You need to pass INBDE. No INBDE score, no CAAPID application. No CAAPID application, no Advanced Standing Program. No Advanced Standing Program, no U.S. dental license. INBDE is the gatekeeper. For international dentists, INBDE presents unique challenges. You graduated years ago. You've been practicing on real patients, not studying textbooks. The exam covers topics you haven't thought about since dental school — and it tests them differently than your home country's exams.