# How to prepare for the DLOSCE The DLOSCE is a 150-item, computer-based clinical judgment exam. Since 2026 it is part of the ADEX Dental Examination that most US dental graduates take for licensure. This guide explains what is on it, how it is scored, and how to prepare. ## Who takes the DLOSCE The American Dental Association owns the DLOSCE, and the Joint Commission on National Dental Examinations (JCNDE) develops it. In April 2026 the ADA licensed it to ADEX, which is phasing out its own DSE OSCE. Every ADEX Dental Examination registration since June 2026 includes the DLOSCE, and JCNDE says all DLOSCE administrations are now conducted through ADEX.[^C4][^C6][^C7] ADEX's 2026 DSE OSCE candidate manual states that the DLOSCE "is a required component of the ADEX Dental Examination effective 6/1/2026." Candidates who registered before June 1, 2026 may make an initial DSE OSCE attempt until December 31, 2026; a failed DSE OSCE is retaken as the DLOSCE.[^C3] You cannot register for the DLOSCE by itself. It comes with the ADEX Dental Examination series, and you schedule it at a Prometric test center.[^C6] The ADA says the integrated examination serves candidates seeking to practice in 48 states and other jurisdictions. ADEX notes that Delaware and New York do not accept an independent third-party assessment for dental licensure. Confirm the requirements of the state where you plan to practice.[^C4][^B498] ## The format | Element | What to expect | | --- | --- | | Items | 150: 148 multiple-choice items and 2 prescription tasks | | Question types | One correct answer, or one or more correct answers | | Cases | Many items include a Patient Box with the information available at the visit | | Media | Images and lifelike 3D models you can rotate, move and magnify | | Tooth numbering | ADA Universal system: 1–32 permanent, A–T primary | | Patients | Pediatric, geriatric, special-needs and medically complex | | Passing score | Scaled scores run from 49 to 99; 75 passes | The 2026 JCNDE guide lists five sections: 37 questions in 75 minutes, an optional 10-minute break, 37 questions in 75 minutes, the 2 prescription tasks in 10 minutes, an optional 30-minute break, 37 questions in 75 minutes, an optional 10-minute break, and 37 questions in 75 minutes. With the optional tutorial and survey, the appointment lasts 6 hours 45 minutes. That is about 2 minutes per question.[^C2] JCNDE now labels its guide "for historical reference" and sends candidates to ADEX.[^C7] ADEX's current DLOSCE manual confirms a seat time of about 6 hours 45 minutes, including a 25-minute introduction and tutorial and three optional breaks, but does not list section times. Check ADEX's current materials before your appointment.[^C10] Read the Patient Box first, every time. If a category is missing, treat that information as unknown; if no allergy is listed, the patient has no known allergies.[^C2] ## How scoring works, and what it means for your strategy **One correct answer.** You earn 1 point for the correct option and 0 for anything else.[^C1] A wrong answer costs the same as a blank, so answer every single-answer question. **One or more correct answers.** These items say: select one or more correct answers, and any incorrect selection earns no credit. Each correct option carries a point value, and the item is worth at most 1 point. Some options are neutral: they neither gain nor lose credit.[^C1][^C2] - If you select **any incorrect option, the whole item scores 0**, even if you also chose every correct one. - If you select **only correct options**, you earn their value. Choosing one of two half-point answers earns 0.5. - Some options give **full credit by themselves**. Selecting two of them still earns 1 point, not 2.[^C2] The practical rule: select every option you are confident is correct, and leave out any option you would only be guessing at. One extra guess can erase the credit you had already earned. **Prescription tasks.** For each task you review a Patient Box, choose a medication from a list, then give the tablet or capsule strength, the total number to dispense, the number per dose, whether to give a loading dose, and the frequency. Each task scores 0 to 4 points against a key set by subject-matter experts. One task involves an antibiotic and the other an analgesic.[^C1][^C2] Prepare for them from the current ADA guidelines. For antibiotics, know the first-line regimens for dental infections and the alternatives for penicillin allergy. The ADA guide, for example, lists azithromycin as a 500 mg loading dose on day 1 followed by 250 mg for 4 more days.[^B114] For pain, know the NSAID-first approach of the ADA's 2024 guideline, the daily maximums (for example 2,400 mg of ibuprofen and 4,000 mg of acetaminophen), and the acetaminophen-alone option when NSAIDs are contraindicated.[^B475] Practice turning a regimen into a quantity: 500 mg three times a day for 7 days is 21 capsules. ## What the exam covers | Content area | Weight | Official subtopics | | --- | ---: | --- | | Restorative | 24% | Diagnosis; preparations; direct and indirect restorations | | Prosthodontics | 19% | Removable; fixed; implants | | Oral Pathology, Pain Management, and TMD | 13% | Oral pathology/oral medicine; orofacial pain and TMD | | Periodontics | 10% | Diagnosis; treatment planning; etiology | | Oral Surgery | 9% | Diagnosis; treatment planning; extractions | | Endodontics | 8% | Diagnosis; treatment planning; emergency management; post-treatment evaluation | | Orthodontics | 6% | Treatment screening; space management | | Medical Emergencies | 6% | Diagnosis; management | | Prescriptions | 5% | Antibiotic; analgesic | Diagnosis, treatment planning and occlusion are covered across the listed content areas.[^C2] Restorative and prosthodontics together are 43% of the exam. Weight your study the same way. ## Use the official resources ADEX's DLOSCE test-prep page links to practice questions, a list of acronyms and abbreviations, and a 3D model tutorial. Practice with the 3D tutorial before test day so the controls do not slow you down. ADEX encourages candidates to use textbooks, lecture notes and other educational resources as their primary study materials.[^C5] The official practice questions are copyrighted. JCNDE says they are best used to learn the item formats, not as a content study aid, and may not reflect current exam content, so do not limit your preparation to them.[^C2] ## A six-week plan This is a suggested plan, not an official requirement. Adjust it to your clinic schedule. | Week | Focus | | --- | --- | | 1 | Take a 37-question timed section cold. Review every explanation. Note your two weakest areas. | | 2 | Restorative and prosthodontics: diagnosis, preparation design, material choice, denture and implant problems. | | 3 | Oral pathology, TMD and periodontics: differentials, biopsy and referral decisions, staging and grading. | | 4 | Oral surgery, endodontics, orthodontics and medical emergencies, including emergency drug doses. | | 5 | Prescription drills until you can write both task types without notes. Mixed timed sections. | | 6 | One full-length practice exam, then targeted review of missed and partial-credit items. Rest the day before. | Each day, answer a timed set, then read the explanation for every option, including the ones you got right. Track partial-credit items separately: they show where you knew some, but not all, of the answer. ## Fees, results and retakes The ADEX Dental Examination series costs $2,995 plus a facility fee. A second or third DLOSCE attempt costs $695.[^C9] Complimentary retakes do not apply to computer-based exams.[^C6] Results are reported as pass or fail. ADEX's FAQ says DLOSCE official results appear in your candidate account within 24 to 48 hours; its DLOSCE manual says most candidates receive official results within 2 to 3 business days, and some wait up to 15 business days.[^C6][^C10] After an unsuccessful attempt there is a 10-day waiting period, and you can register again once official results are posted.[^C6] All ADEX exam components must be passed within 18 months of your first attempt. If you fail a component three times in a row, or do not pass every component within 18 months, you must repeat the whole series.[^C6] After a third failed DLOSCE attempt you must also wait at least six months before taking it again in a new series, and failed DSE OSCE and DLOSCE attempts count together toward these limits.[^C6][^C10] Plan your DLOSCE early enough to leave time for a retake. ## Before test day - Read ADEX's current DLOSCE candidate manual and confirm your appointment details.[^C10] - Practice with the official 3D tutorial. - Bring two original, current, physical forms of identification to the Prometric center: one primary government-issued photo ID with your name and signature, such as a driver's license or passport, and one secondary ID with your name and signature. If your photo ID was not issued in the United States, confirm it with ADEX first.[^C6][^C10] - Arrive at least 30 minutes before your appointment. Arriving after the scheduled start is recorded as a no-show and forfeits the attempt and registration fees.[^C10] - Arrange any testing accommodations before you schedule; requests are reviewed in advance.[^C6] Dentovio is independent and is not affiliated with or endorsed by the ADA, the JCNDE or ADEX. [^C1]: JCNDE, *DLOSCE Technical Report* (2026), "Examination Format", "Prescription Tasks" and "Scoring". [^C2]: JCNDE, *2026 DLOSCE Candidate Guide*, pp. 6–14 and 21. [^C3]: ADEX, *2026 Dental Candidate Manual, Computer-based Diagnostic Skills Examination (DSE OSCE)*, version 20260722, addendum. [^C4]: ADA, *ADA and ADEX advance dental licensure examinations through new agreement*, April 14, 2026. [^C5]: ADEX, *DLOSCE examination test prep*. [^C6]: ADEX, *Frequently asked questions*: DLOSCE registration, retakes, results, the 18-month rule, identification and accommodations. [^C7]: JCNDE, *DLOSCE*. [^C9]: ADEX, *ADEX Dental Examination*, fees. [^C10]: ADEX, *2026 Dental Candidate Manual, DLOSCE*, version 20260727: 3-Time Fail Policy, scoring of examination, candidate identification, attendance and exam administration. [^B114]: American Dental Association, *Chairside guide: antibiotic use when definitive dental treatment is not immediately available* (2019), clinical pathway. [^B498]: ADEX, *ADEX sparks nationwide change*, February 2025, footnote on Delaware and New York. [^B475]: American Dental Association, *Chairside guide: managing acute pain after tooth extraction in adolescents and adults* (2024), recommendations and maximum daily doses. Last updated: 2026-11-08. ## Continue your DLOSCE study - [Try 20 free DLOSCE-style questions](https://dentovio.com/dlosce/free-practice-test/index.html.md) - [Explore the full DLOSCE course](https://dentovio.com/products/dlosce/index.html.md)