Scenario-based Oral Clinical Examination

The new Scenario-based Oral Clinical Examination is designed to objectively evaluate an orthodontist’s knowledge, abilities and critical thinking skills to certify orthodontists based on proficiency and clinical excellence. 


Scenario-based testing is utilized by several other medical and dental specialty boards.  This format allows for testing for a large amount of material in a relatively short period of time.  This allows for questions to be graded objectively based on pre-determined desired responses. 


Scenarios and questions are developed in collaboration with program directors/chairs, examiners, leaders in the industry and the ABO Board of Directors.


  • Successful completion of ABO Written Examination
  • Graduate of an advanced specialty education program in orthodontics and dentofacial orthopedics in the United States or Canada, accredited by the Commission on Dental Accreditation (CODA)
  • Examinees participating in extended programs will be required to complete their program prior to being eligible to take the Clinical Examination


Examination Components:

The examination will be composed of four domains for assessment:



Weighted % of Exam

Data Gathering and Diagnosis
Treatment Objectives and Planning
Treatment Implementation and Management
Critical Analysis and Outcomes Assessment


The scenario-based examination will be held in St. Louis, MO in the ABO Examination Center and will be graded on a Pass/Fail basis.


Each examination will be comprised of scenarios from each of the four domains using ABO provided patient cases. 


Examinees will be exposed to several different exam rooms, each consisting of a different pair of examiners and different patient cases.


Examinees will be presented with a case and questioned on a variety of information depending on each individual scenario.  The following includes some examples of things that may be included in the cases presented:


Patient history

Chief complaint

Treatment plan

Periodontal charting

Layout of current situation

Intra-oral photographs

Extra-oral photographs

Panoramic radiographs

Cephalometric radiographs

Tracings and superimpositions


Discrepancy Index (DI)

Cast-radiograph Evaluation (CRE)

Case Management Form (CMF)   


*Additional details about the exact examination layout will follow. 



How to Learn More

Click here to learn more about how to prepare for the new examination. You can also hear from the ABO Board of Directors through the following:


AAO Podcast

AJO-DO Article


    Benefits of the New Clinical Examination

    The ABO believes the new examination design offers the following benefits:


    • The most fair, reliable and valid testing methodology
    • Equally tests knowledge, skills, and critical thinking abilities in four core performance areas/domains
    • Demonstrates clinical proficiency in objective manner
    • Eliminates the challenges of using patient cases that may be shared or supervised during residency
    • Eliminates unnecessary barriers for residents and orthodontists in varied practice environments
    • Allows more residents and orthodontists that have an interest in becoming board certified to initiate the examination process


    What Others Are Saying about the New Examination Design

    As part of our evaluation process, the ABO board collaborated with educators and leaders in the industry to gain their perspective on the possible change to a scenario-based examination.


    The ABO Board was encouraged by the influx of positive feedback including the following: 


    “I believe this is the future of the ABO. We must move toward validity and reliability of the organization. ABO is the organization that attests good quality orthodontists, and to advance its endeavor, the ABO needs to change. It will change the way we teach in our institutions, but we are prepared and willing to change.”


    “I think it is the way to move forward for the future.”


    “A scenario-based approach would be more reflective of competency and more in-line with other medical specialties.”


    “I see it as an opportunity to more fairly and more accurately test an individuals diagnostic ability, critical thinking skills, and evidentiary knowledge base.”