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ABPD Pediatric Dentistry study materials
ABPD Pediatric Dentistry study resources

ABPD Pediatric Dentistry practice questions

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Question 1Clinical Pediatric Dentistry

At what age does the primary dentition typically begin to erupt?

  1. 4 to 6 months
  2. 10 to 14 months
  3. 14 to 18 months
  4. 6 to 10 months Correct answer.

Explanation

The first primary tooth, usually the mandibular central incisor, erupts between 6 and 10 months of age. Eruption before 4 months or after 12 months is considered outside the typical range.

Question 2Clinical Pediatric Dentistry

Which primary tooth is most commonly retained beyond its expected exfoliation time?

  1. Maxillary primary canine
  2. Mandibular primary central incisor
  3. Mandibular primary second molar Correct answer.
  4. Maxillary primary central incisor

Explanation

The mandibular primary second molar is the most frequently retained primary tooth, often due to ankylosis or absence of its permanent successor. Retention of other primary teeth is less common.

Question 3Clinical Pediatric Dentistry

A 4-year-old child presents with a carious lesion on the smooth surface of a primary maxillary central incisor. Which restorative material is most appropriate for this anterior primary tooth?

  1. Glass ionomer
  2. Amalgam
  3. Composite resin Correct answer.
  4. Stainless steel crown

Explanation

Composite resin is preferred for anterior primary teeth because it provides acceptable esthetics and bonds to enamel. Amalgam is not used in anterior teeth, stainless steel crowns are for posterior teeth, and glass ionomer is less durable for Class III lesions.

Question 4Clinical Pediatric Dentistry

Which of the following is the primary mechanism of action of fluoride in caries prevention?

  1. Enhancement of enamel remineralization Correct answer.
  2. Inhibition of bacterial adhesion
  3. Increase in plaque pH
  4. Reduction of salivary flow

Explanation

Fluoride promotes remineralization of early carious lesions and forms fluorapatite, which is more acid-resistant. It also inhibits demineralization, but its main caricstatic effect is through remineralization.

Question 5Clinical Pediatric Dentistry

A 6-year-old child has a newly erupted permanent first molar with deep pits and fissures. Which preventive treatment is most indicated?

  1. Pit and fissure sealant Correct answer.
  2. Silver diamine fluoride
  3. Prophylactic amalgam
  4. Topical fluoride varnish

Explanation

Pit and fissure sealants are indicated for deep, retentive fissures on newly erupted permanent molars to prevent caries. Fluoride varnish is adjunctive, silver diamine fluoride is for arresting caries, and prophylactic amalgam is not recommended.

Question 6Clinical Pediatric Dentistry

What is the recommended concentration of fluoride in toothpaste for a child under 3 years of age?

  1. 1450 ppm
  2. 500 ppm
  3. 5000 ppm
  4. 1000 ppm Correct answer.

Explanation

For children under 3, a smear of toothpaste with 1000 ppm fluoride is recommended. Higher concentrations are for older children or high-risk cases, and 500 ppm is insufficient for caries prevention.

Question 7Clinical Pediatric Dentistry

Which of the following is a common side effect of silver diamine fluoride (SDF) application?

  1. Tooth whitening
  2. Black staining of carious lesions Correct answer.
  3. Gingival hyperplasia
  4. Enamel hypoplasia

Explanation

SDF causes black staining of arrested carious lesions due to silver ion deposition. It does not whiten teeth, cause enamel hypoplasia, or gingival hyperplasia.

Question 8Clinical Pediatric Dentistry

A 7-year-old child presents with a permanent maxillary central incisor that is avulsed. The tooth has been out of the socket for 30 minutes and is stored in milk. What is the most appropriate immediate management?

  1. Reimplant the tooth and splint it Correct answer.
  2. Prescribe antibiotics and analgesics
  3. Clean the socket and wait for healing
  4. Place the tooth in saline and refer

Explanation

Avulsed permanent teeth should be reimplanted as soon as possible, especially if stored in a physiologic medium like milk. Splinting is then performed to stabilize the tooth.

Question 9Clinical Pediatric Dentistry

Which of the following is the most common type of malocclusion in the primary dentition?

  1. Class II
  2. Class III
  3. Open bite
  4. Class I Correct answer.

Explanation

Class I occlusion is the most common in the primary dentition, characterized by normal anteroposterior relationships. Class II and III are less frequent, and open bite is not a main classification.

Question 10Clinical Pediatric Dentistry

A 5-year-old child has a habit of digit sucking. Which of the following is the most appropriate first-line management?

  1. Palatal crib appliance
  2. Orthodontic headgear
  3. Extraction of primary incisors
  4. Positive reinforcement and reminder therapy Correct answer.

Explanation

First-line management for digit sucking is behavioral, using positive reinforcement and reminder therapy. Appliances are considered if behavioral methods fail, and extraction or headgear are inappropriate.

Question 11Clinical Pediatric Dentistry

What is the primary purpose of a space maintainer in the primary dentition?

  1. To improve esthetics
  2. To preserve arch length after premature loss of a primary tooth Correct answer.
  3. To correct malocclusion
  4. To guide permanent tooth eruption

Explanation

Space maintainers preserve arch length and prevent space loss after premature loss of primary teeth. They do not actively correct malocclusion or guide eruption; they maintain the existing space.

Question 12Clinical Pediatric Dentistry

Which of the following is the most appropriate behavior guidance technique for a 3-year-old child during a dental examination?

  1. Physical restraint
  2. Voice control
  3. General anesthesia
  4. Tell-show-do Correct answer.

Explanation

Tell-show-do is a basic behavior guidance technique that reduces anxiety by explaining and demonstrating procedures. Voice control and restraint are used for more challenging behaviors, and general anesthesia is a last resort.

Question 13Clinical Pediatric Dentistry

A 4-year-old child has early childhood caries (ECC). Which of the following is a primary risk factor for ECC?

  1. Frequent consumption of sugary snacks Correct answer.
  2. Regular dental check-ups
  3. Breastfeeding on demand
  4. Use of fluoride toothpaste

Explanation

Frequent consumption of sugary snacks and drinks is a major risk factor for ECC due to prolonged acid exposure. Fluoride toothpaste and regular check-ups are protective, and breastfeeding on demand is not a primary risk factor when oral hygiene is maintained.

Question 14Clinical Pediatric Dentistry

Which of the following is the most common cause of pulp necrosis in primary teeth?

  1. Dental caries Correct answer.
  2. Developmental anomalies
  3. Trauma
  4. Periodontal disease

Explanation

Dental caries is the most common cause of pulp necrosis in primary teeth, often progressing to pulpitis and necrosis if untreated. Trauma is also a cause but less common overall.

Question 15Clinical Pediatric Dentistry

A 6-year-old child requires a pulpotomy on a primary mandibular second molar. Which medicament is most commonly used for pulpotomy in primary teeth?

  1. Mineral trioxide aggregate
  2. Formocresol Correct answer.
  3. Calcium hydroxide
  4. Ferric sulfate

Explanation

Formocresol has been the most commonly used medicament for pulpotomy in primary teeth, although alternatives like ferric sulfate and MTA are also used. Calcium hydroxide is less effective for pulpotomy.

Question 16Clinical Pediatric Dentistry

Which of the following is the recommended treatment for a primary tooth with a carious pulp exposure and no signs of radicular pathology?

  1. Pulpotomy Correct answer.
  2. Pulpectomy
  3. Indirect pulp cap
  4. Extraction

Explanation

A pulpotomy is indicated for a vital primary tooth with coronal pulp exposure and no radicular involvement. Extraction or pulpectomy are for non-vital teeth or those with radicular pathology.

Question 17Clinical Pediatric Dentistry

What is the most common developmental anomaly of the primary dentition?

  1. Dens invaginatus
  2. Fusion
  3. Enamel hypoplasia Correct answer.
  4. Gemination

Explanation

Enamel hypoplasia is the most common developmental anomaly in primary teeth, often due to systemic or local factors. Fusion and gemination are less common, and dens invaginatus is rare.

Question 18Clinical Pediatric Dentistry

A 10-year-old child presents with a permanent maxillary central incisor that is discolored and non-vital after trauma. Which treatment is most appropriate?

  1. Extraction and implant
  2. Observation
  3. Pulpotomy
  4. Root canal treatment Correct answer.

Explanation

Root canal treatment is indicated for a non-vital permanent tooth with a closed apex to prevent infection and preserve the tooth. Extraction and implant are not first-line for a restorable tooth, and pulpotomy is for vital teeth.

Question 19Clinical Pediatric Dentistry

Which of the following is a characteristic of the primary dentition that affects restorative treatment?

  1. Thicker enamel
  2. Longer crowns
  3. Larger pulp chambers Correct answer.
  4. Less permeable dentin

Explanation

Primary teeth have larger pulp chambers relative to crown size and thinner enamel, which increases the risk of pulp exposure during preparation. They also have more permeable dentin.

Question 20Clinical Pediatric Dentistry

A 3-year-old child has a habit of grinding his teeth during sleep. Which of the following is the most likely diagnosis?

  1. Erosion
  2. Abrasion
  3. Attrition
  4. Bruxism Correct answer.

Explanation

Bruxism is the habitual grinding of teeth, often during sleep, and is common in young children. Attrition is the resulting wear, while abrasion and erosion are caused by external factors.

Question 21Clinical Pediatric Dentistry

Which of the following is the most appropriate antibiotic prophylaxis regimen for a child with a history of infective endocarditis undergoing dental extraction?

  1. No prophylaxis needed
  2. Clindamycin 20 mg/kg orally 1 hour before
  3. Amoxicillin 50 mg/kg orally 1 hour before Correct answer.
  4. Amoxicillin 2 g orally 1 hour before

Explanation

The standard regimen for children is amoxicillin 50 mg/kg orally 1 hour before the procedure. Clindamycin is no longer recommended due to adverse effects, and prophylaxis is indicated for high-risk cardiac conditions.

Question 22Clinical Pediatric Dentistry

A 12-year-old child has a permanent mandibular first molar with a large carious lesion and irreversible pulpitis. The apex is fully formed. Which treatment is indicated?

  1. Extraction
  2. Pulpotomy
  3. Indirect pulp cap
  4. Root canal treatment Correct answer.

Explanation

Root canal treatment is indicated for a permanent tooth with irreversible pulpitis and a closed apex. Pulpotomy is for vital teeth with reversible pulpitis, and extraction is a last resort.

Question 23Clinical Pediatric Dentistry

Which of the following is a common finding in a child with Down syndrome that affects dental treatment?

  1. Enamel hyperplasia
  2. Macroglossia Correct answer.
  3. Delayed tooth eruption
  4. Microglossia

Explanation

Macroglossia (large tongue) is common in Down syndrome and can cause airway and orthodontic issues. Delayed eruption is also seen but macroglossia is a hallmark.

Question 24Clinical Pediatric Dentistry

A 5-year-old child has a retained primary maxillary central incisor and a permanent successor erupting palatally. What is the most appropriate management?

  1. Observe for 6 months
  2. Refer for orthodontic evaluation
  3. Extract the primary incisor Correct answer.
  4. Apply a space maintainer

Explanation

When a permanent tooth is erupting and the primary tooth is retained, extraction of the primary tooth is indicated to allow the permanent tooth to erupt into position. Orthodontic evaluation may follow if alignment issues persist.

Question 25Clinical Pediatric Dentistry

A 7-year-old child presents with a permanent maxillary central incisor that is intruded after trauma. The tooth is fully formed. What is the recommended treatment?

  1. Allow spontaneous re-eruption
  2. Reposition and splint Correct answer.
  3. Perform pulpotomy
  4. Extract the tooth

Explanation

Intruded permanent teeth with closed apices should be repositioned orthodontically or surgically and splinted. Spontaneous re-eruption is only expected in immature teeth with open apices.

Question 26Clinical Pediatric Dentistry

At what age does the primary mandibular central incisor typically erupt?

  1. 20 to 24 months
  2. 6 to 10 months Correct answer.
  3. 16 to 20 months
  4. 12 to 16 months

Explanation

The primary mandibular central incisors are usually the first teeth to erupt, appearing between 6 and 10 months of age. Eruption times vary, but this range is widely accepted.

Question 27Clinical Pediatric Dentistry

Which of the following is the most appropriate first-line behavior guidance technique for a 4-year-old child who is anxious but cooperative?

  1. Tell-show-do Correct answer.
  2. Protective stabilization
  3. General anesthesia
  4. Oral sedation

Explanation

Tell-show-do is a basic, non-invasive behavior guidance technique that reduces anxiety by explaining and demonstrating procedures before performing them. It is first-line for cooperative but anxious children.

Question 28Clinical Pediatric Dentistry

Which primary tooth is most commonly affected by nursing bottle caries (early childhood caries) first?

  1. Mandibular first molars
  2. Maxillary central incisors Correct answer.
  3. Maxillary second molars
  4. Mandibular central incisors

Explanation

Early childhood caries typically begins on the maxillary primary incisors because they erupt first and are bathed in pooled milk or juice during sleep. Mandibular incisors are often spared due to tongue protection and salivary flow.

Question 29Clinical Pediatric Dentistry

What is the recommended fluoride varnish application frequency for a child at high caries risk?

  1. Once per year
  2. Every 2 years
  3. Every 3 to 6 months Correct answer.
  4. Only when caries is detected

Explanation

For children at high caries risk, professional fluoride varnish application is recommended at 3- to 6-month intervals to maximize caries prevention. Lower-risk children may receive it less frequently.

Question 30Clinical Pediatric Dentistry

Which of the following is the most common oral manifestation of vitamin C deficiency in children?

  1. Enamel hypoplasia
  2. Dental fluorosis
  3. Gingival bleeding and inflammation Correct answer.
  4. Delayed tooth eruption

Explanation

Vitamin C is essential for collagen synthesis, and deficiency (scurvy) leads to gingival bleeding, swelling, and inflammation. Enamel hypoplasia and delayed eruption are not typical features.

Question 31Clinical Pediatric Dentistry

Which of the following is the most appropriate treatment for a primary tooth with a carious lesion that is confined to enamel and does not involve dentin?

  1. Stainless steel crown
  2. Pulpotomy
  3. Extraction
  4. Topical fluoride application and monitoring Correct answer.

Explanation

Non-cavitated enamel caries can often be managed with topical fluoride and surveillance to promote remineralization. Restorative or surgical treatment is indicated when dentin is involved.

Question 32Clinical Pediatric Dentistry

What is the typical age range for eruption of the permanent mandibular first molar?

  1. 6 to 7 years Correct answer.
  2. 9 to 10 years
  3. 13 to 14 years
  4. 11 to 12 years

Explanation

The permanent mandibular first molar typically erupts around 6 to 7 years of age, often before the primary teeth are lost. It is the first permanent tooth to erupt.

Question 33Clinical Pediatric Dentistry

Which of the following is the most common type of traumatic dental injury in the primary dentition?

  1. Avulsion
  2. Root fracture
  3. Luxation Correct answer.
  4. Enamel fracture

Explanation

Luxation injuries (subluxation, concussion, intrusive, extrusive) are the most common dental trauma in primary teeth due to the resilient alveolar bone. Fractures and avulsion are less frequent.

Question 34Clinical Pediatric Dentistry

A 6-year-old child presents with a permanent maxillary central incisor that is mobile and discolored after a fall 2 weeks ago. Radiographs show a root fracture in the middle third with no displacement. What is the most appropriate management?

  1. Extract the tooth immediately
  2. Perform root canal therapy
  3. Observe without intervention
  4. Reposition and stabilize with a flexible splint Correct answer.

Explanation

Middle-third root fractures with minimal displacement are best managed by repositioning (if needed) and stabilization with a flexible splint to allow healing. Root canal therapy is indicated only if the pulp becomes necrotic.

Question 35Clinical Pediatric Dentistry

Which of the following is the most appropriate space maintainer for a prematurely lost primary mandibular second molar before the eruption of the permanent first molar?

  1. Transpalatal arch
  2. Band and loop Correct answer.
  3. Lingual arch
  4. Nance appliance

Explanation

A band and loop is a unilateral space maintainer used when a single primary molar is lost and the adjacent teeth are present. It preserves space until the permanent successor erupts.

Question 36Clinical Pediatric Dentistry

Which of the following is the most common cause of early childhood caries?

  1. Delayed tooth eruption
  2. Frequent consumption of sugary liquids from a bottle Correct answer.
  3. Genetic predisposition
  4. Insufficient fluoride in water

Explanation

Early childhood caries is primarily caused by frequent and prolonged exposure to fermentable carbohydrates, often from sugary drinks in a bottle, especially at bedtime. Other factors may contribute but are not the primary cause.

Question 37Clinical Pediatric Dentistry

A 9-year-old child has a permanent maxillary first molar with a deep carious lesion and signs of irreversible pulpitis. The apex is fully formed. What is the most appropriate treatment?

  1. Indirect pulp cap
  2. Extraction
  3. Pulpotomy
  4. Root canal therapy Correct answer.

Explanation

Irreversible pulpitis in a permanent tooth with a fully formed apex requires root canal therapy to remove infected pulp and preserve the tooth. Pulpotomy is typically for primary teeth or immature permanent teeth.

Question 38Clinical Pediatric Dentistry

A 4-year-old child has a retained primary maxillary central incisor with the permanent successor erupting palatally. What is the most appropriate management?

  1. Observe for 6 months
  2. Refer for orthodontic evaluation
  3. Extract the primary tooth Correct answer.
  4. Apply a space maintainer

Explanation

When a permanent successor is erupting palatally and the primary tooth is retained, extraction of the primary tooth is indicated to allow the permanent tooth to move into position. Orthodontic evaluation may follow if alignment issues persist.

Question 39Clinical Pediatric Dentistry

Which of the following is a characteristic radiographic feature of a dentigerous cyst?

  1. Well-defined radiolucency around the crown of an unerupted tooth Correct answer.
  2. Diffuse radiolucency at the apex of a necrotic tooth
  3. Ground-glass opacity
  4. Sunburst appearance

Explanation

A dentigerous cyst appears as a well-circumscribed radiolucency surrounding the crown of an unerupted tooth, often attached at the cementoenamel junction. Other options describe different pathologies.

Question 40Clinical Pediatric Dentistry

A 7-year-old child presents with a permanent maxillary central incisor that is intruded after trauma. The tooth is fully erupted and the apex is closed. What is the most appropriate initial management?

  1. Perform immediate root canal therapy
  2. Allow spontaneous re-eruption and monitor Correct answer.
  3. Extract the tooth
  4. Reposition immediately with forceps

Explanation

For intruded permanent teeth with closed apices, spontaneous re-eruption may occur, but if not, orthodontic or surgical repositioning is considered. Immediate extraction or root canal is not indicated.

Question 41Clinical Pediatric Dentistry

Which of the following is the most common developmental anomaly of the primary dentition?

  1. Double teeth (fusion or gemination) Correct answer.
  2. Enamel hypoplasia
  3. Supernumerary teeth
  4. Dens invaginatus

Explanation

Double teeth, resulting from fusion or gemination, are the most common developmental anomaly in primary teeth. They often appear as a single large tooth or joined teeth.

Question 42Clinical Pediatric Dentistry

A 10-year-old child is diagnosed with amelogenesis imperfecta. Which of the following is the most appropriate initial restorative approach?

  1. Amalgam restorations
  2. Glass ionomer sealants
  3. Composite veneers
  4. Full-coverage crowns Correct answer.

Explanation

In severe amelogenesis imperfecta, full-coverage crowns protect the teeth and improve esthetics and function. Less extensive restorations may be used in milder cases.

Question 43Clinical Pediatric Dentistry

Which of the following is the most appropriate treatment for a primary tooth with a carious pulp exposure and no signs of radicular pathology?

  1. Extraction
  2. Pulpotomy Correct answer.
  3. Indirect pulp cap
  4. Pulpectomy

Explanation

A pulpotomy is indicated for a primary tooth with a carious pulp exposure and no signs of irreversible pulpitis or radicular pathology. It preserves the radicular pulp.

Question 44Clinical Pediatric Dentistry

Which of the following is the most common finding in a child with Down syndrome that affects dental treatment?

  1. Macroglossia
  2. Hypotonia and delayed eruption Correct answer.
  3. Microdontia
  4. Enamel hypoplasia

Explanation

Children with Down syndrome often have hypotonia, which can affect cooperation and oral motor function, and delayed eruption. Other findings like macroglossia and microdontia can occur but are less consistent.

Question 45Clinical Pediatric Dentistry

A 5-year-old child presents with a primary mandibular second molar that has a large carious lesion with pulpal involvement and a radiolucency in the furcation area. What is the most appropriate treatment?

  1. Extraction Correct answer.
  2. Pulpotomy
  3. Stainless steel crown
  4. Pulpectomy

Explanation

Furcation radiolucency indicates radicular pulp involvement or necrosis, making the tooth non-restorable with pulpotomy; extraction is indicated. Pulpectomy may be considered if the tooth is restorable and space maintenance is needed, but furcation involvement often precludes it.

Question 46Clinical Pediatric Dentistry

Which of the following is the most appropriate technique for administering inferior alveolar nerve block in a child?

  1. Use a short needle and deposit solution slowly Correct answer.
  2. Use a 30-gauge needle and aspirate
  3. Use a 25-gauge needle without aspiration
  4. Use a long needle and deposit rapidly

Explanation

For children, a short needle is often sufficient, and slow deposition reduces discomfort and risk of complications. Aspiration is recommended to avoid intravascular injection.

Question 47Clinical Pediatric Dentistry

A 12-year-old child has a permanent mandibular first molar with a large carious lesion and irreversible pulpitis. The apex is fully formed. What is the most appropriate treatment?

  1. Pulpotomy
  2. Root canal therapy Correct answer.
  3. Extraction
  4. Indirect pulp cap

Explanation

Irreversible pulpitis in a mature permanent tooth requires root canal therapy to remove infected pulp and retain the tooth. Pulpotomy is not indicated for irreversible pulpitis in mature teeth.

Question 48Clinical Pediatric Dentistry

A 9-year-old child presents with a permanent maxillary central incisor that is discolored and non-vital after trauma. The apex is open. What is the most appropriate treatment?

  1. Root canal therapy
  2. Revascularization
  3. Apexification Correct answer.
  4. Extraction

Explanation

Apexification is indicated for a non-vital immature permanent tooth with an open apex to induce a calcific barrier before root canal therapy. Revascularization may be considered in selected cases but apexification is a standard approach.

Question 49Clinical Pediatric Dentistry

Which of the following is the most appropriate management for a child with a suspected allergy to latex during dental treatment?

  1. Use latex gloves but avoid powder
  2. Premedicate with antihistamine
  3. Use latex-free gloves and equipment Correct answer.
  4. Perform treatment in a hospital setting

Explanation

For latex allergy, the primary management is avoidance of latex-containing products, including gloves, dams, and other equipment. Premedication is not standard for latex allergy.

Question 50Clinical Pediatric Dentistry

A 3-year-old child has a habit of sucking the thumb vigorously throughout the day. Which of the following is the most likely dental effect if the habit persists beyond 4 years of age?

  1. Deep bite with mandibular incisor retroclination
  2. Unilateral posterior open bite on the preferred side
  3. Posterior crossbite with mandibular constriction
  4. Anterior open bite with maxillary incisor protrusion Correct answer.

Explanation

Prolonged digit sucking places pressure on the maxillary incisors lingually and the mandibular incisors labially, producing an anterior open bite and flared maxillary incisors. The habit also tends to constrict the maxillary arch, but the classic anterior open bite is the hallmark finding.