What is the INBDE?
The Integrated National Board Dental Examination (INBDE) is a new written, cognitive examination for dental licensure scheduled to replace the previous National Board Dental Examination (NBDE) Part I and Part II examinations. The INBDE has the same overall purpose as the NBDE Part I and Part II: to assist state boards of dentistry in evaluating candidates for dental licensure. By integrating content covering the basic, behavioral, and clinical sciences, the INBDE is expected to be more relevant than the current NBDE Part I and Part II examinations.
The INBDE is open to both foreign and domestic dental graduates. It is common for US-based dental students to pursue the exam during their junior year of their postgraduate study, whereas international students are often required to pass in order to apply for state-side postgraduate courses or residency programs. Additionally, dental professionals who acquired their dental degree from an institution not accredited by the Commission on Dental Accreditation (CODA) will need their qualifications verified by the Educational Credential Evaluators.
Test items on the INBDE will require candidates to draw from their knowledge of basic science, behavioral science, and clinical competencies to answer them correctly. For example, INBDE questions will ask about patient care, how dentists approach the practice of dentistry, and how dentists keep up with advances in the profession. The Joint Commission on National Dental Examinations (JCNDE) has issued a formal notification that the Integrated National Board Dental Examination (INBDE) has been available for administration since August 2020. The NBDE Part I was discontinued on July 2020, and the NBDE Part II was discontinued in August 2022.
Exam parameters are constantly being reviewed by the JCNDE. For updates, check out the ADA website Recent and Forthcoming Updates.
EXAM STRUCTURE
The INBDE is a 500-item examination (compared with a total of 900 questions on the NBDE Part I and Part II) which will be administered via computer at test centers throughout the United States and US territories. It will take one and a half days to complete. Essentially, the content of the exam is the same, but the packaging is different.
- All the topics and content of the NBDE Part 1 and 2, but restructured.
- Computer based, 500 multiple choice questions over a day and a half vs 900 questions over two and half days.
- A new user interface with an emphasis on case based questions.
Topics are compartmentalized based on the “Domains of Dentistry.” and integrates undergraduate content in order to achieve a more comprehensive evaluation of a candidate’s dental understanding. The exam extends over two days.
- Day 1 – 3 sets of 100 questions and 1 set of 60 case-based questions (360)
- Day 2 – 2 sets of 70 case-based questions (140)
The total exam time is 12.5 hours, which includes exam orientation and breaks.
NEW QUESTION STRUCTURE
The new INBDE is a restructured condensation of NBDE part I and II, reorganized into 3 main categories:
- Practice and profession.
- Diagnosis and treatment planning.
- Oral Health Management.
The following drop down contains a comprehensive breakdown of the content of each section.
Diagnosis and Treatment Planning
Diagnosis and Treatment Planning includes all aspects of diagnosis, assessment, interpretation of laboratory results, physical evaluation of structure, appearance and function, as well as background, characteristics, circumstances, underlying conditions and psychological, social or behavioral influences to derive an accurate diagnosis and treatment plan, as well as identify reasonable and safe treatment alternatives for any patient. Within the Joint Commission’s Domain of Dentistry, Diagnosis and Treatment Planning is represented by the tasks indicated below.
- Interpret patient information and medical data to assess and manage patients.
- Identify the chief complaint and understand the contributing factors.
- Perform head and neck and intraoral examinations, interpreting and evaluating the clinical findings.
- Use clinical and epidemiological data to diagnose and establish a prognosis for dental abnormalities and pathology.
- Recognize the normal range of clinical findings and distinguish significant deviations that require monitoring, treatment, or management.
- Predict the most likely diagnostic result given available patient information.
- Interpret diagnostic results to inform understanding of the patient’s condition.
- Recognize the manifestations of systemic disease and how the disease and its management may affect the delivery of dental care.
- Recognize the interrelationship between oral health and systemic disease, and implement strategies for improving overall health.
Oral Health Management
Oral Health Management includes all aspects of patient care delivery, including provision and modification of treatment, handling of complications, intervention outcomes assessment, and all developments that arise in the course of managing a patient’s oral health care. Within the Joint Commission’s Domain of Dentistry, Oral Health Management is represented by the tasks indicated below.
- Prevent, recognize, and manage medical emergencies (e.g., cardiac arrest).
- Prevent, recognize, and manage dental emergencies.
- Recognize and manage acute pain, hemorrhage, trauma, and infection of the orofacial complex.
- Prevent, diagnose, and manage pain during treatment.
- Prevent, diagnose, and manage pulpal and periradicular diseases.
- Prevent, diagnose, and manage caries.
- Prevent, diagnose, and manage periodontal diseases.
- Prevent, diagnose, and manage oral mucosal and osseous diseases.
- Recognize, manage, and report patient abuse and neglect.
- Recognize and manage substance abuse.
- Select and administer or prescribe pharmacological agents in the treatment of dental patients.
- Anticipate, prevent, and manage complications arising from the use of therapeutic and pharmacological agents in patient care.
- Diagnose endodontic conditions and perform endodontic procedures.
- Diagnose and manage the restorative needs of edentulous and partially edentulous patients.
- Restore tooth function, structure, and esthetics by replacing missing and defective tooth structure, while promoting soft and hard tissue health.
- Perform prosthetic restorations (fixed or removable) and implant procedures for edentulous and partially edentulous patients.
- Diagnose and manage oral surgical treatment needs.
- Perform oral surgical procedures.
- Prevent, diagnose, and manage developmental or acquired occlusal problems.
- Prevent, diagnose, and manage temporomandibular disorders.
- Diagnose and manage patients requiring modification of oral tissues to optimize form, function, and esthetics.
- Evaluate outcomes of comprehensive dental care.
- Manage the oral esthetic needs of patients.
Practice and Profession
Practice and Profession includes the understanding, implementation and monitoring of effective systems, procedures, and policies that support professional practice integrity, quality control and self or organizational performance assessment, as well as systems, procedures, and policies that enable skillful integration of new knowledge, products and technology, and that minimize risk and enhance the quality of care provided or improve community oral health. Within the Joint Commission’s Domain of Dentistry, Practice and Profession is represented by the tasks indicated below.
- Evaluate and integrate emerging trends in health care.
- Evaluate social and economic trends and adapt to accommodate their impact on oral health care.
- Evaluate scientific literature and integrate new knowledge and best research outcomes with patient values and other sources of information to make decisions about treatment.
- Practice within the general dentist’s scope of competence and consult with or refer to professional colleagues when indicated.
- Evaluate and utilize available and emerging resources (e.g., laboratory and clinical resources, information technology) to facilitate patient care, practice management, and professional development.
- Conduct practice activities in a manner that manages risk and is consistent with jurisprudence and ethical requirements in dentistry and healthcare.
- Recognize and respond to situations involving ethical and jurisprudence considerations.
- Maintain patient records in accordance with jurisprudence and ethical requirements.
- Conduct practice-related business activities and financial operations in accordance with sound business practices and jurisprudence (e.g., OSHA and HIPAA).
- Develop a catastrophe preparedness plan for the dental practice.
- Manage, coordinate, and supervise the activity of allied dental health personnel.
- Assess one’s personal level of skills and knowledge relative to dental practice.
- Adhere to standard precautions for infection control for all clinical procedures.
- Use prevention, intervention, and patient education strategies to maximize oral health.
- Collaborate with dental team members and other health care professionals to promote health and manage disease in communities.
- Evaluate and implement systems of oral health care management and delivery that will address the needs of patient populations served.
- Apply quality assurance, assessment, and improvement concepts to improve outcomes.
- Communicate case design to laboratory technicians and evaluate the resultant restoration or prosthesis.
Foundation Knowledge (FK) Areas
Within the Domain of Dentistry, Foundation Knowledge (FK) Areas represent the knowledge, skills, and abilities that are required to successfully perform tasks represented in the aforementioned Clinical Content Areas. Knowledge in each area is applied by the dentist to aid in the prevention, diagnosis, and management of oral disease and to promote and maintain oral health. The Domain of Dentistry Foundation Knowledge areas are as follows:
- Molecular, biochemical, cellular, and systems-level development, structure, and function.
- Physics and chemistry to explain normal biology and pathobiology.
- Physics and chemistry to explain the characteristics and use of technologies and materials.
- Principles of genetic, congenital, and developmental diseases and conditions and their clinical features to understand patient risk.
- Cellular and molecular bases of immune and non-immune host defense mechanisms.
- General and disease-specific pathology to assess patient risk.
- The biology of microorganisms in physiology and pathology.
- Pharmacology.
- Behavioral sciences, ethics, and jurisprudence.
- Research methodology and analysis, and informatics tools.
The overall breakdown of these categories, individually is represented by these charts.
These percentages may be subject to change and should be verified with the most recent official documentation. The distribution of exam topics can be combined in the following table.
NEW EXAM LOOK
The INBDE is still a computer based multiple choice exam, now 500 questions over a day and a half. But the layout is slightly different, packed with more patient focused information. It will contain the following:
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- Description of the patients.
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- Description of the chief complaint.
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- Some background about the patient including dental and medical history, current medications etc.
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- Current findings which include any additional information regarding the pretreatment or diagnosis obtained.
Some questions in this examination involve a patient box. The patient box presents information available to the practitioner at the time of the visit. If no information is presented in a given area of the patient box, assume the information is either unknown or is not available. For example, if no allergies are listed, assume the patient has no known allergies at the time of visit. Always consider information presented in the patient box when answering questions and pay close attention to all provided patient information.
Some cases in this test involve dental charts. Below are samples of the types of dental charts used within the examination.
For further information about the INBDE exam format and developments, please review the JCNDE INBDE guide document.
NEW SCORING SYSTEM
The Joint Commission on National Dental Examinations (JCNDE) conducts criterion-referenced examinations, where the minimum passing score is established by subject matter experts through rigorous standard-setting activities. These standards are periodically reviewed to ensure they reflect current knowledge and skills necessary for safe practice. Examination results are reported as “pass” or “fail,” with detailed performance information provided to candidates who do not pass, including insights into specific clinical and foundational knowledge areas. The scoring system uses a scale from 49 to 99, with 75 as the minimum passing score, and adjustments are made to maintain this standard as necessary. Various examination forms are utilized to enhance security and ensure comparability of scores across different test versions. The scoring process incorporates psychometric analyses to accurately assess candidate skills, and some questions are experimental and not scored, contributing to future test development.
HOW TO APPLY
The cost to attempt the INBDE can be found on the JCNDE guide to the INBDE document. The first step in application is signing up for a DENTPIN account. Once you’ve registered your DENTPIN, you are able to schedule an exam using PROMETRIC scheduling tool.
The following information is taken from the JCNBE resources on the ADA website.
