1.  Application Policy:  Candidates taking the examination for the first time must apply and pay the Initial Examination Fee not less than ninety (90) days before the date of the exam being applied for.  Candidates who are unsuccessful must reapply and pay the Retest Examination Fee not less than thirty (30) days before the date of the examination being applied for.

2.  Initial Examination Fee:The examination fee is $750.00 and must be paid at the time of application. 

3. Facility Fee:  A facility fee may be charged by the testing site for a site/rental fee for use of instruments, clinic facilities, supplies and disposables.  Some schools require that all instruments be supplied by the testing site school.  A rental charge or deposit imposed by the school must be remitted directly to the school.

4.  Retake Examination Fee: Candidates who are unsuccessful with any part of the examination must submit a new application and pay  a $750 retest fee. 

5.   Limited liability insurance?

Effective for CITA examinations administered on or after February 5, 2008 candidates will not longer be required to obtain professional liability insurance before being allowed to take a CITA dental or dental hygiene examination.  CITA has purchased a blanket Professional Liability Insurance policy that covers all dental and dental hygiene candidates, and their assistants, for all CITA examinations.  The cost of that coverage is included in CITA’s examination fee.  Candidates who have purchased a policy in anticipation of an upcoming examination should contact their agent to see if a premium refund is possible. 

Candidates must satisfy requirements for licensure in at least one of the participating or member states of CITA to be eligible to take the examination.

Candidates who at the time of application have graduated from dental hygiene schools or programs must furnish official final school transcripts with the date of graduation and degree received from the dental hygiene school of attendance, OR a letter signed by the Director of the program verifying the candidate’s name and date of graduation.

 Letter of Certification: If candidates have not already graduated and are taking the examination for the first time, as they make application to take the CITA examination they must present a Letter of Certification, from the Director of the dental hygiene (Form provided by CITA)

The Letter of Certification must be completed by the Director of the program to verify that the candidate has demonstrated sufficient clinical competence to perform dental hygiene services on human subjects, is in good standing at the school or program, is anticipated that all school requirements will have been completed and that the student is recommended for graduation prior to, or within 45 days of the date of the CITA examination.  Alterations to this letter or misrepresentation of any application requirements may result in elimination of the candidate’s application, and forfeiture of the candidate’s application.

Letter of Verification: Once candidates have graduated from the school or program they must have the Program Director complete and submit a Verification of Graduation. (A copy of which will be included in the candidate’s packet and can be obtained from the CITA office).  

CONTENT & SCORING

The examination consists of two (2) individual, skill-specific parts:  one computer-based, the other patient-based.  Each part of the examination is listed below: 

Part I:  Computer-Based Examination (Successful completion of the Dental Hygiene National Board Examination.  Scores must be sent to the CITA office.  Photocopies and student copies are NOT acceptable.)

Part II:  Patient Assessment, Scaling, Plaque/Stain Removal, and Pocket Depth Measurement

PART I-COMPUTER-BASED EXAMINATION:

       For this year's testing series, CITA will accept the successful completion of the Dental Hygiene National Board as administered by the joint commission on dental accreditation as fulfilling the computer-based portion of the CITA examination.

PART II-PATIENT-BASED EXAMINATION:

Examination Content & Scoring

Part II consists of two (2) procedures:
     (a) Case Acceptance/Treatment Selection
     (b) Treatment Evaluation.  

The Case Acceptance/Treatment Selection
Evaluated based on whether the patient meets the published examination requirements (See Candidate Examination Manual). 

Treatment Evaluation Procedure
Candidate performance is evaluated as to whether calculus, determined originally present on selected surfaces, has been removed, whether plaque/stain also has been removed from these teeth, and whether pocket depth measurements were accurate +/- 1.0 mm on the designated teeth. In addition, damage to adjacent soft and hard tissues are evaluated.

Three (3) examiners independently evaluate all calculus and plaque removal, pocket depth measurements, and hard and/or soft tissue damage. From these three independent ratings, a median scoring is determined.  These median competency levels are translated by computer into a numerical score. 

PART II CONTENT

CASE ACCEPTANCE

Treatment and Patient Selection

Intra/Exral Oral Observation

Subgingival Calculus

TREATMENT EVALUATION

Subgingival Calculus

Supragingival Calculus

Sulcus/Pocket Depth Measurements

Tissue and Treatment Management

Questions Regarding the CITA Hygiene Examination

1.  What are the factors that necessitate the CITA examination fee being greater than the fee for state administered examinations?

In general, it should be recognized that all of the states in CITA are moving from an examination process previously administered by independent state boards of dentistry rather than regional testing agencies. Historically, regional testing agency fees have been considerably higher than independent state board fee structures. Being a part of an independent state administered exam, candidates have previously enjoyed exam costs which were offset by general state board operating revenues. However, this has been framed against a backdrop of limited recognition of the independently administered examinations and subsequent limited mobility. The new paradigm of regional and national mobility through regionally administered examinations breaks down previous barriers of recognition and limited mobility, but carries with it higher administrative and examination development expenses.

2.  Some concern has been expressed that the higher CITA fee is a mechanism for a dental board or its members to realize an economic gain? What is the organizational structure of CITA and is its Board of Directors or Officers receiving economic income from the administration of the examination?

CITA was organized and incorporated as a nonprofit 501C-3 corporation and as such is subject to state and federal regulations in order to maintain not for profit status. CITA Board Members and Officers expend considerable amounts of time in their service to the citizens of our states and to the profession but do not receive compensation for their positions as Board Members or Officers of CITA. Their time and energy is donated and provided without salaried compensation.  CITA Board members may participate in the examination process along with other dentists and hygienists as Clinic Floor Monitors or Grading Examiners.  Participants in the administration of the CITA examination receive an honorarium and an allowance for travel, meals and lodging. CITA does employ staff personnel to provide administrative and clerical duties within the CITA office.

CITA consists of representatives from member states who vote on matters brought before the membership. There is a Board of Directors and Officers who serve to govern and carry on the day-to-day activities of the organization. CITA Board Members and Officers are not required to be current state board members.   

3.  What is the relationship between CITA and the state boards of dentistry?

It is important to distinguish that state dental examining boards are typically considered a part of state government. The boards as state agencies have delivered the clinical licensure examinations as a service to the citizens of the state and the profession. In the new regional format state boards of dentistry will no longer be administering the dental hygiene examination as a specific state board function.  Although state board members may assist in the delivery of the examination, the examination will be administered by CITA, an outside independent regional testing agency similar to other regional testing agencies.

Member states and their State Boards of Dentistry have agreed by contract to accept the results of the CITA administered examination as fulfilling the clinical examination component for licensure; however, the state boards of dentistry do not have the specific authority to set what CITA, or any other regional testing agency for that matter, charges for the development and administration of a licensure examination. The fee is determined by the regional testing entity and is a function of exam development expenses, administration expenses, psychometric expenses, staff expenses and examiner travel, honorarium and lodging expenses incurred in the administration of the examination.

4.  If CITA’s testing fee is needed to meet expenses, does this mean that the member state Boards have been losing money during the years they gave the dental hygiene examination?

While each state board of dentistry’s circumstances may differ, it is likely accurate to state that typically the expenses previously incurred by each independent state board in delivering their  dental hygiene examinations were  not covered by the fees generated by examination applicants. The income generated by the licensure renewals fees of existing dental and dental hygiene practitioners was often used to offset the shortfall incurred in the administration of the clinical licensure examinations. In addition, aside for the direct cost of administering the examination such as hotel, travel, honorarium and meals, the indirect expenses such as exam development, psychometric or measurement specialist consultation expenses, technical manual development, and post examination analysis were usually absorbed by boards as general operating costs, which again were paid from general board revenues generated by practitioner licensure renewal. This is one of the many reasons regional testing agencies have for numerous years required a greater examination fee than those states who have independently administered their examinations.

5. What are other regional testing agencies charging for their hygiene examinations?

Examination charges are determined by each testing agency based on a number of factors. The fees charged by each agency may be changed according to determinations made by the various agencies and thus candidates should contact the agencies directly to determine the fees charged by each agency.  The fee charged by CITA is comparable to the fees charged by the other regional testing agencies.

6.  Are funds or scholarships available to help dental hygiene students meet the increased expense of the CITA examination?

It has been suggested that there are monies available in student aid offices for the expense of the licensure examinations.  Students should inquire at the Student Aid Office at the institution where they are enrolled to see if funds are available for this purpose. 

7.  If I am successful on the CITA dental hygiene examination, where will I be able to practice?

Currently, the member states that have joined CITA are Mississippi, North Carolina, Louisiana, Puerto Rico and Alabama.  The following jurisdictions recognize the results of the CITA examinations for licensure purposes.

**Alabama currently has submitted legislation allowing the recognition of the CITA examination.  Until the legislation becomes effective, Alabama is not authorized to license individuals who have taken the CITA examination. The legislation is expected to become effective in mid 2007.  Once legislation has become effective, Alabama will give retroactive recognition to individuals who have previously taken the CITA examination

**Virginia has recently voted to begin accepting the results of CITA examinations taken after September 1, 2007.

8.  Once I pass the CITA dental hygiene examination will I automatically be allowed to practice in those states that recognize the CITA examination?

As the testing agency responsible for administering the examination, CITA has provided to the State Boards of Dentistry of the recognizing states information sufficient to establish that a score of 75 or more on each of the sections of the examination may represent an acceptable demonstration of competence to practice dentistry and/or dental hygiene.  However, each State Board of Dentistry is responsible for determining whether a candidate has fulfilled its state’s standards and requirements for licensure.  The State Boards’ determinations are controlled by individual state law and may therefore have requirements which may not be uniform.  Each licensing jurisdiction may use the examination results to the extent authorized by its statutes.

9.  It states in the candidate manual that for digital radiographs, periapicals and bitewings must each be a 4" x 6" image with both images printed on one sheet of 8 1/2" x 11" premium quality photographic paper.  However, I am having trouble fitting two 4" x 6" images on one sheet, do they have to be 4" x 6"?

CITA prefers the images to be 4" x 6"; however, if you are having problems fitting both images on one sheet, you may make the images smaller but they MUST be of diagnostic quality.