Career Map: Dental Hygienist
This document was developed in collaboration with the College of Dental Hygienists of Ontario (CDHO) and the Ontario Ministry of Citizenship, Immigration and International Trade and updated in August 2014. Requirements may have changed by the time you apply. Please visit the CDHO website at www.cdho.org before completing your application.
Copyright in this Career Map is held jointly by the Queen’s Printer for Ontario and the College of Dental Hygienists of Ontario, © 2014. This Career Map may be used or reproduced by any third party for non-commercial, not-for-profit purposes, provided that no fee, payment or royalty of any kind shall be charged by the third party for any further use or reproduction of the Career Map by any person. Any proposed commercial or for-profit use or reproduction of this Career Map requires a written licence from the Queen’s Printer for Ontario and the College of Dental Hygienists of Ontario.
Access to the Dental Hygiene Profession in Ontario
This Career Map is written for graduates of dental hygiene programs which have not been accredited by the Commission on Dental Accreditation of Canada or by the American Dental Association Commission on Dental Accreditation.
In Ontario, the practice of dental hygiene is regulated under the Regulated Health Professions Act, 1991, (RHPA) and the Dental Hygiene Act, 1991 (DHA). Dental hygienists must comply with the regulations made under the DHA as well as the standards of the College of Dental Hygienists of Ontario (CDHO). Copies of relevant legislation, standards and guidelines relating to the practice of dental hygiene are available on the CDHO website under the “Professional Practice” tab by selecting “Registrants Resource”.
The practice of "dental hygiene” is defined in the Dental Hygiene Act, 1991, as: "… the assessment of teeth and adjacent tissues and treatment by preventive and therapeutic means and the provision of restorative and orthodontic procedures and services."
The CDHO is responsible for regulating the practice of dental hygiene in the interest of the overall health and safety of the public. To practise dental hygiene in Ontario, a certificate of registration with the CDHO is required, otherwise the practice is considered illegal. Only CDHO registrants with the appropriate certificate of registration can legally use the term “dental hygienist”, or a variation or abbreviation of the term.
There are three categories of certificates of registration with the CDHO:
- General – applies to those dental hygienists who meet the basic registration requirements; all registrants are initially registered in the General category.
- Specialty – applies to registrants who hold a General certificate of registration and who have completed a program in restorative dental hygiene that meets the requirements of the College.
- Inactive – is usually held by registrants who are taking some time away from practice. A CDHO registrant with an Inactive certificate of registration cannot practise dental hygiene in Ontario.
There are approximately 13,000 registered dental hygienists in Ontario. Dental hygienists perform some or all of the following procedures in a variety of health care settings, including private practice, long-term care, public health, education, research and administration:
- implement the dental hygiene process of care which includes conducting an initial dental hygiene assessment, planning treatment, implementing the plan and evaluating the treatment
- consult with other health care providers on patient care
- take dental impressions
- instruct patients regarding oral hygiene procedures and disease prevention
- clean teeth above and below the gums to prevent gum disease
- remove stains and deposits from teeth to prevent tooth and root decay
- apply fluoride and/or other therapeutic treatments
- take and develop X-rays
- may perform restorative and orthodontic procedures in collaboration with a dentist
- may work collaboratively with dental assistants, denturists, dental technicians, and or dentists in their health care functions
Dental hygienists work with dentists in a variety of practice settings such as private practice, long-term care, education, research, and administration. Dental hygienists may also work with the military, and/or with public health departments, and with patients of all ages. However, certain procedures cannot begin without an order from a dentist.
As for employment, dental hygienists may be employed by one dentist, a group of dentists, or may work for more than one dentist or facility during their work week. In Ontario, if dental hygienists contract their services to a dentist, they are required to meet self-employment criteria set by the Canada Revenue Agency, likewise when owning businesses.
Dental hygiene and related occupations can be described differently from country to country, or region to region even within Canada. Therefore, it is highly recommended that applicants contact regulatory bodies or licensing jurisdictions for registration requirements and description of scopes of practice.
Applicants Who Graduated in Dentistry
A non-exemptible requirement for registration as a dental hygienist in Ontario is that an applicant must have graduated from a recognized accredited dental hygiene program, or one considered substantially equivalent by the Registration Committee of the CDHO. In Ontario, dental hygiene is considered a separate and distinct health profession from dentistry. Work experience is not considered a substitute for training in an educational supervised setting. Therefore, unless an applicant has successfully completed a program of study in dental hygiene in addition to her/his degree in dentistry, it is unlikely that the applicant’s course of study would be considered equivalent to a recognized accredited dental hygiene program.
The Registration Committee has, over the years, reviewed many courses of study from applicants who graduated in dentistry from Colleges/Universities in Bangladesh, China, Croatia, Egypt, Hong Kong, India, Iran, Iraq, Mexico, Pakistan, Philippines, Poland, Romania, Syria, United States of America, and Yugoslavia. Although the members of the Committee recognized that there was overlap between the programs, they noted that only rarely does a program of study in dentistry focus on the dental hygiene process of care. Most importantly, the Committee felt that the courses reviewed did not ensure competence in the controlled acts of scaling and root planing relative to the dental hygiene process of care. Therefore, these courses of study were not considered equivalent to a recognized accredited dental hygiene program and the applicants were not eligible to sit the CDHO's certificate of registration examinations.
For applicants who graduated in dentistry and who are interested in dental hygiene as an alternative, CDHO recommends they contact educational institutions offering accredited/approved programs in dental hygiene. To access information on pursuing courses of study in dental hygiene in Ontario, please visit the CDHO website at www.cdho.org or use the following link Dental Hygiene Programs.
Entry-to-Practice Requirements in Ontario
In accordance with section 31. (1) 1. of Part VII – Registration of the Dental Hygiene Act, 1991 (Ontario Regulation 218/94), applicants must have graduated from a recognized accredited dental hygiene program, or from a program the Registration Committee of the CDHO considers substantially equivalent. This requirement is non-exemptible.
The Commission on Dental Accreditation of Canada (CDAC), established in 1988 by the Canadian Dental Association, is an autonomous body responsible for accrediting dental, dental hygiene and dental assisting education programs in Canada. (see About CDAC).
For graduates of dental hygiene programs in the USA, a reciprocal agreement permits programs accredited by the Commission on Dental Accreditation of the American Dental Association to be recognized by the Commission on Dental Accreditation of Canada.
Equivalency Assessment Process
Step 1 — Assessing Academic Qualifications
Applicants must first have the National Dental Hygiene Certification Board (NDHCB) assess their course of study to determine if they are eligible to take the national written examination. The NDHCB can be contacted directly at:
The fees and dates for the NDHCB exams are available on the NDHCB website under Exam Application.
If eligible to take the national examination, the applicant is not required to have their course of study assessed again by the Registration Committee of the CDHO.
If not eligible to take the NDHCB examination, and the applicant wishes to proceed with an application to the CDHO, the application will be referred to the Registration Committee to determine if the course of study meets the educational requirements. In this case, the applicant must arrange for the college of graduation to send an original, detailed course description directly to the CDHO. The course description must relate to the years of study.
This course description must also include:
- a detailed description of all the subjects taught within the course of study
- the number of hours spent in each subject
- the number of clinical hours actually spent on scaling, root planing and prophylaxis procedures
- how many and what types of clients these procedures were performed on during the course of study
Once the complete application is received, it takes approximately three months for the Registration Committee to assess the course of study and come to a decision.
The assessment fee is $250. If the application is successful, the CDHO will credit this amount towards the initial certificate of registration fee.
An applicant whose course of study is not considered equivalent by the Registration Committee can request a review of the decision from the Health Professions Appeal and Review Board.
Step 2 — Examinations
There are two kinds of examinations: written certification and clinical competency evaluation.
Written Certification Examination
This examination is offered by the National Dental Hygiene Certification Board. Their office can be contacted directly at National Dental Hygiene Certification Board. For information on the National Dental Hygiene Certification Examination (NDHCE) fees click here. The NDHCB provides a guide and sample questions to assist a candidate prepare for its exam.
If a candidate is not considered eligible to sit the NDHCE and the Registration Committee considers the course of study equivalent, the applicant will be required to successfully complete a provincial examination.
Clinical Competency Evaluation
Applicants who graduated from a non-accredited dental hygiene program are required to successfully complete a provincial clinical competency evaluation. The Examination Committee of the CDHO will set or approve this evaluation, which is held at least once a year.
Applicants are eligible to complete the clinical competency evaluation if:
- they have already successfully completed the NDHCB written certification examination; or
- their course of study has been approved by the Registration Committee and they have successfully completed the provincial written examination.
In accordance to the Dental Hygiene Act, 1991 (Ontario Regulations 218/94 – General – Part I, Examinations), if an applicant fails the examination, the following guidelines apply:
- Retake the examination not more than two years after the failure, unless the applicant presents to the Registration Committee proof of remediation and upgrading approved by the Committee;
- Retake the examination for a fourth attempt if the applicant submits to the Examination Committee proof of remediation and upgrading approved by the Committee, and the Committee is satisfied with the documentation submitted by the applicant; and
- If failing a fourth attempt, the applicant is no longer eligible to retake further examinations.
Step 3 — Registration
To obtain a general certificate of registration, please note the following additional registration requirements. Applicants must:
- Meet the requirement for Good Character
- Be a Canadian citizen or the holder of permanent resident status in Canada or be authorized under the Immigration and Refugee Protection Act (Canada) to engage in the practice of the profession
- Be able to speak and write either English or French with reasonable fluency
- Provide the College with a police record check that is dated no earlier than one (1) year before the date on which the application was submitted
- Provide a certificate of professional conduct from every jurisdiction where the applicant holds a professional certificate of registration
- Successfully complete an approved clinical refresher course (or professional competency assessment, set or approved by the Registration Committee), if the applicant graduated more than three years prior to the application and has not practised dental hygiene in a recognized jurisdiction within the three years
- Provide proof of current professional liability insurance coverage
- Pay the applicable fees
Before Immigrating to Canada
The CDHO will accept and process an application for registration from an applicant from another country. All applications are treated in the same manner and must meet the requirements as specified in this document.
When the Applicant Arrives in Ontario
Applicants may choose to wait until they have arrived in Ontario to begin the application to register with the CDHO.
- The first step in the application process is the completion of the jurisprudence module and exam online on the CDHO website.
- The second step is the completion of the NDHCB exam and the clinical competency evaluation (for graduates of a non-accredited dental hygiene program).
Application guides, frequently asked questions and General Information is available under the Registration tab (please see complementary chart below).
The CDHO does not provide informal assessments. Completed application packages are reviewed in order to determine whether the applicant meets the current registration requirements.
Once the application form is fully completed, the application for registration and supporting documentation can be sent by mail or hand delivered.
Application files are confidential. Release of information to a third party (i.e. employer, family member, agency) requires written authorization from the applicant.
The following chart highlights the documentation applicants need to submit when applying for a certificate of registration with the CDHO. Please note that for documents submitted in languages other than English or French, the applicant must include official translations (issued in Ontario or abroad).
|Form A||Application for Registration as a Dental Hygienist in Ontario
|Submit a completed and notarized form.
Form A includes a section on professional liability insurance. Please note that all registrants holding a general certificate must maintain a minimum of professional liability insurance with $1,000,000 coverage for each occurrence and a deductible of no more than $10,000.
|Form B||Certificate of Professional Conduct||Applicants are required to submit this form directly to the regulatory body in any jurisdiction in which they practised dental hygiene or any other regulated profession.
Once the form is processed, the regulatory body must send it directly to the CDHO (not through the applicant).
This form must be current and submitted within the three (3) months before you register.
|Form C||Certificate of Dean or Principal of College/University Granting Diploma/Degree in Dental Hygiene||Submit this form to your College/University. A representative from your institution of graduation completes this form (section 2) and sends it directly to the CDHO along with an official transcript of your results.|
|Form D||Authorization to Release Information||This form authorizes the CDHO to verify or obtain additional information related to your application.|
|Additional Documents Include||
Language Proficiency Assessment
As per section 29. (4) 3. of Part VII – Registration of the Ontario Dental Hygiene Act, 1991 (Ontario Regulation 218/94), an applicant "(…) must be able to effectively comprehend and communicate in either English or French, both orally and in writing." Language proficiency is assessed informally through the applicant’s ability to successfully complete the written examination(s) and clinical competency assessment.
Occupational Training and Upgrading
If an applicant has not practised dental hygiene within the three years before his/her application is received by the CDHO within a jurisdiction recognized by the CDHO, the applicant must successfully complete an approved clinical refresher course or professional competency assessment. Applicants must contact the CDHO office for information on registering for a Refresher course that is approved by the Registration Committee.
Labour Market Information
For information on Labour Market in Ontario, applicants are recommended to visit the Government of Canada Job Bank website where they can access topics such as:
- Job Search in Ontario (can browse by “Dental Hygienists”)
- Explore careers by occupation, education program, wages, outlook, skills and knowledge
- Job Market Trends in Ontario (and other provinces)
Fees and Timelines
- Please refer to "Fees" associated with Registration on the CDHO website or on the application form checklist.
- CDHO accepts certified cheques, money orders, or credit cards (Visa, MasterCard). Personal cheques and/or cash payments are not accepted. All amounts are payable to the CDHO in Canadian Dollars only.
- For applicants who are successful on the first attempt at the NDHCE and the clinical competency evaluation, the application process takes approximately 3 to 8 months.
- The dates of the upcoming NDHCB examinations are posted on its website and the clinical competency evaluations are held 1–2 times per year, depending on the demand.
- Once a completed application has been received by the CDHO, it takes approximately 5–10 business days to complete the process. Applicants are informed by email or by phone about any missing or incomplete information on their application form which may result in longer processing time. A confirmation email is sent after the application is processed.
For more information on Registration requirements in Ontario, please contact:
CDHO – College of Dental Hygienists of Ontario
69 Bloor Street East, Suite 300
Toronto, ON M4W 1A9
Toll free: 1-800-268-2346
Office Hours: 8:30 a.m. to 4:30 p.m. (Eastern Time – EST)
For information on Professional Associations, please contact:
CDHA – The Canadian Dental Hygienists Association
96 Centrepointe Drive
Ottawa, ON K2G 6B1
Toll Free: 1-800-267-5235
ODHA – Ontario Dental Hygienists’ Association
201 – 3425 Harvester Road
Burlington, ON L7N 3N1
Toll Free: 1-800-315-6342
Email: firstname.lastname@example.org Web site: www.odha.on.ca
For a list of educational institutions in order to obtain more information on pursuing courses of study in dental hygiene (in Ontario), please visit the CDHO website or see the Dental Hygiene Programs document.
For more information on the National Dental Hygiene Certification Board (NDHCB), please contact:
For information on where and how to get help with settlement in Ontario visit www.settlement.org or contact:
For information about accessing health-related professions in Ontario, please contact:
Access Centre for Internationally
163 Queen Street East, 2nd Floor
Toronto, ON M5A 1S1
Toll Free: 1-800-596-4046