Our Mission

CDCA-WREB-CITA serves jurisdictions in the United States, Canada, Puerto Rico, and Jamaica in the pursuit of public health, safety, and welfare by ensuring that safe and competent dental care is provided by qualified dental practitioners. Once the three largest regional exam administration agencies, through our shared missions we combined to become one agency, with one mission: one national examination.

Our Vision

It is the vision of the CDCA-WREB-CITA to be the nationwide resource in the development, innovation, and administration of competency assessments for the oral health professions. To do this, we are:

  • Committed to designing and administering assessments based on sound principles of testing and measurement.
  • Pledged to excellence, integrity, and fairness.
  • Committed to service, equity, and support for educational institutions and licensure candidates.

Why one examination

As an independent testing agency that administers the ADEX dental and dental hygiene clinical licensure examinations, CDCA-WREB-CITA sets uniform standards for excellence in testing administration.

A nationally accepted uniform examination meets the needs of candidates looking for initial licensure without limits, making licensure portable across jurisdictions throughout their careers. A national standard brings jurisdictions confidence in the performance abilities of incoming professionals.

CDCA-WREB-CITA is devoted to developing a psychometrically sound and legally defensible licensure examination consistent with current dental standards of care in an evolving environment. This commitment led us to develop the industry leader in simulated patient assessment, CompeDont™, and the SimProDH for use in dental hygiene assessments. We continue to develop streamlined processes that provide candidates with access to the tools they will need to be successful while also equipping examiners and educators with resources they can use to help facilitate the development of a national dental community.


ADEX Dental and Dental Hygiene Examinations evaluate candidates’ psychomotor skills and didactic performance for entry-level practice. The American Board of Dental Examiners (ADEX) is comprised of representatives from member jurisdictions’ boards. Nearly all US states participate.

ADEX Membership gives a recognizing state dental board direct involvement in the development and evolution of the examinations through committee appointments; and approval of the final form of the examinations in dentistry and dental hygiene. A strict development and review process begins with a regularly updated occupational analysis (OA) to ensure current practice and standards of care are represented. ADEX uses information from the OA to determine the content necessary to include in each examination.

With these ADEX-driven directives, CDCA-WREB-CITA develops examinations utilizing a team of subject matter experts. Then, psychometricians set discriminate values for candidate performance and determine the final score (pass or fail). Using this criterion, exams are piloted and evaluated. States who join CDCA-WREB-CITA extend invitations to board members to become examiners in this process.

Results must be demonstrative of psychometrically sound, valid expressions of readiness for the oral professions before being approved for use by ADEX.

1968, Fifty-three different licensure exams for US states and jurisdictions.

1969, The North East Regional Board of Dental Examiners (NERB) is founded.
1976, The Western Regional Examining Board (WREB) is founded.

2004-2005, The American Board of Dental Examiners (ADEX) is founded with representation from recognizing dental boards. ADEX is a test development organization, not a testing organization.
2005, The Council of Interstate Testing Agencies, Inc. (CITA) is formed. The first ADEX Dental Examinations are delivered.

2007, NERB administers it’s first ADEX Dental Exam.

2009, The first ADEX Dental Hygiene Examinations are delivered and is adopted by NERB.
2015, ADEX approves Patient-Centered Curriculum Integrated Format examinations.

2015, NERB becomes The Commission on Dental Competency Assessments (CDCA).
April 2020 ADEX approves CompeDont™ simulated tooth.

August 3, 2021, CDCA and WREB merge to form CDCA-WREB and administer the ADEX exam as a single testing agency.

August 1, 2022, CDCA-WREB and CITA merge to become CDCA-WREB-CITA, simplifying the licensure process for schools, candidates and dental boards offering the universally accepted ADEX licensure standard throughout North America.

Board of Directors

Proprietary Simulated Patient Assessment 

Developed specifically for high-fidelity simulated patient experiences, exclusively for use in ADEX examinations.
Tooth 5
CompeDont logo
Tooth 3
SimProDH v1

Member States

States and exam-recognizing jurisdictions’ Boards of Dentistry may vote to become a member of CDCA-WREB-CITA. Active board members from those jurisdictions, dentists, dental hygienists and public members, then become voting members of the agency and are able to participate as examiners at CDCA-WREB-CITA administered ADEX licensure examinations. Examinations take place throughout the U.S., in Canada, Mexico and, the Commonwealth of Jamaica. Many members find examining to be an enriching experience. These dental and dental hygiene members can remain active members in CDCA-WREB-CITA, even after their dental board tenure is completed.

Members and select consultant members are also eligible to attend organizational Annual Meetings. Our Annual Meetings give attendees the opportunity to participate in business sessions, town hall, examiner training, elections, CE sessions, networking events, and more.

Member state’s leadership actively participates in a unique State Board Presidents/Vice-Presidents Forum, which typically happens just prior to the Annual Meeting. Additionally, each member jurisdiction is offered three seats on the CDCA-WREB-CITA Steering Committee. The Steering Committee helps provide guidance and governance within the organization.

There is no cost or obligation to member jurisdictions to become a member state/jurisdiction.


Dental and Dental Hygiene professionals act as examiners for CDCA-WREB-CITA in the delivery and grading of assessments nationwide. These examiners are members of the organization through either their participation on their state board, or their qualifications as industry experts in dental education and practice. Executive Directors and state board staff may update their board rosters with us at any time.

Members of state dental boards become examiners upon their appointment and become eligible to examine so that they may actively participate in the licensing process in the service of their board missions. This membership extends beyond the terms of the individual.

A Consultant Member application is available to persons who have not served on boards of dentistry. Consultant Examiners are appointed for a one-year term and may be reappointed upon the recommendation of the Board of Directors and approval of the Steering Committee. A Consultant Examiner must maintain an active license in good standing to practice dentistry or dental hygiene and be in practice for at least five years. Consultant Examiners cannot vote or hold office within the organization but may participate on committees where permitted.

Applications for consultancy are reviewed bi-annually at the will of the Board of Directors. If approved, applicants will be required to adhere to non-disclosure policies, detail conflicts of interest, and be active participants in the examination process as defined by the member participation policy including accepting and fulfilling two (2) assignments per year.

Frequently Asked Questions

Find answers to the most common questions on topics such as applying for ADEX and other exams, sample OSCE questions, how to get score reports, attempt limits, and more.