In Indiana, Foreign-Trained Dentists Can Now Become Dental Hygienists
A new Indiana law creates a fast-track licensure pathway for internationally trained dentists to practice as dental hygienists, igniting debate over workforce shortages, professional standards, and the future of dental hygiene.
Indiana has officially redrawn the map for dental workforce entry. As of July 1, 2026, House Bill 1254 allows foreign-trained dentists to obtain full dental hygienist licensure without completing a United States dental hygiene program.
The policy is being framed by organized dentistry as a pragmatic response to persistent staffing shortages. Dental practices across the country have struggled to recruit and retain dental hygienists, creating bottlenecks in patient care and production. Indiana’s solution: tap into a pool of highly educated clinicians already trained in dentistry, many of whom face steep financial and logistical barriers to practicing in the US.
Historically, internationally trained dentists have had two options: repeat 2 to 3 years of dental school through advanced standing programs, which may cost upwards of $150,000, or leave the profession. HB 1254 introduces a third path, but applicants must still meet rigorous requirements, including credential evaluation, English proficiency (if applicable), passing the National Board Dental Hygiene Examination, a regional clinical board exam, and a background check. The result is a significantly faster and more affordable route, with total costs estimated between $2,500 and $5,000.
But the legislation is not without controversy. The American Dental Hygienists’ Association has consistently opposed such pathways, arguing that dental hygiene is a distinct discipline requiring Commission on Dental Accreditation-accredited education. Its position centers on patient safety, professional integrity, and a broader claim that workforce shortages stem from retention and systemic issues, not a lack of qualified dental hygienists.
However, the Indiana Dental Hygienists’ Association did not publicly oppose the bill and maintained a neutral stance throughout the legislative process. Behind the scenes, efforts focused on ensuring safeguards, such as requiring the same licensure exams and English-translated transcripts, signaling a compromise approach rather than outright resistance.
In effect, Indiana has launched a real-world test case. Can internationally trained dentists integrate seamlessly into dental hygiene roles? Will this alleviate access issues, or create new tensions within the profession?
