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Career Map
for Internationally
Trained
Dental Hygienists
This document was developed by the College of Dental Hygienists of Ontario (CDHO).
Requirements may have changed by the time you apply. For up to date registration forms and
guides, please visit the CDHO website at www.cdho.org before completing your application.
© Copyright in this Career Map is by the College of Dental Hygienists of Ontario 2013. 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 College of Dental Hygienists of Ontario.
Career Map for Internationally Trained Dental Hygienists
Access to the Dental Hygiene Profession in Ontario
Preamble
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 the Province of Ontario, the practice of “dental hygiene” is defined in the Dental Hygiene Act, 1991 as follows:
“… the assessment of teeth and adjacent tissues and treatment by preventive and therapeutic means and the
provision of restorative and orthodontic procedures and services.” – Scope of practice, 3. Ontario Dental Hygiene
Act, 1991 (S.O. 1991, Chapter 22). The College of Dental Hygienists of Ontario (CDHO) is the provincial regulatory
body overseeing the profession of dental hygiene. CDHO is responsible for regulating the practice of dental
hygiene in the interest of the overall health and safety of the public in Ontario. Therefore, to practise dental
hygiene in Ontario one must hold a certificate of registration with the CDHO, otherwise the practice is considered
illegal. As such, only CDHO registrants with the appropriate certificate of registration can legally use the term
“dental hygienist”, or a variation or abbreviation of the term.
Moreover, the practice of dental hygiene is regulated under the Regulated Health Professions Act, 1991, and
Dental Hygiene Act, 1991. Thus, all registered dental hygienists in Ontario must comply with a number of
regulations. The CDHO website at www.cdho.org provides applicants with access to relevant legislative
information, registration information, and guidelines related to the practice of dental hygiene in the province.
There are only three categories of certificates of registration with CDHO:
General – It applies to those dental hygienists who meet the registration requirements and do not hold a
specialty;
Specialty – It applies to registrants who have taken an accredited (or considered substantially equivalent)
course of study in restorative dental hygiene.
Inactive – It is usually held by registrants who are taking some time away from practice (e.g.; a maternity
leave). A CDHO Registrant with an Inactive certificate of registration cannot practise dental hygiene
in Ontario.
CDHO has currently 11,994 active registered dental hygienists in Ontario (general and specialty certificates
combined). 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 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; and

may work collaboratively with dental assistants, denturists, dental technicians, and or dentists in their health
care functions.
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Career Map for Internationally Trained Dental Hygienists
Dental hygienists work with dentists in a variety of practice settings such as private practice, long-term care,
education, research, and even administration. Dental hygienists may also work with the military, and/or with
public health departments, and work 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 practise.
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 received 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 were overlaps between the two courses, they had many
concerns. 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 applicants’ courses of
study were not considered equivalent to a recognized accredited dental hygiene program and they 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 to please 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 (Registration\Educational Institutions) or use the following link Educational Institutions.
Entry-to-Practice Requirements in Ontario
The CDHO oversees compliance with current registration requirements for dental hygienists in Ontario. In
accordance with section 31. (1) 1. of Part VII – Registration of the Ontario 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.
As for accreditation of programs, 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. “Accreditation process is a non-governmental, peer review
process that measures education programs and hospital dental services against predetermined national
requirements. CDAC acts as a partner with the profession, educational institutions and health facilities to protect
and further the public interest through the accreditation process” (see About CDAC).
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Career Map for Internationally Trained Dental Hygienists
As for dental hygiene programs in the USA, currently there is a reciprocal agreement permitting programs
accredited by the Commission on Dental Accreditation of Canada to be recognized by the Commission on Dental
Accreditation of the American Dental Association. Notwithstanding the agreement, applicants are advised to
obtain up-to-date information on registration requirements in effect in the jurisdiction where they intend to
practise.
Equivalency Assessment Process
Step 1 — Assessing Academic Qualifications
You must first have the National Dental Hygiene Certification Board (NDHCB) assess your course of study and
determine whether or not you are eligible to take its national examination. The NDHCB can also be reached as
follows:
National Dental Hygiene Certification Board
1929 Russell Road, Suite 322, Ottawa, Ontario K1G 4G3
Telephone: 613-260-8156
Fax: 613-260-8511
E-mail: [email protected]
For information on the NDHCB examination fees, click here.
If you are eligible to take the national examination, you are not required to have your course of study assessed
again by the Registration Committee of the CDHO.
If you are not eligible to take the NDHCB examination, you can request that your application be referred to the
Registration Committee of the CDHO for consideration. In this case, you must arrange for your college of
graduation to send an original, detailed course description directly to the CDHO, and the course description must
relate to your years of study.
This course description should also include:

a detailed description of all the subjects taught within your 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; and

how many and what types of clients you were required to perform these procedures on during your course
of study.
It takes approximately three months for the Registration Committee of the CDHO to assess the course of study
and come to a decision once it has received the completed application form and all the required documentation.
The assessment fee is $250. If your application is successful, the CDHO will credit this amount towards your initial
certificate of registration fee.
Appeals
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.
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Career Map for Internationally Trained Dental Hygienists
Step 2 — Examinations
There are two kinds of examinations: written certification and clinical competency evaluation.
a)
Written certification examination
This examination is offered by the National Dental Hygiene Certification Board, and you must contact their office
directly. For information on the NDHCE fees click here.
The NDHCB provides a guide and sample questions to assist a candidate prepare for its exam.
If you are not considered eligible to sit the NDHCE and the Registration Committee considers your course of study
equivalent, you will be required to successfully complete a provincial examination.
b) Clinical competency evaluation
If you have graduated from a non-accredited dental hygiene program, you are required to successfully complete
a provincial clinical competency evaluation. The Registration Committee of the CDHO will set or approve this
evaluation, which is held at least once a year.
You will be eligible to complete the clinical competency evaluation if

you have already successfully completed the NDHCB written certification examination; or

your course of study has been approved by the Registration Committee and you have successfully
completed the provincial written examination.
In accordance to the Dental Hygiene Act, 1991 (Ontario Regulations 218/94 – General – Part I, Examinations), if a
candidate fails the examination the following guidelines apply:

Retake the examination not more than two years after the failure, unless he/she presents to the Registration
Committee proof of remediation and upgrading approved by the Committee;

Retake the examination for a fourth attempt if he/she submits to the Registration 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 candidate is no longer eligible to retake further examinations.
Step 3 — Registration
Please note the following additional registration requirements for a general certificate of registration:
1.
If you have previously practised dental hygiene or another profession, you must satisfy the CDHO that
there has been no finding of, or current proceeding involving allegations of, professional misconduct,
incompetence or incapacity or any like finding or proceeding against you that affects your fitness to
practise the profession;
2.
You must satisfy the CDHO that you have not been convicted or charged with, and not found “not guilty”
of an offence that affects your fitness to practise the profession;
3.
You must be a Canadian citizen or a holder of a permanent resident status in Canada or be authorized
under the Immigration and Refugee Protection Act (Canada) to engage in the practice of the profession;
4.
You must be able to speak and write either English or French with reasonable fluency;
5.
You must provide the College with a police record check that is dated no earlier than one year before
the date on which your application was submitted; and
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Career Map for Internationally Trained Dental Hygienists
6.
If you completed your dental hygiene program more than three years before you apply for registration
with the CDHO, you must successfully complete a refresher course or professional competency
assessment set or approved by the Registration Committee, unless you have been practising dental
hygiene in a recognized jurisdiction.
Application Process
Before You Immigrate to Canada
The CDHO will accept and process an application for registration from an applicant from a foreign country. All
applications are treated in the same manner and must meet the requirements as specified in this document.
When You Arrive in Ontario
You may choose to wait until you have arrived in Ontario to begin your application to the CDHO.
Steps
After completing the NDHCB exam and the clinical competency evaluation (for graduates of a non-accredited
dental hygiene program), the application package is available online through the CDHO website under the
Registration Tab (please see complementary chart below).
The CDHO does not provide informal assessments. Therefore, completed applications are reviewed in order to
determine whether the applicant meets the current registration requirements.
Registration forms must be fully completed and have the appropriate documents attached. Please note that
application files and applicants’ information are confidential. Inquiries pertaining to an application are replied to
the applicant only, unless the CDHO is provided with a written authorization by the applicant for information to
be released to a third party (e.g.; an employer, spouse, family member, or agency).
The following chart summarizes the documentation you 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
Form A
Title
Application for
Registration as a Dental
Hygienist in Ontario
(Accredited and NonAccredited Institutions)
Description
Submit a completed and notarized form.
Form A includes a section on professional liability insurance.
This insurance can be obtained from the Canadian Dental
Hygienists Association, 1-800-267-5235; the Ontario Dental
Hygienists’ Association, 1-800-315-ODHA, or you may also
contact a broker of your choice.
Please note that all registrants holding a general certificate
must maintain a minimum of $1,000,000 coverage for each
occurrence and with a deductible of no more than $10,000.
You should wait to obtain your professional liability insurance
until your application has been approved if your application
has been referred to the Registration Committee.
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Career Map for Internationally Trained Dental Hygienists
Form
Form B
Title
Certificate of Professional
Conduct
Description
Applicants are required to submit this form directly to the
regulatory body in any jurisdiction in which applicants
practised dental hygiene or any other regulated profession.
In return, 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
months before you register, unless you have not practised in
that jurisdiction since the form was received by the CDHO.
Form C
Certificate of Dean or
Principal of College/
University Granting
Diploma/Degree in
Dental Hygiene
Complete Section 1 and submit to your College.
A representative from your college 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.
Jurisprudence Module
Certificate
Completing the
Jurisprudence Module
online on the CDHO
website at www.cdho.org
– Registration/
Jurisprudence *English or
French+
A copy of your Jurisprudence Module Certificate.
Additional Documents
– The original or a notarized copy of the Canadian Police Information Centre Criminal Record
Report (CPIC report) that is dated no earlier than one year before the date on which your
application is submitted.– A copy of your degree/diploma in dental hygiene.
– A copy of the National Dental Hygiene Certification Board certificate.
– A notarized copy of your Canadian birth certificate or current Canadian passport OR
citizenship card OR permanent residency papers OR authorization under the Immigration
and Refugee Protection Act (Canada).
– A notarized copy of the documentation to support a name change, if applicable.
– Application Checklist.
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 applicant’s ability to successfully
complete the written examination(s) and clinical competency assessment.
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Career Map for Internationally Trained Dental Hygienists
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 a 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 CDHO.
As for Continuing Education, the CDHO Quality Assurance Program provides guidelines for CDHO registrants.
Please visit the CDHO website at www.cdho.org (Quality Assurance tab).
Labour Market Information
For information on Labour Market in Ontario, applicants are recommended to visit the website
www.labourmarketinformation.ca (Government of Canada) 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; and

Job Market Trends in Ontario (and other provinces).
Fees and Costs
The following details outline current costs pertaining to registration processes. Please be aware that changes in
fees or requirements are subject to change, so refer to the CDHO website www.cdho.org (Registration tab) for
up-to-date information on registration forms, checklists and guides.
For payment of registration fees, CDHO accepts certified cheques or money orders (always issued to CDHO), or
credit card (please see application checklist’s list of acceptable credit cards). Personal cheques and/or cash
payments are not accepted. All amounts are payable in Canadian Dollars only.
Initial Application Fee (Accredited and Non-Accredited)
CAN$75.00
Assessment of Course of Study (Non-Accredited)
Important Note: If the application is approved, CDHO will credit the assessment fee towards
the fee for the initial certificate of registration.
CAN$250.00
CDHO Provincial Written Examination
CAN$75.00
CDHO Clinical Competency Assessment
CAN$500.00
Annual Renewal – Certificate of Registration General or Specialty
CAN$250.00
Annual Renewal – Certificate of Registration Inactive
CAN$50.00
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Career Map for Internationally Trained Dental Hygienists
Additional Information
 For more information on Registration
requirements in Ontario, please contact
CDHO – College of Dental Hygienists of Ontario
69 Bloor Street East, Suite 300
Toronto, Ontario M4W 1A9 Canada
Telephone: 416-961-6234 / Toll Free: 1-800-268-2346
Fax: 416-961-6028
Web site: www.cdho.org
Office Hours – 8:30 a.m. to 4:30 p.m.
(Eastern Time – EST)
For email contact and staff directory, please follow the
link CDHO Staff Directory or access the CDHO
at www.cdho.org (“The College” tab\”Contact Us”).
 For more information on Professional
Associations, please contact
CDHA – The Canadian Dental Hygienists Association
96 Centrepointe Drive
Ottawa, Ontario K2G 6B1
Telephone: 613-224-5515 / Toll Free: 1-800-267-5235
Fax: 613-224-7283
E-mail: [email protected]
Web site: www.cdha.ca
ODHA – Ontario Dental Hygienists’ Association
201 – 3425 Harvester Road
Burlington, Ontario L7N 3N1
Telephone: 905-681-8883 / Toll Free: 1-800-315-6342
Fax: 905-681-3922
E-mail: [email protected]
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 follow
the link Educational Institutions or access the
CDHO at www.cdho.org (“Registration”
tab\”Educational Institutions”).
 For more information on the National Dental
Hygiene Certification Board (NDHCB), please
contact
NDHCB — National Dental Hygiene Certification Board
1929 Russell Road, Suite 322
Ottawa, Ontario K1G 4G3
Telephone: 613-260-8156
Fax: 613-260-8511
E-mail: [email protected]
Web site: www.ndhcb.ca
 For information on where and how to get help
with settlement in Ontario, visit
www.settlement.org or contact
Ontario Council of Agencies Serving Immigrants
(OCASI)
110 Eglinton Avenue West, Suite 200
Toronto, Ontario M4R 1A3
Telephone: 416-322-4950
Fax: 416-322-8084
E-mail: [email protected]
Web site: www.ocasi.org
 For information about accessing health related
professions in Ontario, contact
HealthForceOntario Marketing and Recruitment
Agency
E-mail: [email protected]
Tel: 416-862-2200
North America: 1-800-596-4046
International: 1-800-596-40464
TTY: 416-862-4817
Mail: 163 Queen Street East, Toronto, Ontario,
Canada M5A 1S1
© Copyright CDHO 2013.
If you are applying to a private dental hygiene program
in Ontario and would like to know the status of this
program, contact the Ministry of Training, Colleges and
Universities, Private Institutions Branch at
416-314-0500 or visit http://www.tcu.gov.on.ca/eng/
postsecondary/schoolsprograms/pcc/
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