What Happens if You Fail the NBDHE

I. Understanding the NBDHE Exam

The National Board Dental Hygiene Examination (NBDHE) is designed to assess whether a candidate is prepared to practice safely and competently as a dental hygienist. Rather than focusing solely on memorization, the exam emphasizes clinical judgment, decision-making, and application of knowledge.

The NBDHE is structured around:

• Patient case scenarios
• Integration of multiple subject areas (periodontology, pharmacology, radiology, oral pathology, ethics, and community health)
• Questions that require prioritization and critical thinking

Because of this format, many students find the NBDHE more challenging than traditional school exams. A strong academic record in dental hygiene school does not always guarantee success if exam preparation focuses too heavily on passive review rather than clinical application. Understanding the intent and structure of the exam is an important first step in improving performance, especially if a retake is needed.

For more information on the format of the NBDHE, visit this article.

II. What Happens Immediately After Failing the NBDHE

If you fail the NBDHE, here’s what to expect:

• You will receive an official score report indicating a failing result
• The report does not show a numeric score, only pass/fail
• Your dental hygiene program and licensing body may be notified, depending on your situation

While the initial reaction can be emotional, it’s important to remember that failing does not permanently affect your eligibility to become licensed.

Pro-Tip: Visit this article to learn more about how many hours you should spend on studying for the NBDHE

III. Emotional and Psychological Impact

Failing the NBDHE can have a significant emotional and psychological impact. Many candidates experience feelings of disappointment, frustration, anxiety, or self-doubt, especially after investing months into NBDHE preparation and practice.

Common emotional responses include:

• Fear about future career plans
• Loss of confidence in clinical ability
• Stress related to financial or licensure delays
• Comparison with peers who passed

These reactions are completely normal. It’s important to remember that failing the NBDHE does not determine your worth, intelligence, or potential as a dental hygienist. Exam performance is influenced by many factors, including stress levels, test-taking skills, and familiarity with board-style questions.

Taking time to acknowledge these emotions and then shifting focus toward a constructive plan can make a meaningful difference in both mental well-being and future exam success. Many candidates find that addressing anxiety, improving confidence, and changing study strategies leads to a much stronger performance on their next attempt

IV. NBDHE Retake Policy and Waiting Period

The biggest question that students ask is: Can I retake the NBDHE? Yes. You are allowed to retake the NBDHE, and many candidates go on to pass successfully on a second attempt.

After failing, you must wait 60 days before you are eligible to retake the exam. This waiting period is designed to give candidates adequate time to strengthen weak areas and improve readiness. Additionally, a maximum of four testing administrations are permitted within a one-year period.

There is no lifetime limit on the number of attempts, but note that there is a five years/five attempts eligibility rule in which candidates must pass the examination within a) five years of their first attempt or b) five examination attempts, whichever comes first. After the fifth year or fifth attempt, the waiting period between retakes increases to 12 months.

Pro-Tip: Visit this article to view a full breakdown of NBDHE costs.

V. How to Prepare to Retake the NBDHE

Identify Weak Areas

After failing the NBDHE, the most important first step is identifying where your preparation fell short. While the score report does not provide a detailed breakdown, reflecting on your exam experience can be very helpful. Consider which topics felt most challenging, where you hesitated the longest, and whether certain case studies felt unfamiliar. Many candidates discover that their weaknesses lie not in factual knowledge, but in applying concepts across clinical scenarios. Recognizing these gaps allows you to focus your efforts more strategically during your retake preparation.

Adjust Your Study Plan

Once weak areas are identified, your study plan should be adjusted to address them directly. A second attempt should not simply repeat the same approach used the first time. Instead, shift toward more active study methods, such as practice questions, case-based learning, and timed exams. Reducing time spent passively reviewing familiar material and increasing focus on clinical reasoning can significantly improve performance. Creating a realistic schedule that prioritizes consistency and allows for regular review is key to building confidence and retention.

Consider Professional Tutoring

For some candidates, professional tutoring can be a valuable resource after failing the NBDHE. Working with an experienced tutor can help clarify difficult concepts, improve test-taking strategies, and provide personalized feedback that is difficult to achieve through self-study alone. This method is especially beneficial for students who struggle with exam anxiety, time management, or clinical application of knowledge. A guided approach can help streamline your preparation and improve efficiency during your retake period.

VI. Financial and Logistical Considerations

Retaking the NBDHE involves both financial and logistical planning, which can add stress for candidates preparing for a second attempt. Understanding these costs ahead of time can help you plan more effectively and avoid unexpected expenses.

The primary cost associated with retaking the exam is the NBDHE examination fee, which must be paid again at the time of re-registration. As of December 2025, the exam fee is $600 USD. In addition to the exam fee, students may incur other expenses such as:

• Updated or additional study materials
• Practice tests or question banks
• Tutoring or review courses
• Travel or accommodation costs if the testing center is not local

While not every student will need all of these resources, costs can add up, especially if preparation extends over several months.

Budgeting Tips for NBDHE Retake Preparation

To manage expenses more effectively:

• Reuse study materials whenever possible instead of purchasing entirely new resources
• Focus spending on tools that make improvements on specific weak areas, rather than broad content review
• Create a realistic study timeline to avoid last-minute purchases or rushed decisions
• Set aside a small monthly budget dedicated to exam preparation costs

Planning ahead allows you to focus on studying rather than financial stress. A thoughtful approach to budgeting can make the retake process more manageable and help you prepare with greater confidence and peace of mind.

VII. How Failing the NBDHE Affects Your Licensing Path

Many licensed dental hygienists have faced the challenge of failing the NBDHE and gone on to have successful careers. Failing the NBDHE exam delays licensure, but it does not disqualify you.

You cannot apply for dental hygiene licensure until you pass the NBDHE exam. However, once you pass, previous failures are generally not emphasized in the licensure process.

Each regulatory authority may have slightly different rules, so it’s always best to confirm requirements with your local licensing body.

While it is discouraging, it is important to stay motivated - a passing score is achievable! Ensure that you stay on track by remembering key dates for exam registration and having in mind which test day will work best for you.

VIII. Maintaining Motivation and Confidence

Failing the NBDHE can challenge even the most dedicated students, but maintaining motivation and confidence is a critical part of long-term success. Many licensed dental hygienists who are practicing today did not pass the exam on their first attempt. What ultimately set them apart was not perfection but persistence.

Dental hygiene students who pass after an initial failure often report that the experience helped them approach the exam with a clearer strategy, stronger clinical reasoning skills, and improved test-taking confidence. With reduced pressure and a more focused study plan, many candidates actually perform better on their second attempt than they did initially.

Remember that the NBDHE measures readiness at a specific moment in time, not your potential as a dental hygienist. Staying committed, adapting your approach, and trusting the process often lead to stronger outcomes and, ultimately, exam success.

IX. When to Seek Additional Help

Candidates should consider reaching out for academic support if they feel unsure about how to structure their study plan, struggle to identify weak areas, or find that their scores are not improving despite consistent effort. Repeated difficulty with case studies or persistent confusion around core clinical concepts are also strong indicators that guided instruction may be beneficial.

Emotional support is equally important. Persistent anxiety, loss of motivation, sleep disruption, or feelings of self-doubt can interfere with effective studying and exam performance. These challenges are common, especially after a failed attempt, and do not reflect a lack of ability. Speaking with mentors, instructors, peers, or mental health professionals can help restore confidence and improve focus. Even finding the right NBDHE Tutor may provide both emotional support during your preparation. 

Seeking help is not a sign of failure, it is a proactive step toward success. Many candidates find that combining academic guidance with emotional support leads to clearer direction, reduced stress, and stronger performance on the NBDHE.

X. Common Mistakes That Lead to Failure

Understanding why students fail can help prevent repeat mistakes.

1. Underestimating Case Studies

The NBDHE places heavy emphasis on clinical scenarios and case-based questions that require judgment, prioritization, and critical thinking. Oftentimes, these case studies integrate multiple areas of dental hygiene, such as community health and clinical assessment. Understanding this matters as it will help you to have a more strategic approach to case-based questions.

2. Passive Studying

Relying only on reading notes or watching videos without practicing questions can reduce exam readiness. Focusing on memorization will only get you so far. It is important to take time to complete practice exams and simulate test day. This will not only build confidence but also help to assess weaknesses and strengths. Ensure that your study sessions not only build on your core clinical concepts but builds your test-taking skills.

3. Poor Time Management

Some candidates struggle with pacing, spending too long on difficult questions and rushing through others. To help you with this, ensure that you first know how many questions are covered on the NBDHE exam. Knowing the format allows you to build your test-taking strategy and have a more efficient approach to taking the exam. Additionally, take time to complete practice tests to familiarize yourself with the exam format and to help simulate the day of the exam. This will allow you to build time management skills.

View the format of the NBDHE Exam here.

4. Test Anxiety

Anxiety can significantly affect performance, even in well-prepared students. To manage test day anxiety, take some time prior to the exam to research the exam format and even research the testing center itself. Having a list of things to bring to the exam and planning your trip ahead of time will help to reduce anxiety.

XI. How to Turn Failure into a Learning Opportunity

Although failing the NBDHE can feel discouraging, it can also serve as a powerful learning opportunity. A failed attempt often provides valuable insight into how the exam is structured, how questions are framed, and where preparation strategies may need adjustment. Candidates who take time to reflect on their exam experience frequently return with a clearer understanding of what the test is truly assessing.

Reviewing your failed attempt can help guide smarter and more focused studying. Think about which sections that felt most challenging, whether time management was an issue, and how confident you felt navigating case-based questions. This self-assessment allows you to move away from broad, unfocused review and toward targeted preparation that addresses specific weaknesses.

It’s also important to recognize that many dental hygiene students do go on to pass the NBDHE on a second or third attempt. With greater familiarity, reduced anxiety, and improved study strategies, subsequent attempts are often more successful. Rather than viewing failure as a setback, reframing it as part of the learning process can lead to stronger performance, increased confidence, and ultimately, exam success.

XII. FAQ

Q: How soon can I retake the NBDHE after failing?

A: Candidates must wait 60 days before they are eligible to retake the exam.

Q: How many times can I take the NBDHE?

A: There is no lifetime limit. Just be aware of the five years/five attempts eligibility rule, in which candidates must pass the examination within a) five years of their first attempt or b) five examination attempts, whichever comes first after which, the waiting period is extended to 12 months between each retake.

Q: Will failing the NBDHE appear on my record?

A: NBDHE results are reported as pass or fail, and detailed scores are not released. While exam attempts are recorded by the testing body, failing the NBDHE typically does not negatively impact licensure or employment once you pass. Employers generally focus on whether you are licensed, not how many attempts it took.

Q: Do I need to pay again to retake the exam?

A: Yes. Candidates must pay the full examination fee of $600 USD again when registering to retake the NBDHE. Additional costs may also include updated study materials, practice exams, or tutoring, depending on your preparation needs.