Western Regional Examining Board (WREB) Dental Examination

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What is the Western Regional Examining Board (WREB) Dental Examination?

The Western Regional Examining Board (WREB) Dental Examination is one of the primary clinical competency assessments used in the United States to determine a candidate’s readiness for dental licensure. Established in 1976, WREB was created to provide a standardized clinical examination that multiple states could recognize, moving away from individual state-run exams.

Official Exam Name & Acronym: Western Regional Examining Board Dental Examination (WREB).

Conducting Body/Authority: The exam is administered by CDCA-WREB-CITA. In recent years, the Western Regional Examining Board merged its operations with the Commission on Dental Competency Assessments (CDCA) and the Council of Interstate Testing Agencies (CITA) to create a unified national clinical testing standard. This organization is a non-profit corporation comprised of state dental boards and educators.

Purpose of Exam: The primary purpose is Professional Licensure. Passing the WREB (now the unified CDCA-WREB-CITA exam) demonstrates to state dental boards that a candidate possesses the clinical skills and judgment necessary to practice dentistry safely on the public.

Geographic Validity: The WREB/CDCA-WREB-CITA results are recognized in 48 states across the U.S., as well as the District of Columbia, Jamaica, and Puerto Rico. It is the most widely accepted clinical dental examination in North America.

Level of Competence: This is an entry-level professional clinical examination. It is designed for students in their final year of dental school or graduates of accredited dental programs to prove they meet the minimum standards for safe practice.

Brief History: Originally serving only the western United States (Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, and Washington), WREB expanded significantly over four decades. In 2022, the formal merger with CDCA and CITA was finalized to eliminate the “alphabet soup” of regional boards, moving toward a single national clinical examination standard (often following the ADEX curriculum).


Who Can Take the Western Regional Examining Board (WREB) Dental Examination? (Eligibility Requirements)

To ensure patient safety and professional integrity, the WREB has strict eligibility criteria. Candidates must fall into one of the following categories:

  • Current Students: Students in their final year of a dental program accredited by the Commission on Dental Accreditation (CODA) or the Commission on Dental Accreditation of Canada (CDAC).
  • Graduates: Individuals who have already earned a DDS or DMD degree from a CODA/CDAC-accredited institution.
  • International Graduates: Graduates of non-accredited foreign dental schools are eligible only if they are currently enrolled in an advanced standing program at a CODA-accredited school or have met specific state-board requirements where they intend to practice.

Documentation Checklist

  • Certification of Eligibility: A letter or form signed by the Dean of the candidate’s dental school confirming they are ready for clinical examination.
  • Academic Transcripts: Official transcripts showing degree conferral (for graduates).
  • Identification: Two forms of valid ID, one being a government-issued photo ID (Passport or Driver’s License).
  • National Board Scores: Proof of passing the Integrated National Board Dental Examination (INBDE).
  • Professional Liability Insurance: Candidates must often provide proof of malpractice insurance (though many school-hosted sites include this in the facility fee).

Language & Background Requirements

  • Language Proficiency: While WREB does not mandate a specific TOEFL score, the exam is conducted entirely in English. Most U.S. dental schools require a TOEFL iBT score of 90-100 for admission to the programs that lead to WREB eligibility.
  • Background Check: Candidates must disclose any criminal history or previous board disciplinary actions during the online registration process.

Eligibility Summary Table

Requirement Criteria Details
Academic Degree DDS or DMD (or final year student) from CODA/CDAC school.
Prerequisite Exam Passing score on the INBDE (National Boards).
Insurance Professional Liability/Malpractice coverage required.
International Grads Must be in an accredited “International Dentist Program” (IDP).
ID Requirements Two forms of ID (at least one government photo ID).

How to Register for the Western Regional Examining Board (WREB) Dental Examination

Exam Schedule & Availability

The exam is not held on a single national date. Instead, it is hosted at various CODA-accredited dental schools throughout the year, primarily between January and June to coincide with graduation cycles. Registration typically opens 60–90 days before the scheduled exam date at a specific location.

Exam Fees (2024-2025 Estimates)

The cost of the WREB dental exam is substantial and varies slightly based on the components taken. Below is a breakdown of the estimated costs:

Fee Type Estimated Amount (USD)
Full Dental Examination Fee $2,350 – $2,600
Site/Facility Fee (Paid to the school) $300 – $700
Individual Component Retake $500 – $1,200
Late Registration Fee $250
Cancellations (More than 30 days prior) $100 Administrative Fee
Total Estimated Investment $2,750 – $3,500

Booking Process

  1. Create an Account: Visit the official CDCA-WREB-CITA online portal and create a candidate profile.
  2. Upload Credentials: Submit digital copies of your Dean’s certification or transcripts.
  3. Select a Site: Browse the “Calendar of Exams” to find a dental school location and date that suits you.
  4. Payment: Pay the full examination fee via credit card. Note that the Site Fee is often paid separately to the dental school hosting the exam.
  5. Confirmation: Once processed, you will receive a Candidate ID and an admission poster for the exam.

Retake Policy

  • Waiting Period: There is no mandatory waiting period for the first retake, but you must register for a new session at an available site.
  • Maximum Attempts: Most states and the board allow 3 attempts. After three failures, candidates are usually required to complete a remedial year of dental education before a fourth attempt.
  • Fees: You only pay for the specific component (e.g., Endodontics) that you failed, plus a proportional site fee.

Western Regional Examining Board (WREB) Dental Examination Exam Format & Structure

The WREB exam has transitioned almost entirely to Simulated Patient (Manikin) formats, though some states still offer/require patient-based options. The most common format follows the ADEX (American Board of Dental Examiners) curriculum, which WREB now administers.

Timing & Duration

Section Duration Format
Restorative (Class II & III) 4 – 6 Hours Clinical (Manikin or Patient)
Endodontics 3 Hours Manikin
Prosthodontics 3 Hours Manikin
Periodontics 2 Hours Clinical (Manikin or Patient)
Diagnostic Skills (DSE) 3.5 Hours Computer-Based (CBT)

Syllabus & Content Domains

Domain Specific Tasks Covered Weightage
Restorative Class II Composite/Amalgam, Class III Composite. Focus on prep and restoration. 35%
Endodontics Access, cleaning, and shaping of an anterior tooth and a posterior (molar) tooth. 20%
Prosthodontics Preparation for a PFM crown, All-Ceramic crown, and a bridge abutment. 20%
Periodontics Scaling and root planing; calculus detection and removal. 15%
Diagnostic Skills Treatment planning, oral pathology, and radiographic interpretation. 10%

How is the Western Regional Examining Board (WREB) Dental Examination Scored?

Passing Score

The passing threshold for all sections is 75.00 or higher. This is a criterion-referenced scoring system, meaning you are judged against a fixed set of clinical standards, not against other candidates.

Scoring Mechanics

  • No Negative Marking: You are scored on what you perform correctly. However, a “Critical Deficiency” (e.g., damaging an adjacent tooth, performing the wrong procedure) results in an automatic failure of that section.
  • Compensatory vs. Non-Compensatory: You must pass each component individually. A very high score in Prosthodontics cannot “make up” for a failing score in Endodontics.
  • Scaled Scoring: Raw points from examiners are converted to a 0–100 scale. Three independent examiners grade your work anonymously.

Result Declaration

Results for the computer-based (DSE) portion are often available within 24–48 hours. Clinical/Manikin results typically take 2 to 3 weeks to be finalized and posted to the candidate’s online profile.


How Difficult is the Western Regional Examining Board (WREB) Dental Examination?

The WREB is considered Challenging to Very Difficult. While the procedures themselves are standard dental school fare, the “Board Standard” for precision is much higher than daily clinic work. The time pressure and the presence of independent examiners add significant stress.

Historical Pass Rates

Metric Approximate Pass Rate
First-Time Pass Rate (CODA Students) 82% – 88%
Overall Pass Rate (Including Retakes) 94%
International Graduate Pass Rate 65% – 75%

Most Challenging Topics: Candidates most frequently fail the Endodontics section (due to procedural errors like perforations) and the Restorative section (due to over-preparation or poor contact points).


WREB vs. Similar Certifications: Which One is Right for You?

Feature WREB (CDCA-WREB-CITA) ADEX CRDTS
Admin Body CDCA-WREB-CITA Administered by CDCA Central Regional
Geography 48 States (Widest) 48 States ~40 States
Format Manikin/Patient Mixed Unified ADEX Format Clinical/Manikin
Cost ~$2,500 ~$2,500 ~$2,400
Recognition Highest Highest (Identical) Moderate/High

When to choose WREB: Since the merger, WREB and ADEX are essentially the same exam. You should choose this exam if you want the maximum flexibility to move between states, as it is accepted almost everywhere in the U.S.


How to Prepare for the Western Regional Examining Board (WREB) Dental Examination

Recommended Study Timeline

  • 3-4 Months Before: Review the official Candidate Guide (Manual). This is your “bible.” Understand every grading criteria.
  • 2 Months Before: Begin intensive manikin practice. Focus on the specific teeth used in the exam (e.g., Acadental ModuPRO).
  • 1 Month Before: Mock Board Exams. Have a faculty member grade your work strictly according to WREB criteria.
  • Total Prep Time: 150–200 hours of focused clinical practice.

Best Study Resources

  • Official WREB/CDCA Manuals: Free on the official website.
  • Dental Board Busters: Highly recommended for the Diagnostic Skills (DSE) portion.
  • StudentDoctorNetwork (SDN) Forums: Excellent for “boots on the ground” advice from recent test-takers.
  • Acadental Practice Kits: Use the exact same manikin heads and teeth used in the exam.

What to Expect on WREB Exam Day

  • Check-in: Arrive at least 60 minutes early. You will receive a packet with your candidate number and assigned cubicle.
  • Orientation: A mandatory Q&A session with the Floor Coordinator.
  • The “Fishbowl”: In patient-based exams, you send your patient to a separate area (the “fishbowl”) where examiners grade the work. You are not allowed in this area.
  • Anonymity: You must never tell an examiner your name or your school. You are only identified by your Candidate ID.
  • Prohibited Items: No cell phones, no textbooks, and no outside assistance.

After Passing the WREB Dental Examination

Passing the WREB is the final clinical hurdle. Once you have your passing score report:

  1. Apply for State Licensure: Submit your scores to the state board where you wish to practice.
  2. Jurisprudence Exam: Most states require a short open-book test on local dental laws.
  3. CPR/BLS: Ensure your Basic Life Support certification is current.
  4. DEA Registration: Apply for your DEA number to prescribe controlled substances.

Frequently Asked Questions

1. Does the WREB score expire?
Most states require you to apply for licensure within 5 years of passing the exam. If you wait longer, you may need to retake it.

2. Can I take the WREB if I graduated from a foreign school?
Only if you have completed an advanced standing program at a CODA-accredited school or meet specific state-specific “alternate pathway” requirements.

3. What happens if I fail one section?
You only need to retake that specific section. You do not need to retake the sections you passed, provided you pass the failed section within the board’s time limit (usually 12-18 months).

4. Is the manikin exam easier than the patient exam?
It is more predictable because manikins don’t bleed or get tired, but the grading standards are often stricter because “ideal” conditions are expected.

5. How much does it cost to retake a section?
Usually between $500 and $1,100 per section, plus a site fee.

6. Are there breaks during the exam?
Yes, clinical sessions are long, and candidates are allowed to take breaks, though the timer for the procedure does not stop.

7. Can I choose which teeth to work on?
No. For manikin exams, the teeth are assigned. For patient exams, you must find a patient with a specific type of cavity that meets WREB criteria.

8. What is the DSE?
The Diagnostic Skills Examination. It is a computer-based test focusing on treatment planning and diagnosis.

9. Does WREB offer a “re-score”?
You can request a “Scoring Review,” but because work is graded by three independent examiners, it is extremely rare for a score to be overturned.

10. How do I send my scores to a state board?
You can request official score reports through your CDCA-WREB-CITA candidate portal for a small fee (approx. $35).

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