What Is the NDEB?

The National Dental Examining Board of Canada (NDEB) is the governing authority responsible for ensuring that anyone who practices dentistry in Canada meets a consistent national standard of knowledge, skill, and professionalism.

For internationally trained dentists, this means completing a structured evaluation pathway — known as the NDEB Equivalency Process — to demonstrate competence equivalent to a graduate of an accredited Canadian dental program.

Who Needs to Complete the Equivalency Process?

The equivalency pathway applies to dentists who graduated from a non-accredited dental program, meaning their dental school is not recognized under NDEB’s list of accredited institutions in countries like Canada, the U.S., Australia, New Zealand, or Ireland.

If your dental school is accredited, you may apply directly to the NDEB Certification Process or a qualifying program at a Canadian university.

If not, you’ll begin with the Equivalency Process, which includes three rigorous assessments designed to evaluate your fundamental, clinical, and practical competence.

Why the Equivalency Process Exists

The NDEB created this system to ensure that all dentists practicing in Canada—regardless of where they were educated—can provide safe, effective, and ethical care that meets Canadian public standards.

It’s not a barrier; it’s a bridge—one that allows international dentists to prove their capabilities and integrate into the Canadian dental profession.

Step-by-Step Breakdown of the Three NDEB Exams

AFK Exam — Assessment of Fundamental Knowledge

The AFK exam tests your understanding of core dental sciences—everything from anatomy and pathology to restorative dentistry and ethics.

Structure:

200 multiple-choice questions

Conducted digitally over two sessions (morning and afternoon)

Covers biomedical sciences, dental materials, pharmacology, radiology, and patient management

Goal:

To confirm that your theoretical foundation is equivalent to that of a Canadian dental graduate.

Tips for Success:

Build your study schedule around topic weight distribution.

Use mock exams to simulate timing (ConfiDentist’s mock AFK tests mirror real exam pacing).

Aim for a score of 75 or higher, which is the typical benchmark to proceed to the next stage

ACJ – Assessment of Clinical Judgment

Once you pass the AFK, you move on to the ACJ, often considered the most intellectually challenging stage.

It’s a case-based examination that measures how well you can diagnose, interpret, and plan treatments in realistic patient scenarios.

Structure:

Two booklets of case-based questions

Topics include diagnostic imaging, treatment planning, and patient care ethics

Emphasis on radiographic interpretation and decision-making

Common Challenges:

Many candidates struggle with time management and diagnostic prioritization.

ConfiDentist’s faculty—composed of licensed Canadian dentists and past NDEB mentors—train students to read cases critically and think “like a Canadian clinician.”

NDECC — Clinical Competence Examination

The NDECC (National Dental Examining Board Clinical Competence) replaced the older ACS format.

This is a hands-on exam that assesses your practical dental skills through simulated clinical exercises.

Structure:

12 clinical exercises in restorative, prosthodontic, and operative dentistry

Conducted in a simulated clinic environment

Candidates must pass all 12 exercises to proceed

Focus Areas:

– Manual dexterity

– Infection control and clinical safety

– Patient simulation under time constraints

Preparation Strategy:

Candidates who invest in realistic lab practice and mock simulations consistently perform better.

ConfiDentist provides access to a fully equipped clinical simulation environment, allowing students to build muscle memory and confidence before the real exam.