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The local anesthesia examination is a TWO part examination; written and clinical. Candidates may take the written and clinical portion of the examination in any order they prefer (ie: there is no requirement to take and/or successfully complete one part of the exam before the other). Candidates must pass both the written and clinical portions of the examination within twelve (12) months after the initial attempt of either part. The examination is an evaluation of specific local anesthesia knowledge and clinical technique, as well as the candidate’s compliance with professional standards during the course of the examination. Below is a summary of the specific content, criteria and scoring associated with the examination.

Written LA Examination Scorable Items X Points Scored per Item = Max Points
Case Based Questions      
40 case based questions 40 1 40
Multiple Choice Questions      
20 multiple choice questions 20 1 20
BETA Test Questions and Cases varies 0  
Total Exam Points/ Max Score (Each question has only 1 correct answer)     60
Passing score: 75% = 45/60 questions answered correctly
Time Limit: 2 hours maximum is allowed for the written examination.

Cases, Categories and Topics covered:
    -  Pre-Anesthetic Patient Assessment
    -  Head, Neck, and Oral Anatomy
    -  Pharmacology and Physiology
    -  Delivery Technique
    -  Prevention and Management of Complications

The written LA examination is administered by CRDTS' proctors with candidates using electronic tablets in a classroom setting at the dental hygiene schools who also offer the clinical LA examination.

Clinical LA Examination Scoring

The candidate must safely and competently administer:
    - One (1) posterior superior alveolar (PSA) injection
    - One (1) inferior alveolar (IA) injection

Successful completion of BOTH injections is required to Pass the clinical examination
The clinical examination is Pass/Fail based on the scoring criteria in the manual.

Examination Scoring System

Only State Boards of Dentistry are legally authorized to determine standards of competence for licensure in their respective jurisdictions. However, in developing the local anesthesia examination, CRDTS has recommended a score of ‘75’ to be a demonstration of sufficient competence for the WRITTEN portion of the examination and a score of ‘Pass’ to be demonstration of sufficient competence for the CLINICAL portion of the examination and participating State Boards of Dentistry have agreed to accept that standard. In order to achieve “CRDTS Local Anesthesia status”, candidates must successfully complete BOTH the written and clinical portions of the Local Anesthesia examination with a score of 75 or more on the WRITTEN examination and a score of ‘Pass’ on the CLINICAL examination.

Scoring for the written examination is described in the scoring chart listed previously.

Scoring for the clinical examination utilizes a Pass/Fail criterion-based grading system to differentiate between acceptable (SAT) and unacceptable performance (DEF). Criteria have been established for each of the two required injections. CRDTS on-site proctors and three off-site examiners independently evaluate each injection and apply the criteria in assessing performance.

Any scorable item that is confirmed as a Critically Deficient (DEF) error by CRDTS proctors or by at least two independent examiners will result in failure of the Local Anesthesia Examination even if all other rated criteria and scorable items are successfully completed.

Any scorable item that is confirmed as Satisfactory (SAT) means the candidate was able to demonstrate competence for that scorable item and/or criteria.

Critically Deficient Errors

Critically deficient errors (DEF) are any actions or techniques that could lead to patient injury and/or may jeopardize the overall safety of the patient. Such an error demonstrates unacceptable skill, knowledge or judgment of the local anesthetic procedure.

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