensure everywhere in the U.S.?

Yes. JCNDE states the NBDHE is accepted for dental hygiene licensure by all U.S. states, the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands.