Overview
In the United States, dental licensure is controlled by each state board of dentistry. The ADA says all applicants must meet three basic requirements: education, written examination, and usually a clinical assessment.
For internationally trained dentists, the ADA says the most common path is to complete additional predoctoral education at a CODA-accredited dental school and earn a U.S. DDS or DMD, often through an advanced standing program.
Best first move
Pick your target state first, then compare that state’s rules with the advanced standing programs you are eligible for.
Main USA Routes for International Dentists
1) Advanced standing DDS/DMD
This is the main route for most internationally trained dentists. You enter a CODA-accredited DDS or DMD program with advanced standing instead of starting from year one.
- Usually 2–3 years long
- Leads to a CODA-accredited degree
- Commonly used for state licensure eligibility
2) Advanced dental education only
Some dentists complete CODA-accredited postdoctoral programs such as AEGD, GPR, or specialties, but the ADA notes that in the majority of states this alone does not replace the need for a CODA-accredited DDS or DMD if the original dental degree was from a non-accredited school.
- May help in some states
- Not a safe assumption nationwide
- Always verify with the state board
3) State-specific exceptions
Some states have alternative or additional pathways tied to residency, portfolio review, postgraduate years, or other board-specific rules. These are not uniform.
- Highly state-dependent
- Can change without warning
- Check the state board directly
Step-by-Step Preparation Roadmap
Choose your target state
State licensure rules come first. Do not build your entire plan without checking the board where you want to practise.
Get a DENTPIN
You need a DENTPIN to apply to major dental testing and application services.
Prepare credential evaluation
ADEA CAAPID requires international transcripts to be evaluated through WES or ECE, depending on the program.
Take the INBDE
All U.S. licensing jurisdictions require the INBDE. Many advanced standing schools also expect or require it.
Prepare TOEFL and school-specific requirements
The ADA says most dental schools require TOEFL for international dentists. Some schools also ask for bench tests, interviews, supplemental fees, or school-specific transcript rules.
Apply through CAAPID
ADEA CAAPID lets you submit one centralized application to participating advanced standing programs.
Complete a CODA-accredited DDS or DMD
This is usually the key educational step that makes state licensure possible for internationally trained dentists.
Pass the clinical licensure requirement and apply to the state board
Most states still require a clinical assessment. The exact accepted exam or pathway depends on the state.
Current Costs
| Item | Current fee | Notes |
|---|---|---|
| INBDE examination fee | $890 | 2026 individual purchase fee. |
| INBDE international processing fee | $435 | Applies to candidates from dental programs not accredited by CODA. |
| CAAPID first program | $264 | 2026–27 cycle fee. |
| CAAPID each additional program | $115 | 2026–27 cycle fee. |
| WES / ECE evaluation | Varies | Program-specific preference; paid separately to the evaluator. |
| TOEFL | Varies | Paid separately; many schools require it. |
| Supplemental school fees | Varies | Many schools charge extra application or interview-related fees. |
| Clinical licensure exam / state application | Varies by state and exam | Often paid later in the process. |
Simple estimate builder
Big cost warning
- Advanced standing DDS/DMD tuition is usually the largest cost by far.
- International candidates often spend heavily on travel, transcript handling, school supplements, and relocation.
- State board fees and clinical exam fees come later and vary widely.
Credential Verification
What CAAPID usually requires
- Official dental school transcript evaluation through WES or ECE
- Transcripts for U.S. graduate coursework if applicable
- Letters of evaluation
- Personal statement
- Relevant standardized test scores
Common delay points
- Choosing the wrong evaluator for a school that only accepts ECE or only accepts WES
- Name mismatch across passport, DENTPIN, transcript, and evaluation reports
- Late TOEFL or INBDE score delivery
- Ignoring school-specific supplemental requirements
Exams and “Marks Needed”
INBDE
The INBDE is a pass/fail licensure examination used by all U.S. jurisdictions.
TOEFL
Many schools require it, but the minimum score depends on the program.
Bench test / interview
Some advanced standing schools use bench tests and interviews to shortlist applicants.
Licensure
A clinical assessment is still required in most jurisdictions, but acceptance varies by state.
What really matters for admission
- Passing the INBDE
- Strong English communication
- Good transcript evaluation
- Bench test performance where required
- Interview strength
- Applying to schools whose requirements match your profile
Practical reality
- There is no single national “safe score” for advanced standing admission.
- Programs review applicants differently.
- The right strategy is usually broader, school-specific preparation rather than chasing one number.
State Licensure After Graduation
What every state will care about
- Graduation from a CODA-accredited program
- Passing the INBDE
- Meeting the state’s clinical assessment requirement
- State jurisprudence / law exam if required
- Background checks and application documents
ADEX example
The ADEX Dental Examination acceptance map says that, as of March 6, 2026, the jurisdictions not accepting ADEX Dental for initial licensure are Delaware and New York.
That does not mean every other state is simple. You still need to check the exact board rules, remediation rules, and alternative pathways.