NDHCE Exam Breakdown

NDHCE Exam Breakdown

Domain WeightGrade Percentage
Responsibility and Accountability7-13%
Client and Professional Relationships2-8%
Health & Safety and Practice Management3-9%
Foundational Knowledge14-20%
Assessment and Diagnosis20-26%


Number of questions: (13 to 22 MCQs)

The Dental Hygienist: 

1.01 Applies ethical principles. 

1.02 Complies with current national jurisprudence requirements and relevant legislation, standards, and codes. 

1.03 Works within scope of practice and own level of competence, both independently and as part of an interprofessional team. 

1.04 Maintains privacy and confidentiality in accordance with relevant legislation. 

1.05 Maintains documentation and records consistent with relevant legislation. 

1.06 Recognizes incompetent or unsafe practice of self and others and responds appropriately. 

1.07 Implements quality improvement activities based on self-assessment of own professional learning needs. 

1.08 Incorporates new evidence from research, clinical expertise, and other relevant resources to support dental hygiene practice. 


Number of questions: (3 to 13 MCQs)

The Dental Hygienist: 

2.01 Demonstrates sensitivity to client diversity. 

2.02 Implements communication approaches (e.g., verbal, nonverbal, visual, written and electronic forms of communication) for clients and stakeholders based on their characteristics, needs, linguistic level, and health literacy. 

2.03 Collaborates with communities, interprofessional teams, and stakeholders to improve oral health outcomes. 

2.04 Acts as a client advocate. 


Number of questions: (5 to 15 MCQs)

The Dental Hygienist: 

3.01 Applies principles of infection prevention and control. 

3.02 Applies principles of risk reduction for client, colleague, and practitioner safety, health and well-being. 

3.03 Takes responsibility for the use, maintenance, and disposal of equipment and materials involved in the delivery of dental hygiene services. 

3.04 Uses information systems (e.g., health records, online pharmacology database, financial records, etc.) for the collection, retrieval, and storage of data to support dental hygiene practice. 

3.05 Manages time, resources (e.g., financial, materials, personnel, etc.), and priorities to ensure effective dental hygiene practice. 


Number of questions: (23 to 34 MCQs)

The Dental Hygienist: 

4.01 Uses knowledge of basic principles of research methods and statistics in dental hygiene practice. 

4.02 Uses knowledge of the behavioural sciences (e.g., psychology, sociology, etc.) in dental hygiene practice. 

4.03 Uses knowledge of anatomy, biology, histology, pathology, and physiology in dental hygiene practice. 

4.04 Uses knowledge of biochemistry and nutrition in dental hygiene practice. 

4.05 Uses knowledge of immunology and microbiology in dental hygiene practice. 

4.06 Uses knowledge of pharmacology in dental hygiene practice. 

4.07 Uses knowledge of periodontology in dental hygiene practice. 

4.08 Uses knowledge of head/neck anatomy and physiology in dental hygiene practice. 

4.09 Uses knowledge of oral/dental anatomy and physiology in dental hygiene practice. 

4.10 Uses knowledge of oral/dental embryology and histology in dental hygiene practice. 

4.11 Uses knowledge of oral pathology in dental hygiene practice. 

4.12 Uses knowledge of dental radiography in dental hygiene practice. 

4.13 Uses knowledge of orthodontics in dental hygiene practice. 

4.14 Uses knowledge of restorative dentistry, endodontics, prosthodontics, and oral surgery in dental hygiene practice. 


Number of questions: (34 to 44 MCQs)

The Dental Hygienist: 

5.01 Assesses epidemiological data (e.g., demographic data, determinants of health, etc.). 

5.02 Assesses health history including prescribed and non-prescribed pharmaceuticals, herbs, and supplements. 

5.03 Assesses vital signs. 

5.04 Identifies clients for whom the initiation or continuation of treatment is contraindicated. 

5.05 Identifies clients at risk for medical emergencies. 

5.06 Assesses the head and neck region. 

5.07 Assesses intraoral soft tissues other than the periodontium. 

5.08 Assesses intraoral hard tissues. 

5.09 Assesses the periodontium. 

5.10 Assesses hard and soft deposits. 

5.11 Identifies risk factors for diseases including dental, oral, and periodontal pathologies. 

5.12 Determines the need for radiographs. 

5.13 Uses additional diagnostic modalities (e.g., photographs, study models, pulpal testing, microbiological testing, caries and oral cancer screening tests, etc.), as needed. 

5.14 Assesses dietary practices. 

5.15 Uses oral health indices. 

5.16 Assesses and interprets radiographs. 

5.17 Assesses clients’ oral health knowledge, beliefs, attitudes, motivation, skills, and barriers to learning as part of the educational process. 

5.18 Determines the need for consultation with other professionals. 

5.19 Formulates a dental hygiene diagnosis using problem solving and decision-making skills. 


Number of questions: (10 to 18 MCQs)

The Dental Hygienist: 

6.01 Prioritizes clients’ needs through a collaborative process involving clients, family, care providers, and others, as needed. 

6.02 Identifies strategies to minimize the risk of a medical emergency. 

6.03 Adapts strategies and interventions for clients with diverse needs. 

6.04 Develops dental hygiene care plans based on assessment data and a client-centred approach. 

6.05 Supports clients’ autonomy by assisting them in making informed decisions about dental hygiene services. 

6.06 Determines the need for client referral to other health professionals. 

6.07 Develops educational interventions, health promotion strategies, and community oral health programs based on assessment data and a client-centred approach. 


Number of questions: (32 to 42 MCQs)

The Dental Hygienist: 

7.01 Applies principles of instrumentation. 

7.02 Exposes and processes intraoral and extraoral radiographs. 

7.03 Teaches clients oral self-assessment techniques. 

7.04 Provides coaching/advice to clients regarding oral self-care. 

7.05 Counsels clients regarding tobacco cessation strategies. 

7.06 Provides clients with information regarding dietary practices. 

7.07 Implements strategies to manage client pain, anxiety and discomfort, including local anesthesia. 

7.08 Provides non-surgical periodontal therapy using hand instrumentation. 

7.09 Provides non-surgical periodontal therapy using powered instrumentation. 

7.10 Applies anticariogenic agents and therapies. 

7.11 Applies appropriate chemotherapeutics/pharmacotherapeutics excluding anticariogenic agents. 

7.12 Takes impressions and fabricates study models, tooth whitening trays, and sports mouthguards. 

7.13 Provides tooth whitening services. 

7.14 Takes intraoral and extraoral photographs. 

7.15 Applies and removes periodontal dressings and removes sutures. 

7.16 Places temporary restorations. 

7.17 Responds to medical emergencies. 

7.18 Implements educational interventions, health promotion strategies, and community oral health programs that meet clients’ learning needs. 


Number of questions: (10 to 18 MCQs)

The Dental Hygienist: 

8.01 Uses measurable criteria to evaluate outcomes. 

8.02 Revises dental hygiene care plans, educational interventions, health promotion strategies, and community oral health programs, as needed. 

8.03 Evaluates the effectiveness of clinical dental hygiene care. 

8.04 Evaluates the need for client referral to other health professionals. 

8.05 Provides recommendations to clients regarding their ongoing care. 

8.06 Evaluates the effectiveness of educational interventions, health promotion strategies, and community oral health programs. 

8.07 Communicates evaluation outcomes to clients, family, care providers, stakeholders, and others. 

Source: NDHCE Blueprint