The DLOSCE Folds Into ADEX: What Changes

The Dental Licensure Objective Structured Clinical Examination (DLOSCE) was the ADA's computer-based clinical licensure exam, launched by the Joint Commission on National Dental Examinations (JCNDE) in 2020. It tested clinical judgment with images and 3D models rather than hand skills. In 2026 it stopped being a separate exam.

On April 14, 2026, the ADA and the American Board of Dental Examiners (ADEX) announced "an agreement to license the ADA's Dental Licensure Objective Structured Clinical Examination (DLOSCE) for incorporation into the ADEX Dental Examination." Here is what changed and when.

What are the key dates?

From the ADA's announcement:

• No later than August 1, 2026: ADEX sunsets its own computer-based DSE OSCE. "Upon sunset of the DSE OSCE, all ADEX Dental Examination administrations will include the DLOSCE."
• After August 1, 2026: "The DLOSCE will no longer be offered or administered as a standalone examination to new DLOSCE candidates, except in conjunction with the ADEX Dental Examination."
• After October 9, 2026: "All standalone administrations of the DLOSCE will cease."

The JCNDE's DLOSCE page now says "All administrations are conducted through ADEX" and calls its 2026 DLOSCE Candidate Guide "for historical reference purposes only." Commissioners on the Dentist and Dental Hygienist Compact noted the same October 9 cutoff in their May 18, 2026 meeting.

What does the ADEX dental exam look like now?

ADEX describes its Dental Examination series this way: "All candidates will challenge five hand-skill components and the ADA's Dental Licensure OSCE (DLOSCE)." The hand-skill parts are periodontal, endodontic, prosthodontic, anterior restorative and posterior restorative, performed on manikins. The periodontal exam became a required component effective August 1, 2026.

ADEX lists the series fee at $2,995 plus a facility fee that varies by location, with one complimentary retake per clinical procedure. A second or third attempt at the computer-based DLOSCE costs $695, per ADEX.

Why does this matter for licensure?

The DLOSCE on its own had no hand-skills component. Some boards accepted it as a clinical assessment; others insisted on a hands-on exam. Folding it into ADEX means new candidates take both together, which the ADA says "simplifies licensure pathways and supports licensure portability." ADEX's chair said the agreement preserves "the clinical hand-skills evaluation that remains central to licensure in most U.S. jurisdictions."

The ADA also noted that the ADEX Dental Examination is accepted or required in "48 states and other jurisdictions," including Washington, D.C., Puerto Rico, Jamaica and the U.S. Virgin Islands. The ADEX map lists Delaware and New York as the two states that do not accept it for initial licensure. See ADEX and which clinical exams each state accepts.

Who is affected, and how?

1. Candidates who planned on a standalone DLOSCE. That option is gone. You register for the ADEX dental series, which includes the DLOSCE.
2. Candidates who already took the standalone DLOSCE. The JCNDE says results remain available through DENTPIN for anyone who took it through the ADA on or before September 25, 2026, with audits available for 30 days after official results. Whether a past standalone result still satisfies a particular board is that board's call.
3. Dentists first licensed with a standalone DLOSCE. Your license is unaffected. The question arises when you apply in another state that asks which clinical exam your license followed. Texas, for example, requires that an out-of-state license used for credentials "followed a successful completion of a general dentistry clinical examination administered by another state or regional examining board." Read the target state's rule closely.

Does the change affect hygienists?

Not directly. The DLOSCE was a dentist exam. The JCNDE's separate hygiene exam, the DHLOSCE, launched in 2025 and is still administered through Prometric, according to the JCNDE.

Should a new graduate do anything differently?

Plan on ADEX, confirm it with your target board, and book early: ADEX notes that some exam sites limit registration to students of that school. If your target state is New York or Delaware, ADEX alone will not get you a first license. See your first dental license as a new graduate and the PGY-1 residency route.

When the exams are behind you, our Full State Dental License Application service ($899 per state) prepares the license file: transcripts, score reports, verifications, a question-by-question guide and board tracking. You take every exam yourself and complete, sign and submit the application. Not sure your exam history fits a state? The $149 Dental Licensure Readiness Review checks it.