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Purpose: This report describes the overall process used for set­ting the pass/fail score for the National Board Dental Hygiene Examination (NBDHE). Methods: The Objective Standard Setting (OSS) method was used for setting the pass/fail score for the NBDHE. The OSS method requires a panel of experts to determine the criterion items and proportion of these items that minimally competent candidates would answer correctly, the percentage of mastery and the confidence level of the error band. A panel of 11 ex­perts was selected by the Joint Commission on National Dental Examinations (Joint Commission). Panel members represented geographic distribution across the U.S. and had the following characteristics: full-time dental hygiene practitioners with expe­rience in areas of preventive, periodontal, geriatric and special needs care, and full-time dental hygiene educators with experi­ence in areas of scientific basis for dental hygiene practice, pro­vision of clinical dental hygiene services and community health/ research principles. Utilizing the expert panel’s judgments, the pass/fail score was set and then the score scale was established using the Rasch measurement model. Results: Statistical and psychometric analysis shows the actual failure rate and the OSS failure rate are reasonably consistent (2.4% vs. 2.8%). The analysis also showed the lowest error of measurement, an index of the precision at the pass/fail score point and that the highest reliability (0.97) are achieved at the pass/fail score point. Conclusion: The pass/fail score is a valid guide for making de­cisions about candidates for dental hygiene licensure. This new standard was reviewed and approved by the Joint Commission and was implemented beginning in 2011.

• Describe the overall process used for setting the pass/fail score for the National Board Dental Hygiene Examination.
• Explain why psychometric and legally defensible pass/fail scores are important.
• Discuss the Objective Standard method used for setting the pass/fail score.

Infection by the human immunodeficiency virus (HIV) causes the host to have a compromised immune system due to the virus’s ability to infect cells of the immune system, such as helper T-cells (specifically CD4+ T-cells), macrophages and dendritic cells. HIV remains latent within these cells, which func­tion as memory cells and remains in the body for years. People who have a compromised immune system caused by HIV are more highly susceptible to other infections, including periodon­tal disease. Until recently, very little attention has been given to the potential interactions between chronic oral infections, such as periodontal disease and latent HIV reactivation/upregulation. This review focuses on the literature available between 2009 and 2011, evaluating the potential link between bacterial infec­tions, including oral infections caused by periodontal pathogens, the reactivation of latent HIV leading to the potential failure of highly active antiretroviral therapy and acquired immunodefi­ciency syndrome (AIDS) progression. It has been hypothesized that infections by periodontal pathogens can stimulate reactiva­tion of HIV-latently infected cells. Studies showed that soluble factors produced in response to periodontal pathogens by gingi­val cells could be indirect contributors to HIV-1 promoter activa­tion. It was also found that the oral bacteria stimulated the HIV promoter activation in a dose-dependent and time-dependent manner. While these preliminary studies present a potential link between oral periodontal pathogens and HIV reactivation, ad­ditional clinical and epidemiological studies are needed to clarify the causal link and mechanisms of HIV latency reactivation as­sociated with oral pathogens.

• Discuss the pandemic nature of HIV throughout the world.
• Identify the recent literature on the link between infection by oral pathogens and the reactivation of latent HIV virus.
• Discuss how the studies discussed in the article support the hypothesis that periodontal pathogens can stimulate reactiva¬tion of HIV-latently infected cells.