A Journey Measured in Smiles

By: Marc A. Bernardo

            The journey to graduation and licensure embarks as soon as your white coat has been bestowed upon you.  Licensure is the light at the end of the tunnel and the culmination of the blood, sweat and tears you have put in.  Luckily, there are different routes one can take in order to become a licensed professional. 

Running out of gas: National Board Exam I (NBDE Part 1)

            Towards the end of your D2 year, the NBDE Part I will feel like running out of gas. After an exhaustive two years of committing the sciences to knowledge, you will have to find the courage to conquer yet another test.  At WesternU, you must take a mock board and then apply with the Office of Academic Affairs to be cleared to schedule a NBDE Part 1 test date.  This exam is generally taken between the months of March and July of the D2 year before you enter clinic.  This exam encompasses the sciences you have learned during your first two years of dental: Anatomical Sciences, Biochemistry, Physiology, Microbiology, Pathology, and Dental Anatomy and Occlusion. 

Feeling Flat: National Board Exam II (NBDE Part II)

            On any long road trip, getting a flat tire is frustrating, but a necessary obstacle to your final destination. In the beginning of the D4 year, the NBDE Part II is the final requirement to take before licensure.  This exam is comprised of 500 questions, testing in the disciplines of Endodontics, Operative Dentistry, Oral and Maxillofacial Surgery, Oral Diagnosis, Orthodontics / Pediatric Dentistry, Patient Management, Periodontics, Pharmacology, Prosthodontics and a Case Based Component.  A mock NBDE Part II takes place during the summer of the D4 year prior to the Fall semester.  Students are then encouraged to take the exam between the months of August – December. 

The Long Stretch

            After driving by the two rest stops, you face a crossroads.  Each route from here on out will take you to your destination (‘WesternU Licensure Boulevard’) however the paths vary quite drastically.  Along with the clinical competencies required for graduation, students must take one of these routes in order to be licensed.  The routes are listed in the table below.

Destination: Licensure Boulevard

Route 1: Western Regional Examining Board(WREB)

Route 2: Residency – General Practice Residency (GPR) or

 Advanced Education in General Dentistry Program (AEGD)

Route 3: Licensure by Portfolio


Route 1:  Western Regional Examining Board

            This road is short, however poses uncontrollable conditions.  Dental faculty spend all four years preparing students for this tedious exam, which is to be taken during the spring of your D4 year.  The WREB consists of an operative component (two restorations on live patients), endodontics (access and condensation on two extracted teeth), periodontal treatment (scaling and root planning on live patients), and comprehensive treatment planning (computer simulated).  The course of this exam is over two days and requires all patients and extracted teeth to be screened and meet the minimum qualifications to be a patient candidate.  The states accepting the WREB are pictured below. 


            The benefit of taking the WREB is that it is only a two-day exam and passing results lead to licensure qualification.  However, there are certain variables that students must think about.  Students must be prepared to gather qualified patients, teeth, and be prepared to perform at high level in a stressful environment.  Each patient poses different characteristics than another; hence no two students’ WREB exam is identical. 

Route 2: Residency – General Practice Residency (GPR) or Advanced Education in General Dentistry Program (AEGD)

            This route is an extension of dental education post graduation.  GPR and AEGD programs last one or two years and will result in licensure without taking the WREB.  Some say that one year of residency translates to five years of lessons learned in private practice.  There may be limitations upon where one can practice after completing a program in a respected state; hence one should choose a residency wisely.  Also, many residency programs are now requiring students to take the Advanced Dental Admissions Test to be taken after the NBDE Part I.  This exam aims to help programs determine how academically sound an applicant is. 

Route 3:  Licensure by Portfolio

            This route requires students to be proactive during the road.  For a hypothetical example, gas receipts must be collected at each fill-up, and road signs must be watched closely.  Students must begin collecting clinical data as soon as they enter the clinic (The Dental Center and Community Service Learning Sites).  Each procedure completion is taken into account in a final tally of treatments rendered in order to be eligible for licensure.  The primary modes of procedure data collection is via E*Value and Axium; hence students must make sure CDT codes are entered in timely and correctly.   Procedures by discipline are charted below.

              WesternU students must submit for a Candidate ID# from the Dental Board of California not more than one year before graduation.  The Dean and CDM will submit the form in your behalf.  The dental board will then issue the student a candidate number.  Students must submit procedure experiences and pass six Licensure by Portolio competencies (equivalent to CDM competency exams).  The portfolio is to be submitted 90 days prior to graduation.  Students must then get fingerprinted and pass the ethics and NBDE part II exams.  Licensure is then issued at time of graduation.   Students may opt to still take the WREB if Licensure by Portfolio requirements have not been met.  Search for ‘California Licensure by Portfolio’ in the WesternU CDM SharePoint for more information.

            It is important to know that this route only allows for the licensed professional to practice in the state of California.  ADA has yet to release the other states that will also be accepting this method of licensure. 

Licensure Boulevard

            This is the end of the road.  Although you are now able to practice as a clinician, a dental journey is never-ending.  There are countless places to visit, material to learn, and experiences to be had in order to to fulfill your professional adventure.  This journey is measured in smiles; like the ones you give.