The Objective Exam: An Update on the ADA’s DLOSCE

Written By: Stephanie Zbin 

Stephanie is the 2018-2019 National ASDA Council on Communications Chair and a member of Marquette ASDA

Ethically sound, universally accepted, valid, reliable – what more do you need to know?

What is the DLOSCE?

A station-based examination currently under research and construction by the ADA’s DLOSCE Steering Committee. The acronym DLOSCE stands for Dental Licensure Objective Structured Clinical Examination. Stations of the exam may consist of diagnostic tools, such as radiographs or models, and calibrated medical actors or simulators. Although the Canadian OSCE does not currently include simulated patients, advancements in this area of technology may allow for this to be a realistic station type in the near future (1). 

The ADA’s DLOSCE is intended to be another way for states to determine qualification for licensure and its acceptance will be on a state by state basis. Variations of the DLOSCE are currently accepted in California, Colorado, Minnesota, and Washington as dental licensure and “OSCEs are widely used in the health sciences, including optometry, medicine, physical therapy, radiography, rehabilitation medicine, nursing, pharmacy, podiatry, and veterinary medicine.” (1, 3)

                  The Department of Testing Services (DTS) will oversee the generation and validity of the examination. DTS is ‘shared service’ of the ADA that participates in high-stakes testing through “content development, administration, analysis, and reporting” (3). Most of us have come in to contact with DTS before when we took NBDE boards, and they are the governing body responsible for the admissions and licensure examinations for many health sciences professions (1). 

Why is this the ‘ideal’ path to licensure?

  • This exam is in line with the ADA’s desire to eliminate live patients from dental licensure.
  • The ADA’s Department of Testing Services (DTS) is uniquely able to validate this test, as they have for several other health sciences examinations.
  • A goal of this exam is for it to be universal to all U.S. states; this portability is a tool for practicing dentists.
  • The ADA recognizes public health and ethics issues at play here and wants to eliminate those problems. 
  • The DLOSCE content will be based on current entry-level practices with a focus on frequency and patient care 
  • The standards for this path to licensure are within the needs of the exam
    • Standard 1.0 states that the valid test score should have a specific use - to reveal who is ‘competent’ to practice dentistry 
    • Standard 2.0 states that the score must be reliable and there should be a low chance of random error (3). 
    • The rationale for cut scores and the summarization of test development procedures must be available (3)

Does this align with ASDA L-1 Policy on the ideal licensure exam?

This exam as it currently is outlined does align with ASDA’s L-1 Initial Licensure Pathways policy (2). We believe that the exam must be valid, reliable, reflective of current dental practices, and not involving live patients. We also state that the exam should be “universally accepted”, which the DLOSCE makes steps towards within the limitations of a state by state legislature system. 

At this point, the DLOSCE does not include a kinesthetic portion, as outlined in ASAD’s stance. The hands-on portion of the ideal exam would be a manikin-based assessment in addition to a portfolio of the student’s comprehensive patient care (2). 

What progress is this exam making?

  • ADA’s Council on Dental Education and Licensure (DCEL) requested a business plan from DTS, funding approved in February 2017 (3)
  • Former ADA president, Dr. Gary Roberts, appointed members to the DLOSCE Steering Committee (1, 3)
  • Presentation of Exam progress given to deans of dental school in January 2018 (3)
  • The exam is expected to be active for the dental school class of 2020 (1, 3). 
  • “Education and Examination Matters” and “Credentialing Matters” were a part of the Wisconsin Dental Examining board meeting agenda on March 7, 2018 (4).


1.        American Dental Association. (2017). Dental Licensure Objective Structured Clinical Examination (DLOSCE) FAQ. Retrieved from 15 March 2018. 


2.        American Student Dental Association (2016). L-1 Initial Licensure Pathways (revised 1998, 2001, 2002, 2005, 2013, 2016).Retrieved from 19 March 2018. 


3.        Department of Testing Services (DTS). (2018) Department of Testing Services (DTS) and Dental Licensure Objective Structured Clinical Examination (DLOSCE). Retrieved from 20 March 2018. 


4.        Wisconsin Dental Examining Board. (2018). Dentistry Examining Board Meeting Dates, Agendas, and Minutes. Retrieved from 26 March 2018.  

Contact Stephanie at