The American Dental Hygienists’ Association supports the Dentist and Dental Hygienist Compact (DDH Compact)
What is Licensure Portability?
Licensure portability supports professional development and increases access to care. ADHA is proud to support the Dentist and Dental Hygienist (DDH) Compact, which provides a pathway for dental hygienists to be authorized to practice in participating states without obtaining a separate license in each one. This gives dental hygienists the flexibility to pursue new career opportunities across state lines without worrying that their license will not transfer.
The Council of State Governments (CSG) partnered with the Department of War (formerly Defense) (DoW), the American Dental Association (ADA), and the American Dental Hygienists’ Association (ADHA) to support the mobility of licensed dental hygienists through the development of the DDH Compact. The compact creates reciprocity among participating states and reduces barriers to licensure portability. Practitioners must complete continuing education requirements in the state where they hold their qualifying license but are not required to complete continuing education in states where they hold compact privileges.
Dental hygienists are eligible to participate in the compact if they have an active, unencumbered license in a participating state, have passed the National Board Examination or another exam accepted by the compact commission, completed a clinical assessment, graduated from a Commission on Dental Accreditation (CODA)–accredited program, and have no disqualifying criminal history.
As of January 2026, 12 states have enacted compact legislation, with several additional states considering legislation. The partner organizations responsible for the compact have developed model legislation for states to use. States may join the compact by enacting this model legislation through their legislatures. Interstate compacts take time to implement due to the coordination required among state legislatures, regulatory boards, and the established DDH Compact commission.
DDH Compact partners provide several resources that explain how the compact works and how states and practitioners can participate.
[Insert Video on DDH Compact Overview]
Commonly Frequently Asked Questions: [Drop down]
How does the Dentist and Dental Hygienist Compact work?
The Dentist and Dental Hygienist Compact is a mutual recognition model compact similar in form and function to professional licensure compacts for nurses, physical therapists and psychologists. Dental hygienists who are licensed in one compact member state can practice in another participating state by obtaining a compact privilege.
What is a compact privilege? What does a compact privilege allow me to do in another compact state?
A compact privilege is the legal authorization for a dental hygienist to practice in a remote state where they do not hold a primary license. To qualify, a dental hygienist must hold an active, unencumbered license in a participating compact state and meet all additional eligibility requirements. Once a dental hygienist applies for a compact privilege, they may begin practicing in the remote state after eligibility is verified, jurisprudence requirements are satisfied, and all applicable fees are paid. A licensee practicing under a compact privilege must adhere to the same scope of practice and standards as dental hygienists licensed in that remote state. If the remote state requires a specialty license to limit practice to a particular specialty, the practitioner must also obtain that specialty license to practice within that limited scope.
How do I apply for a compact privilege, and how much will it cost? The compact commission is currently setting up the necessary procedures, rules and systems for the compact to function. The commission will also set up a data system and an application process. Once this is established, practitioners will be able to apply for a compact privilege to work in other compact member states. Regarding cost, member states will set up the fee structure through rules. With other compacts, the fee for a compact privilege is typically less than the fee for a license. The fee for the Dentist and Dental Hygienist Compact privilege to practice will be up to the member states.
How do practitioners qualify for the compact?
To be eligible to obtain a compact privilege in a remote state, a dental hygienist must have:
- An unencumbered license in a state that has joined the compact;
- Graduated from a dental hygiene education program accredited by the Commission on Dental Accreditation;
- Passed the National Board Examination;
- Completed a clinical assessment for licensure;
- Passed a background check prior to obtaining their qualifying license;
- Passed any jurisprudence requirements established by the remote state;
- Pay all required fees.
If a state requires a specific clinical assessment for licensure, can it join the compact?
Yes. States can join the compact regardless of what clinical assessment their statute requires. This allows states to retain their sovereignty over licensure requirements. The model compact legislation defines clinical assessment broadly to encompass all valid measures of clinical competence allowed by states for licensure. In joining the compact, participating states are agreeing to accept practitioners from other states who may not have the identical clinical assessment requirements.
What is the Compact Commission?
The commission is a recognized government agency established by the compact. The commission will be comprised of one delegate from each participating state. The commission writes rules and bylaws to administer and implement the compact. As stated in section 7 of the compact, commissioners will be a designee from each participating state’s licensing authority. The commission is not a dental board. It cannot affect state licensing requirements or take action against a licensee.