How to Get Your Dental Hygienist License in Texas (2026)

How to Become a Registered Dental Hygienist in Texas

Texas is one of the largest dental hygiene labor markets in the United States. Four major metropolitan areas — Houston, Dallas-Fort Worth, Austin, and San Antonio — each rank among the country's top 15 most populous cities, and all are experiencing rapid population growth that drives continuous dental workforce demand. A massive Dental Service Organization presence, combined with a strong private practice sector, makes Texas a top destination for dental hygienists nationwide. Licensure is issued by the Texas State Board of Dental Examiners (TSBDE).

Step 1: Complete an Accredited Dental Hygiene Program

Texas requires graduation from a dental hygiene program accredited by the Commission on Dental Accreditation (CODA). The state has an extensive in-state program network including Lone Star College (Houston), Tarrant County College (Fort Worth), Austin Community College, San Antonio College, Texas A&M College of Dentistry (Dallas), and UT Health Science Center San Antonio, among many others. Out-of-state graduates from CODA-accredited programs may apply for Texas licensure through the standard pathway.

Step 2: Pass the NBDHE

The National Board Dental Hygiene Examination (NBDHE), administered by the JCNDE, is required for Texas licensure. Sit during or after your graduating semester and arrange for official score submission to the TSBDE. Texas does not set a score expiration under current rules, but confirm this at time of application as the Board periodically updates its policies.

Step 3: Pass a Clinical Examination

Texas accepts two regional clinical board examinations:

• ADEX (American Board of Dental Examiners) — standardized live-patient clinical exam accepted in most U.S. states; testing sites available in Texas and nationwide
• CRDTS (Central Regional Dental Testing Service) — live-patient clinical exam with testing sites in Texas and across the South Central and Midwest region

Both exams require patient assessment, periodontal scaling, radiography, and case documentation. Score reports must be submitted from the testing agency directly to the TSBDE. Texas is an active testing site state, so candidates often find local testing dates convenient.

Step 4: Apply for Your State License

Submit your application to the Texas State Board of Dental Examiners after clearing both board exams. Required materials typically include:

• Completed TSBDE application (available through the Verifier online portal)
• Official CODA-accredited program transcripts
• Official NBDHE and clinical board score reports
• Current CPR/BLS certification
• Application fee — approximately $75–$115
• Background check

Visit tsbde.texas.gov for the current application, fee schedule, and instructions. Texas also requires a separate Local Anesthesia Administration Permit for RDHs who wish to administer local anesthetics — this involves additional education, examination, and a permit fee beyond the base RDH license.

Continuing Education Requirements

Texas has one of the lower CE requirements nationally: 12 CE hours per two-year renewal cycle. However, the TSBDE mandates a specific component:

• Anesthesia monitoring CE — required within the 12 hours; covers monitoring of patients under nitrous oxide and other anesthesia modalities

The remaining CE hours may cover any TSBDE-approved topic. Texas RDHs holding a Local Anesthesia Permit have additional CE requirements tied to that credential. The Texas Dental Hygienists' Association (TDHA) and Texas Dental Association both provide abundant CE programming. Retain all CE documentation for three years; TSBDE audits occur.

Texas Dental Hygienist Salary Ranges

Texas offers competitive absolute salaries, particularly in its major metros:

• Entry-level (0–2 years): $58,000–$70,000/year
• Mid-career (3–7 years): $70,000–$86,000/year
• Experienced (8+ years): $86,000–$105,000/year
• Houston metro: largest market; DSO concentration and Medical Center proximity drive premium rates; per-diem $42–$62/hr
• Dallas-Fort Worth metro: tech-sector spillover inflates benefits packages; Plano, Frisco, and McKinney suburban practices aggressively recruit RDHs
• Austin metro: highest per-diem rates in Texas ($48–$65/hr) driven by tech-industry workers with premium dental benefits and limited supply of local RDHs
• San Antonio metro: strong military dental demand (Fort Sam Houston, Lackland AFB, Randolph AFB); DSO presence growing rapidly
• No state income tax: a meaningful take-home pay advantage vs. states like California or New York with equivalent gross salaries

Top Employers for Dental Hygienists in Texas

• Private and group dental practices — dominant throughout Texas suburbs; Katy, Sugar Land, The Woodlands, Southlake, Flower Mound, and Round Rock are among the highest-density private practice markets
• Dental Service Organizations — Texas is one of the most DSO-dense states in the country; Heartland Dental, Aspen Dental, Pacific Dental Services, and dozens of regional groups operate hundreds of Texas locations
• Texas A&M College of Dentistry (Dallas) and UT Health San Antonio School of Dentistry — academic dental centers with staff RDH positions and adjunct faculty roles
• Military dental programs — Brooke Army Medical Center (BAMC), Wilford Hall, and the extensive San Antonio military healthcare complex employ civilian and contract dental hygienists
• FQHCs and community health centers — Avenue 360 Health & Wellness (Houston), CommUnity Care (Austin), and CommunityMed Family Urgent Care serve large underinsured populations
• Texas Children's Hospital and UT Physicians — pediatric and hospital-based dental programs in Houston