Updated on: October 10, 2025
Texas lawmakers are debating how much training your dentist really needs – here’s what’s at stake for your next dental visit
Ever wonder what makes sure your dentist actually knows what they’re doing before they start poking around in your mouth? Right now, Texas lawmakers are having a heated debate about exactly that – and the outcome could affect every dental visit you make for years to come.
There are two competing bills making their way through the legislature, and they couldn’t be more different in their approach to keeping your smile safe.
The Current System: What Protects You Now
Before any dentist or dental hygienist can touch your teeth in Texas, they have to jump through some serious hoops:
- Pass a written exam (the book knowledge part)
- Pass a hands-on skills exam (the “can you actually do this” part). In Texas, approved hands-on clinical exams include ADEX, CDCA-WREB-CITA, CRDTS, and SRTA. The Texas State Board of Dental Examiners accepts these results, requiring applicants to complete the hands-on periodontics and prosthodontics sections for licensure.
- Get regulated by the Texas State Board of Dental Examiners (the watchdogs)
Texas currently accepts sim/manikin based examinations administered by designated regional examining boards, meaning future dentists prove they can perform basic procedures competently before they get near real patients.
The Two Bills: Here’s What You Need to Know
The Compact Bills: House Bill 1799 (HB 1799) These bills relate to the Interstate Dentist and Dental Hygienist Compact, which would allow Texas to join an interstate agreement. Think of it as a professional club where licensed dental pros from other states can quickly jump into the Texas workforce to help out in underserved communities – especially those small towns where you might be driving an hour just to get a cleaning.
The Controversial Alternative There’s another set of bills – House Bill 1803 (HB 1803) and Senate Bill 1109 (SB 1109) – that takes a totally different approach. This one wants to significantly reduce licensing requirements, and that’s where dental professionals are sounding the alarm. Industry experts are worried this could put you at risk by lowering the bar for who gets to practice dentistry on your teeth.
The compact approach is just like what Texas did four years ago when Governor Abbott made it easier for doctors from other states to practice here through the Interstate Medical Licensure Compact. That move helped bring more physicians to Texas and made healthcare more accessible across the state.
Why This Matters to You (Beyond the Obvious)
Here’s the thing about dental work – there’s no “undo” button. When someone messes up a filling, crown, or root canal, you’re dealing with pain, additional procedures, and potentially thousands of dollars in corrective work.
The hands-on skills exam ensures that your dentist has actually demonstrated they can perform basic dental procedures before they practice on real people. For instance, the ADEX exam features five skill-specific components, including a high-fidelity computerized assessment that tests practical competency.
What Texans Actually Want
According to an American Association of Dental Boards survey, 82% of Americans want dentists and dental hygienists to pass both written and practical exams before providing care. That’s an overwhelming majority saying “prove you can do this before you do it on me.”
Makes sense, right?
The Real Problem: Workforce Shortages
Texas does have a genuine dental care shortage problem. Many areas, particularly rural communities, struggle to attract and keep dental professionals. The current licensing requirements can make it harder for dentists to move between states, which limits the available workforce.
But here’s the question: Is the solution to lower standards, or to find better ways to get qualified professionals where they’re needed?
The Expert Perspective
Dr. Rudy Ramos, a Houston-area dentist and former Chair of the Texas State Board of Dental Examiners, has been vocal about maintaining rigorous licensing standards. As someone who’s seen both the regulatory side and the practical side of dental care, his perspective carries weight in these discussions.
The debate also involves Arthur Chen-Shu Jee, DMD, President of the Board of Directors of the American Association of Dental Boards, who represents the national perspective on dental licensing standards.
What’s Really at Stake
This isn’t just bureaucratic wrangling – it’s about the fundamental question of how much training and testing we require before someone becomes responsible for your oral health.
ADEX and other regional exams — such as CRDTS and SRTA — support licensure portability across many states that use third-party assessments, helping address mobility while maintaining professional standards.
The licensing process serves as a critical check and balance. The Governor appoints State Board members specifically to make important decisions about public dental health and safety – that’s not something to take lightly.
The Bottom Line for Your Next Dental Visit
If the more restrictive bill passes, you might have fewer dentist options in some areas, but higher confidence that whoever treats you has met rigorous standards.
If the less restrictive bill passes, you might have more dentist options, but potentially less assurance about their hands-on competency before they got licensed.
Why This Debate Isn’t Going Away
The tension between access and standards isn’t unique to Texas or to dentistry. It’s happening in healthcare fields across the country as states struggle to balance professional standards with workforce needs.
But when it comes to irreversible procedures in your mouth, most Texans seem to lean toward “better safe than sorry.”
The question for lawmakers: Can Texas solve its dental workforce shortage without compromising the safety standards that 82% of Americans say they want?
Legislative Links:
- House Bill 1799 (HB 1799): https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB1799
- House Bill 1803 (HB 1803): https://legiscan.com/TX/bill/HB1803/2025
- Senate Bill 1109 (SB 1109): https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=SB1109
- More info on the Dentist and Dental Hygienist Compact: https://ddhcompact.org/
What You Can Do:
Contact your state representatives about which approach you support
Stay informed as these bills move through the legislative process
Ask your current dentist about their training and certification
Pro Tip: Regardless of which bill passes, always feel free to ask your dentist about their training, certifications, and experience. Any good dental professional should be happy to discuss their qualifications with patients.
Your smile is worth protecting – and so is your right to know who’s protecting it.
Editor’s Note:
A previous version mentioned only the ADEX exam. Texas also accepts regional clinical exams such as CRDTS, SRTA, and CDCA-WREB-CITA.




