1) Ashley, 14 years old, has type 1 diabetes & is scheduled for her continuing care appt after lunch. Why is it important for her to be seen promptly?
a) To ensure she does not become drowsy after her meal
b) To reduce the risk of an emergency developing
c) To enable her to follow her strict meal regimen
d) To allow sufficient time to complete dental hygiene therapy
2) Mr. Ungle, 35 years old, presents for his continuing care appt. The DH records generalized posterior periodontal probing depths of 5-6 mm. Mr. Ungle reports some sensitivity on the maxillary left quadrant. What radiographic views would be most appropriate to take to assess this area?
a) 4 vertical bitewings
b) 4 horizontal bitewings
c) 2 vertical bite wings
d) 2 horizontal bitewings
3) Ms. Cameron, 44 years old, is taking antidepressant medication & is experiencing mild xerostomia. What should the DH suggest to alleviate Ms. Cameron’s discomfort?
a) Increase frequency of toothbrushing
b) Use and essential oil mouth rinse
c) Chew candies or breath mints
d) Use a saliva substitute
4) Which one of following factors is the most reliable indicator that oral self-care procedures are effective?
a) Reduction of dental biofilm
b) Change in tissue colour
c) No signs of gingival inflammation
d) Absence of calculus
5) What is a mechanism by which desensitizing dentifrices work?
a) Blocks the pulpal neural response
b) Increases the fluid flow within the dental tubules
c) Promotes the formation of more physiological dentin
d) Stimulates cementoblast activities
6) Which step will facilitate sterilization in a pressurized steam sterilization unit
a) Tightly fill chamber tray w/ instrument packages to ensure heat conduction
b) Provide space between packaged instruments to ensure steam circulation
c) Pack the chamber tray w/ unwrapped instruments to maximize steam penetration
d) Ensure the chemical solution is at the appropriate level in the reservoir
7) Who would benefit most from shorter continuing care intervals?
a) A client who just completed a tobacco use cessation program
b) A client who is starting an at-home tooth whitening program
c) A client w/ recently diagnosed type 2 diabetes
d) A client w/ a diagnosis of hyperthyroidism
8) A DH takes a maxillary impression.in assessing the result, the DH notes good representation of the vestibule to the left of the central frenum, w/ a shallow imprint of the lip on the right side. What technique should be used to ensure a better impression?
a) Place impression tray further back in the mouth
b) Insert the impression tray on the right side first
c) Fill the impression tray w/ more alginate
d) Seat the impression tray lifting both sides of the lip
9) Mr. Carlyle, 51 years old, presents w/ gingival recession of 2mm on the facial surfaces of all molars and premolars. The exposed roots are hard & intact. Upon exploration, he jumps w/ pain at majority of sites. What should DH include in Mr. Carlyle’s DH treatment plan?
a) Chlorhexidine mouthrinse
b) Fluoride varnish
c) Pit & fissure sealants
d) Topical anesthetic
10) Joey, 11 years old, needs local anesthesia for perio debridement in quad 3. The procedure will take approximately 30 minutes to complete once anesthetized. What anesthetic agent & injection(s) would be ideal for this situation?
a) Mepivicaine 3% & the inferior alveolar nerve block, the lingual & long buccal nerve injections
b) Lidocaine 2% & buccal infliltration(s)
c) Articaine 4% w/ epinephrine 1:200,000 and the inferior alveolar nerve block & long buccal nerve injections
d) Prilocaine 4% w/ epinephrine 1:200,000 and an incisive nerve block, long buccal and lingual nerve injections
11) Don, an 18 year old athlete, has been taking penicillin for periocoronitis of tooth 38. He presents for repair of a clasp on an ill-fitting max partial denture. Don reports a metallic taste and a burning sensation in the palatal area. The clinical assessment reveals a lesion under the partial denture. There is a white, curd-like material w/ underlying erythematous mucosa. What condition should the DH suspect?
a) Denture stomatitis
b) Erosive lichen planus
c) Necrotizing periodontitis
d) Pseudomembranous candidiasis
12) Ms. Katerinova, 32 years old, has recently received local anesthetic for periodontal debridement by the DH. She reports pai & some difficulty opening her mouth the day after treatment. What post care recommendations should the DH consider?
a) Heat therapy, warm saline mouth rinse & analgesics
b) Cold therapy, antimicrobial mouth rinse & analgesics
c) Antibiotic treatment & warm saline mouth rinse
d) Analgesics & referral for physiotherapy
13) Kevin, 22 years old, arrives for his initial DH appointment. The DH notes that he has not seen a physician for the last 4 years. The client’s intraoral assessment reveals removable white plaques on the soft palate and reddish-purple lesions on the gingiva and the palate. What should the DH suspect?
a) Nicotine stomatitis
b) Oral cancer
c) HIV infection
d) Oral candidiasis
14) During perio debridement, the DH administered 2 cartridges of xylocaine (lidocaine 2%) w/ epinephrine 1:100,000 & an additional cartridge of articaine (Septanest SP 4%) w/ epinephrine 1:100,000. What information should be documented in the client’s chart?
a) 3.6 ml of Lidocaine 2% w/ epinephrine 1:100,000 & 1.7 ml of Septanest SP 4% w/ epinephrine 1:100,00
b) 36 mg of Lidocaine 2% w/ epinephrine 1:100,000 & 17 mg of Septanest SP 4% w/ epinephrine 1:100,00
c) 144 mg of Lidocaine 2% w/ epinephrine 1:100,000 & 72 mg of Septanest SP 4% w/ epinephrine 1:100,00
d) 72 ml of Lidocaine 2% w/ epinephrine 1:100,000 & 34 ml of Septanest SP 4% w/ epinephrine 1:100,00
15) In reviewing the following radiograph, how should the area surrounding the crown of tooth 15 be interpreted?
a) Pericoronitis
b) Primordial cyst
c) Eruption follicle
d) Supernumerary tooth
16) A client regularly uses beclomethasone dipropionate (Belcovent) to treat asthma. What is a possible oral manifestation caused by this type of medication?
a) A soft creamy white lesion that when removed leaves a red & raw surface
b) A painful, white ulcerative lesion that leaves a permanent scar
c) A painful, white necrotizing lesion w/ an inflammatory halo
d) A white, keratinized, bilateral, asymptomatic lesion
17) A 78 year-old client has recently developed osteoarthritis. Her intraoral assessment reveals moderate interproximal dental biofilm w/ open gingival embrasures. What oral self-care recommendation should the DH provide to address this issue?
a) Brush using the Fones technical
b) Floss using the ‘C’ shape method
c) Clean w/ an interdental brush
d) Use floss w/ a holder
18) Katia, 17 years old, presents for her continuing care w/ profound mental disability. During the appt, the DH notes that she ahs several traumatized areas on her lips & tongue. Which one of the following strategies would be the most appropriate in this situation?
a) Suggest behavior modification to reduce lip biting
b) Recommend a nightguard
c) Apply a topical antiseptic agent to the traumatized areas
d) Consult w/ the client’s caregiver to determine the cause of her injuries
19) A severely disabled 6-year old Sara, presents for her continuing care appt. her mother informs the DH that she is usually uncooperative & resists sitting in her wheelchair during daily oral care. Which one of the following recommendations should the DH make concerning the provision of Sara’s oral self care at home?
a) Place child in a supine position
b) Lay the child on the bed placing her head in her mother’s lap
c) Maintain the child in an upright position
d) Use a tilt board in the child’s wheel chair
20) Tristan, 14 years old, refuses to have a professional topical fluoride tx after the DH explain the benefits of fluoride. What action by Tristan would indicate that he understands the benefits of fluoride?
a) Paraphrases the info provided
b) Repeats the info verbatim
c) Listens with eye contact
d) Defers the decision to his parents
21) Which tooth is missing from the following radiograph?
a) Tooth 35
b) Tooth 36
c) Tooth 45
d) Tooth 46
22) The client asks the DH how often the masks are changed. How should the DH respond?
a) Once in morning and once after lunch
b) Between clients, or if the mask becomes wet
c) Once every two hours
d) If the mask becomes splattered
23) Robert, 13 years old, reports sensitivity to pressure on tooth 37. He had sealants placed on all molars 1 week ago. What should the DH do to dertamine the source of discomfort?
a) Take PA of tooth 37
b) Adjust dental sealant in quad 3
c) Check occlusion w/ articulating paper
d) Conduct a pulp vitality test
24) Gary, 14 years old, presents for his DH appt. it has been 19 months since he was last treated. His mother states that he has never had any decay even though he doesn not like to brush his teeth. What type of dental radiographs would be indicated?
a) Pan film only
b) Posterior BW only
c) Posterior PA films
d) Two occlusal films
25) Which one of the following oral microorganisms may overgown w/ the use of broad-spectrum antibiotics?
a) Porphyromonas gingivalis
b) Streptococcus mutans
c) Actinomyces viscosus
d) Candida albicans
26) Lila, 16 years old, presents for her continuing care appt. during the intraoral assessment. During the intraoral assessment, the DH notes redness, swelling and suppuration around a recent tongue piercing. What action should the DH take?
a) Ask lila to remove the tongue jewelry and proceed w/ tx
b) Inform lila of the findings & refer her to a physician
c) Irrigate the area w/ a saline solution
d) Teach lila how to brush her tongue properly
27) What is an example of effective time management?
a) Charting each tooth individually
b) Keeping a clock in the operatory
c) Completing the progress notes prior to care
d) Using a set routine or sequence
28) Which one of the following conditions is associated w/ the normal aging process?
a) Root caries
b) Smaller pulp chamber
c) Xerostomia
d) Gingival recession
29) When placing pit & fissure sealants, which one of the following procedures produces microscopic porosities?
a) Etching
b) Polymerization
c) Isolation
d) Air-powder polishing
30) Mrs. Ridley, 81 years old, is now living w/ her daughter’s family. When she presents for her 9-month continuing care appt, she appears w/drawn & anxious even though she has been a long-standing client in the practice. During the intraoral assessment, the DH notes poor oral hygiene, a fractured upper denture, & bruising of the edentulous ridge. What should the DH suspect?
a) Iron deficiency
b) Dementia
c) Self-neglect
d) Elder abuse
31) Mr. Applebaum, 29 years old, presents for his annual continuing care appt. he reports extreme sensitivity to cold in the mandibular right quad. Intra oral findings reveal localized ging recession of 4 mm on teeth 43 & 44. What should the DH recommend for Mr. Applebaum?
a) Acidulated phosphate fluoride
c) Composite restorations
d) Gingival graft
32) Which one of the following design features provides the best tactile sensitivity in a hand instrument?
a) Long functional shank
b) Serrated handle texture
c) Paired working ends
d) Hollow handle
33) Mrs. Weinberg, 78 years old, indicates a concern about small ulcers at the corners of her mouth that do not heal. What vitamin or mineral deficiency may cause this type of lesion?
a) Riboflavin
b) Vit k
c) Zinc
d) Calcium
34) Which one of the following statements about the clinical significance of calculus is true?
a) The surface texture of subgingival calculus causes gingivitis
b) Lactobacillus microorganisms are essential for the formation of calculus
c) The correlation between dental biofilm & gingivitis is much stronger than the correlation between calculus & gingivitis
d) When calculus becomes embedded in the connective tissue it results in an inflammatory response
35) Mrs. Savage, 73 years old, presents for her 6-month continuing care appointment. She has moderate chronic perio, generalized gingival recession of 2 mm, & porcelain crowns on her maxillary teeth. The DH notes the presence of root caries on the maxillary premolars. What fluoride agent should the DH select for Mrs. Savage?
a) Acidulated phosphate fluoride gel
b) Sodium monofluorophosphate dentifrice
c) Stannous fluoride solution
d) Sodium fluoride varnish
36) Amy, 7 years old, presents for her continuing care appt. the first permanent molars are fully erupted. The enamel is partially or completely missing throughout, w/ yellowish-brown intrinsic staining. Amy most likely has which one of the following conditions?
a) Systemic hypoplasia
b) Dental fluorosis
c) Amelogenesis imperfecta
d) Erythroblastosis fetalis
37) Shamir, 17 years old, has uncontrolled type 1 diabetes. In spite of good oral self care, shamir is at increased risk for dental caries. What is the best explanation for this conclusion?
a) A wide fluctuation in blood glucose levels
b) A high carb diet to control hypoglycemia
c) A reduction in phagocytic activity due to hyperglycemia
d) A reduction in salivary flow due to fluid loss
38) A community DH has provided oral health education in local high school for 6 months. The primary objective of the program was to improve the level of dental health knowledge in the student population. What outcome measure would be best suited to determine if the interventions were successful?
a) Assess the oral hygiene status of participating students
b) Administer a post-test survey to the students
c) Gather information about program attendance
d) Follow up w/ the students’ parents regarding home practices
39) Which one of the following conditions always appears in the mouth as a band of white keratotic tissue along the buccal mucosa, parallel to the occlusal plane?
a) Frictional keratosis
b) Lichen planus
c) Leaukoplakia
d) Linea alba
40) What feature is characterized by small, raised, soft, yellow papules located bilaterally on the buccal mucosa?
a) Fordyce’s granules
b) Koplik’s spots
c) Lichen planus
41) Mr. Roznowski, 33 years old, has multiple sclerosis. He is now living w/ his mother & is unhappy w/ his loss of autonomy. How should the DH proceed?
a) Assist only w/ his DH needs
b) Contact a social worker on Mr. Roznowski’s behalf
c) Provide info regarding resource agencies
d) Consult w/ Mr. Roznowski’s mother
42) Residents of a facility for older adults identify a need for more preventative oral care services. The DH confirms this need. During the program planning stage, which one of the following issues should the DH address?
a) Resources required for implementation
b) Calibration of examiners for needs assessment
c) Type of dental indices to use
d) Satisfaction w/ oral care services
43) The DH administers LA for perio debridement in sextant 1. The needle tip is inserted & advanced to the correct depth & location. Which one of the following steps must be performed to ensure proper aspiration?
a) Slowly w/draw the needle tip while aspirating
b) Slowly advance the needle tip while aspirating
c) Aspirate twice w/out moving the needle tip during aspiration
d) Aspirate twice, rotating the bevel after the first aspiration
44) Patricia, 17 years old, expresses concern about her “bad breath”. Her toothbrushing & flossing techniques are adequate. What should the DH recommend?
a) Tongue cleaning
b) Referral to a dietitian
c) Antiseptic mouthrinse
d) Salivary assessment
45) A DH is asked to assess safety & emergency preparedness in the practice environment. What must be readily accessible?
a) A medical stretcher
b) A portable source of oxygen
c) A copy of the Compendium of Pharmaceuticals & Specialties (CPS)
d) A clearly posted route to the nearest hospital
46) A client has been diagnosed w/ localized slight chronic perio. What radiographic findings should the DH expect to observe?
a) Fuzziness in the interdental crest region
b) Radiolucency in the interradicular area
c) Presence of a vertical bone defect
d) Widened perio ligament space at the apex
47) According to G.V. black classification, what type of carious lesion is present on tooth 13?
a) Class II
b) Class III
c) Class IV
d) Class V
48) The DH will be using air polishing to remove stains from a client’s teeth. Which one of the following statements correctly describes the technique?
a) Position the nozzle tip near the cervical third of the tooth
b) Direct the powder spray at the gingival margin
c) Direct the powder spray on the tooth for 4-5 continuous seconds
d) Position the nozzle tip 3-5 mm from the tooth
49) Todd, 18 years old, presents to his continuing care appt w./ fractures of the lingual surfaces of teeth 41-31. What most likely caused these fractures?
a) A parafunctional habit
b) Bulimia nervosa
c) A tongue barbell
d) Pencil chewing
50) Mrs. Peters, 67 years old, has a recent history of leukemia. She is scheduled for a continuing care appt. the DH updates her HH. She confirms that she is presently in remission. Which one of the following actions should the DH take next?
a) Document the changes in the client’s health history and initiate DH therapy
b) Consult w/ the client’s physician regarding her hematologic status prior to DH therapy
c) Confer w/ the dentist & send the client for a hematologic eval prior to DH therapy
d) Confirm w/ the client that prophylactic antibiotics have been taken & initiate DH therapy
51) A DH is motivated to ensure continuing competence. Which one of the following strategies would best serve this purpose?
a) Consulting w/ colleagues frequently
b) Presenting a professional manner w/ clients
c) Reviewing DH journals regularly
d) Participating in health promotion activities
52) A client’s diet is contributing to her increased incidence of dental caries. What represents the greatest dental caries risk for this client?
a) Triglycerols
b) Disaccharides
c) Cellulose
d) Xylitol
53) Based on the following radiograph, what is the best interpretation of the radiopacity on the apical third of the mesial root of tooth 36?
a) Radiographic artifact
b) Enamel pearl
c) Residual gutta percha
d) Retrograde restoration
54) What clinical finding indicates the presence of infection in the periodontium?
a) Radiographic crestal bone loss
b) Perio probing depths
c) Clinical attachment loss
d) Bleeding on probing
55) Mr. Barrett, 49 years old, arrives late for his perio debridement appt as he is “very busy at work”. His HH indicates he is still smoking 25 cigarettes per day & he continues to take his antihypertensive medication. His breathing appears labored. What should the DH do initially?
a) Accommodate Mr. Barrett’s time constraints & shorten the appt
b) Consult Mr. Barrett’s physician about the medication
c) Obtain Mr. Barrett’s pulse, respiration, & BP readings
d) Schedule another appt when Mr. Barrett is feeling better
56) Leonard, 8 years old, attends his continuing care appt. his mother reports that the swelling of his upper lip & the loss of tooth 21 was due to bicycle injury. During the course of the appt, the DH observes that leonard has multiple circular bruising on both arms and the back of his neck. What should the DH do next?
a) Document the findings and see if leonard appears w/ similar lesions at the next session
b) Arrange to speak w/ leonard’s school principal to discuss the concerns
c) Speak to the dentist to determine office protocols for this situation
d) Document the findings and file a report w/ the local child protection agency
57) What oral self-care strategy should be recommended in the recorvery phase of the oral candidiasis?
a) Rinse w/ warm salt water
b) Avoid the use of sodium lauryl sulfate
c) Replace the currently used toothbrush
d) Rinse w/ chlorhexidine
58) A panoramic radiograph taken on David, 14 years old, reveals teeth 14 & 24 are morphologically complete but unerupted. What is the most probable cause?
a) Congenitally missing teeth
b) Retained first primary molars
c) Impacted canines
d) Normal eruption
59) What specific oral side effect is associated w/ most calcium channel blockers & most anticonvulsants?
a) Xerostomia
b) Gingival atrophy
c) Tissue sloughing
d) Gingival overgrowth
60) Under what condition is a topical fluoride application most beneficial?
a) When it is applied as an aqueous solution
b) When application follows pit & fissure sealant application
c) When it is applied to demineralized dental enamel
d) When application follow restorative procedures
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