As a dentist who studied at a school on the East Coast, but took the Western Regional Board, I am often asked what’s the difference between the NERB and the WREB?

Note: The North Eastern Regional Board (NERB) is now called the “Commission on Dental Competency Assessments” or the CDCA, but will be referred to as the NERB for the remainder of this blog post.

The main difference between the NERB and the WREB is defined by the states who accept each exam. While there is overlap, a notable state that does not accept the NERB exam is California. Since California did not accept the NERB while I was a senior dental student, I elected to take the WREB at Temple University while attending the University of Maryland. It is best to check each exam’s website for up-to-date listings of states accepting their exams.

The WREB exam consists of a clinical section (operative, perio, and endo) and a three-hour free-response exam where you are required to treatment plan three separate cases (one of which is a child).

The NERB exam consists of a clinical section (operative, perio, endo, and prosth) and a multiple choice exam.

For the WREB clinical exam, each candidate is required to satisfactorily complete two of the following procedures:

  • Class II amalgam
  • Class II composite
  • Class III composite

For the NERB exam, each student is require to do either a class II amalgam or a class II composite and a class III composite. Ideal class three lesions are typically challenging to identify and secure for the exam making patient selection for the NERB more difficult.

Both exams have similar periodontal requirements – basically, each candidate is required to scale and root plane an entire quadrant (6-8 teeth) with moderate to heavy calculus deposits. There are probing depth requirements for both exams; however, the WREB is more stringent as it requires two of the six teeth to have at least 1 pocket of 5 mm or more (most instructors recommend that calculus be visible on the bitewing radiographs for the WREB).

For the endo section: The NERB requires that a student access, instrument, and obturate a plastic central incisor and access a plastic molar. The WREB requires that a student access, instrument, and obturate a single rooted extracted-natural tooth and access, instrument and obturate (one canal) of a multi-rooted tooth. Each student is required to submit before and after radiographs for the WREB (not the NERB). The extracted and plastic teeth are mounted in similar typodonts for both exams. Both exams follow the same principles of infection control.

For the prosth section of the NERB, a student is required to prepare a central incisor for an all-ceramic crown; and the abutments of a three unit bridge from a molar to a premolar on a typodont (plastic teeth). The premolar is prepared for a PFM and the molar prepared for an all-metal crown. The WREB does not have a prosth section.