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ADC Written (Dental Therapy) study materials
ADC Written (Dental Therapy) study resources

ADC Written (Dental Therapy) practice questions

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Question 1Dental Therapy (professional practice, assessment and treatment within scope)

Which tooth surface faces the tongue in the mandibular posterior region?

  1. Mesial
  2. Occlusal
  3. Buccal
  4. Lingual Correct answer.

Explanation

The lingual surface is the aspect of a tooth that faces the tongue, which in the lower arch lies toward the inside of the dental curve. In mandibular posterior teeth this surface is often termed lingual rather than palatal. Buccal faces the cheek, mesial faces the midline, and occlusal is the chewing surface.

Question 2Dental Therapy (professional practice, assessment and treatment within scope)

Which instrument is most appropriate for removing supragingival calculus from a tooth surface during a scaling appointment?

  1. Explorer
  2. Periodontal probe
  3. Periodontal curette
  4. Sickle scaler Correct answer.

Explanation

Sickle scalers have a pointed tip and a triangular cross-section designed for heavy supragingival calculus removal. Curettes are finer and intended for subgingival debridement and root planing, while explorers and probes are assessment instruments only. Using the correct instrument class protects the gingival attachment and improves efficiency.

Question 3Dental Therapy (professional practice, assessment and treatment within scope)

What is the primary purpose of taking bitewing radiographs?

  1. To evaluate the temporomandibular joint
  2. To assess root morphology of third molars
  3. To measure the angulation of impacted canines
  4. To detect interproximal caries and alveolar bone levels Correct answer.

Explanation

Bitewing radiographs show the crowns of upper and lower posterior teeth together with the crestal bone, making them ideal for detecting interproximal caries and monitoring bone height. They are not designed to show root apices or the TMJ. Periapical or panoramic views are used when those structures must be assessed.

Question 4Dental Therapy (professional practice, assessment and treatment within scope)

A patient reports a dull ache in the lower right molar region that worsens with cold drinks and lasts several seconds after the stimulus is removed. Which pulpal diagnosis is most consistent with this presentation?

  1. Reversible pulpitis Correct answer.
  2. Irreversible pulpitis
  3. Normal pulp
  4. Pulpal necrosis

Explanation

Reversible pulpitis produces a provoked, sharp or dull discomfort that resolves promptly once the stimulus is removed, and the pulp remains vital and capable of healing. Pain that lingers well after the cold is removed, or occurs spontaneously, suggests irreversible pulpitis. Necrotic pulps typically do not respond to thermal testing.

Question 5Dental Therapy (professional practice, assessment and treatment within scope)

Which local anaesthetic agent is contraindicated in a patient with a documented true allergy to ester-type anaesthetics?

  1. Prilocaine
  2. Lidocaine
  3. Articaine
  4. Benzocaine Correct answer.

Explanation

Benzocaine is an ester-type local anaesthetic, so a genuine ester allergy makes it unsuitable for topical use. Lidocaine, articaine and prilocaine are all amide agents and are structurally unrelated to esters. Cross-reactivity between esters and amides is not expected.

Question 6Dental Therapy (professional practice, assessment and treatment within scope)

Which finding best indicates that a patient's oral hygiene is well controlled before periodontal therapy is reviewed?

  1. Generalised bleeding on probing
  2. Reduced plaque scores and minimal gingival bleeding Correct answer.
  3. Presence of supragingival calculus only
  4. Increased pocket depths since the last visit

Explanation

Low plaque scores combined with minimal bleeding on probing indicate that the patient is effectively removing biofilm and that gingival inflammation is resolving. Bleeding on probing, calculus deposits and increasing pocket depths all signal ongoing disease or inadequate plaque control. These measures guide the interval before further active therapy.

Question 7Dental Therapy (professional practice, assessment and treatment within scope)

Which fluoride concentration is typical of a standard over-the-counter adult fluoride toothpaste in many markets?

  1. 50 to 100 ppm
  2. 5,000 ppm
  3. 1,000 to 1,500 ppm Correct answer.
  4. 22,600 ppm

Explanation

Most over-the-counter adult fluoride toothpastes contain between about 1,000 and 1,500 ppm fluoride, usually as sodium fluoride or sodium monofluorophosphate. Products at 5,000 ppm are prescription high-fluoride pastes, and 22,600 ppm describes professional varnish. Very low concentrations such as 50 to 100 ppm are used in infant products in some regions.

Question 8Dental Therapy (professional practice, assessment and treatment within scope)

What is the recommended first response when a patient becomes pale, sweaty and light-headed shortly after receiving an inferior alveolar nerve block?

  1. Position the patient supine with legs elevated and monitor Correct answer.
  2. Place the patient upright and give a hot drink
  3. Administer intramuscular adrenaline immediately
  4. Continue the procedure without interruption

Explanation

These features suggest a vasovagal syncopal episode, so the priority is to lay the patient supine with the legs raised to improve cerebral perfusion while monitoring airway, breathing and circulation. Adrenaline is reserved for anaphylaxis, which presents differently. Continuing treatment while the patient is symptomatic risks injury.

Question 9Dental Therapy (professional practice, assessment and treatment within scope)

Which statutory body typically regulates the registration and professional conduct of dental therapists in the United Kingdom?

  1. Care Quality Commission
  2. General Dental Council Correct answer.
  3. National Health Service England
  4. British Dental Association

Explanation

The General Dental Council is the statutory regulator that maintains the register of dental professionals and sets standards of conduct and practice. The British Dental Association is a professional association and trade union, not a regulator. The Care Quality Commission regulates service providers, and NHS England commissions services.

Question 10Dental Therapy (professional practice, assessment and treatment within scope)

A dental therapist is asked to carry out a procedure that falls outside their agreed scope of practice. What is the most appropriate action?

  1. Proceed and record the procedure as delegated
  2. Ask the patient to sign a consent form first
  3. Proceed if a colleague has previously done the same procedure
  4. Decline and refer the matter to the supervising dentist Correct answer.

Explanation

Professionals must work within their scope of practice and the local delegation agreement, so an out-of-scope request should be declined and referred back to the dentist. Past practice by others or patient consent does not extend a clinician's competence or authorisation. Records must accurately reflect what was actually done.

Question 11Dental Therapy (professional practice, assessment and treatment within scope)

Which periodontal measurement is recorded to document the position of the gingival margin relative to the cementoenamel junction?

  1. Furcation grade
  2. Probing pocket depth
  3. Bleeding index
  4. Clinical attachment level Correct answer.

Explanation

Clinical attachment level is calculated from the probing depth and the position of the gingival margin relative to the cementoenamel junction, so it reflects historical attachment loss. Probing depth alone measures only the sulcus or pocket. Bleeding indices and furcation grades describe inflammation and root involvement rather than attachment position.

Question 12Dental Therapy (professional practice, assessment and treatment within scope)

Which dietary advice is most appropriate for a patient with active caries who frequently snacks on biscuits between meals?

  1. Replace biscuits with dried fruit eaten frequently
  2. Increase brushing to four times daily without changing diet
  3. Switch to sugary drinks consumed slowly throughout the day
  4. Reduce the frequency of sugar intake and confine it to mealtimes Correct answer.

Explanation

The frequency of sugar exposure is a key driver of caries, so reducing how often fermentable carbohydrate is eaten and limiting it to meals lowers acid attacks. Dried fruit and sipped sugary drinks prolong exposure. Brushing alone cannot offset repeated sugar challenges.

Question 13Dental Therapy (professional practice, assessment and treatment within scope)

Which tooth is most commonly affected by a dens invaginatus anomaly?

  1. Mandibular canine
  2. Maxillary central incisor
  3. Maxillary lateral incisor Correct answer.
  4. Mandibular first molar

Explanation

Dens invaginatus most often affects the maxillary lateral incisor, which may show an anomalous crown shape and is prone to early pulpal involvement. Mandibular molars and canines are rarely affected. The maxillary central incisor is not the typical site.

Question 14Dental Therapy (professional practice, assessment and treatment within scope)

A child presents with a retained primary molar and no visible successor on examination. Which action is most appropriate for a dental therapist?

  1. Reassure the parent and take no further action
  2. Extract the primary molar immediately
  3. Place a stainless steel crown on the primary molar
  4. Refer for radiographic assessment before deciding on management Correct answer.

Explanation

When a successor is not visible clinically, radiographs are needed to confirm whether the permanent tooth is present, ectopic or absent before any extraction decision. Extracting prematurely could compromise arch space if the successor is simply delayed. Reassurance without investigation risks missing pathology.

Question 15Dental Therapy (professional practice, assessment and treatment within scope)

Which principle of the Mental Capacity Act applies when an adult patient with a learning disability is unable to consent to treatment?

  1. Consent can be presumed from the patient's silence
  2. Treatment must always be refused
  3. Decisions must be made in the patient's best interests Correct answer.
  4. A relative must always sign the consent form

Explanation

When a patient lacks capacity for a specific decision, treatment should proceed only if it is in their best interests, following the statutory principles and considering less restrictive options. Capacity is decision-specific and must be assessed rather than assumed. Relatives do not automatically hold decision-making authority unless legally appointed.

Question 16Dental Therapy (professional practice, assessment and treatment within scope)

Which feature distinguishes a gingival pocket from a periodontal pocket?

  1. Periodontal pockets always occur without inflammation
  2. Gingival pockets show true attachment loss
  3. Gingival pockets are always deeper than six millimetres
  4. Gingival pockets arise from coronal migration of the gingival margin without attachment loss Correct answer.

Explanation

A gingival (pseudo) pocket is formed by enlargement or coronal movement of the gingival margin while the junctional epithelium remains at its original level, so there is no true attachment loss. A periodontal pocket involves apical migration of the attachment. Pocket depth alone cannot distinguish the two; the clinical attachment level is needed.

Question 17Dental Therapy (professional practice, assessment and treatment within scope)

Which radiograph is most suitable for assessing the position of an unerupted third molar in relation to the inferior dental canal?

  1. Panoramic radiograph Correct answer.
  2. Upper standard occlusal
  3. Bitewing
  4. Periapical of the upper incisors

Explanation

A panoramic radiograph provides a broad view of both jaws, allowing the relationship of an unerupted mandibular third molar to the inferior dental canal to be assessed. Bitewings exclude the apices, and upper occlusal and anterior periapical views do not show the mandibular canal. Further imaging such as cone beam CT may follow if the relationship is unclear.

Question 18Dental Therapy (professional practice, assessment and treatment within scope)

What is the main purpose of a fissure sealant?

  1. To reduce gingival inflammation
  2. To prevent caries in susceptible pits and fissures Correct answer.
  3. To whiten the enamel surface
  4. To restore lost tooth structure

Explanation

Fissure sealants create a physical barrier that stops plaque and fermentable carbohydrate from collecting in deep pits and fissures, preventing caries initiation. They are not restorative materials and do not treat gingivitis or alter tooth shade. Retention depends on adequate isolation and etching of the enamel.

Question 19Dental Therapy (professional practice, assessment and treatment within scope)

Which handpiece is designed to deliver a water spray to cool the tooth during cutting with a rotary bur?

  1. Curing light
  2. High-speed air turbine with water coolant Correct answer.
  3. Air motor without water
  4. Ultrasonic scaler

Explanation

High-speed air turbine handpieces incorporate water and air spray ports to cool the bur and tooth during cutting, limiting thermal damage to the pulp. Motors without water do not provide this cooling. Ultrasonic scalers remove deposits, and curing lights polymerise restorative material.

Question 20Dental Therapy (professional practice, assessment and treatment within scope)

A patient with a history of infective endocarditis is due to have a subgingival scaling. According to widely used guidance, which action is most appropriate?

  1. Prescribe antibiotics only after bleeding occurs
  2. No antibiotic prophylaxis is required for any patient
  3. Give antibiotics to every patient after scaling
  4. Consider antibiotic prophylaxis according to current national guidance Correct answer.

Explanation

Guidance on prophylaxis has changed over time and varies between countries, so the clinician should follow current national recommendations for high-risk cardiac patients undergoing procedures involving gingival manipulation. Universal prophylaxis is not supported, and giving antibiotics after bleeding begins is not a recognised preventive strategy. Local protocols should be checked.

Question 21Dental Therapy (professional practice, assessment and treatment within scope)

Which action best reduces the risk of cross-infection between patients in the dental surgery?

  1. Reusing disposable needles after wiping them
  2. Cleaning and disinfecting surfaces and changing gloves between patients Correct answer.
  3. Storing sterilised instruments in an open tray
  4. Wearing the same gloves for consecutive patients

Explanation

Effective infection control combines hand hygiene, fresh gloves for each patient, and cleaning and disinfection of contaminated surfaces. Reusing needles or gloves transmits bloodborne pathogens. Sterilised instruments must be stored in a way that maintains sterility until use.

Question 22Dental Therapy (professional practice, assessment and treatment within scope)

Which material is commonly used as a direct tooth-coloured restorative for a small occlusal cavity in a permanent molar?

  1. Zinc oxide eugenol
  2. Resin composite Correct answer.
  3. Amalgam
  4. Glass ionomer cement for all posterior cavities

Explanation

Resin composite is widely used for small to moderate occlusal cavities because it bonds to enamel and dentine and matches tooth colour. Amalgam is not tooth-coloured, zinc oxide eugenol is a temporary sedative material, and glass ionomer is generally reserved for specific situations such as high caries risk or primary teeth.

Question 23Dental Therapy (professional practice, assessment and treatment within scope)

What is the main rationale for using a rubber dam during endodontic or restorative treatment?

  1. To reduce the need for local anaesthesia
  2. To improve the taste of the materials used
  3. To isolate the operative field and protect the airway Correct answer.
  4. To speed up polymerisation of composite

Explanation

A rubber dam isolates the tooth from saliva and contaminants and protects the patient's airway from instruments and materials. It does not anaesthetise the tooth or alter the setting chemistry of composites. Its use is a recognised safety and quality standard in endodontics.

Question 24Dental Therapy (professional practice, assessment and treatment within scope)

A patient attends with generalised gingival enlargement and reports taking a calcium channel blocker. Which management step is most appropriate first?

  1. Extraction of all affected teeth
  2. Prescribing a course of antibiotics
  3. Liaison with the prescriber plus meticulous plaque control Correct answer.
  4. Immediate periodontal surgery

Explanation

Drug-influenced gingival enlargement often improves with excellent plaque control, and liaising with the prescriber allows consideration of an alternative medication. Surgery is reserved for persistent cases after plaque control is optimised. Antibiotics and extractions are not first-line management for this condition.

Question 25Dental Therapy (professional practice, assessment and treatment within scope)

Which factor most strongly increases a patient's caries risk when reviewing their medical history?

  1. Frequent intake of fermentable carbohydrates and reduced saliva flow Correct answer.
  2. Use of an electric toothbrush
  3. Attendance every six months
  4. Regular use of fluoride toothpaste

Explanation

Caries risk rises with frequent exposure to fermentable carbohydrate and with reduced salivary flow, which may follow medication, radiotherapy or certain systemic conditions. Fluoride use, regular attendance and effective brushing are protective rather than harmful. Risk assessment should combine dietary, salivary and behavioural factors.

Question 26Dental Therapy (professional practice, assessment and treatment within scope)

Which instrument is most appropriate for removing supragingival calculus from the buccal surfaces of the upper posterior teeth?

  1. A plastic composite instrument
  2. A sickle scaler Correct answer.
  3. A periodontal probe
  4. An ultrasonic scaler tip

Explanation

Sickle scalers have a pointed tip and a triangular cross-section designed for heavy supragingival calculus on crown surfaces, so they suit accessible buccal deposits on posterior teeth. They are not intended for subgingival use because their shape can traumatise the sulcus. Choosing an instrument matched to deposit location and tissue depth is a core scaling decision.

Question 27Dental Therapy (professional practice, assessment and treatment within scope)

What does a probing depth measurement of 3 mm with no bleeding and a stable clinical attachment level most likely represent?

  1. A healthy sulcus within normal limits Correct answer.
  2. A periodontal abscess
  3. Generalised aggressive periodontitis
  4. Gingival recession requiring grafting

Explanation

Probing depths of 1 to 3 mm with no bleeding on probing and no loss of attachment are consistent with a healthy gingival sulcus. Pocket depth alone does not diagnose disease; bleeding, attachment loss and radiographic bone level must be interpreted together. A single shallow reading without inflammation is therefore a normal finding.

Question 28Dental Therapy (professional practice, assessment and treatment within scope)

Which local anaesthetic property makes it suitable for a patient who needs a short procedure and must avoid prolonged soft tissue numbness?

  1. A short duration of action Correct answer.
  2. A vasoconstrictor that prolongs its action
  3. A low pH of the cartridge
  4. A high lipid solubility

Explanation

Duration of action determines how long anaesthesia and soft tissue numbness persist, so a short-acting agent limits the period of risk from biting trauma. Lipid solubility affects potency and onset rather than the total anaesthetic duration. Matching agent duration to procedure length is a standard prescribing decision in dental therapy.

Question 29Dental Therapy (professional practice, assessment and treatment within scope)

Which advice should be given to a patient immediately after a simple extraction regarding the socket?

  1. Sucking on the socket to remove the clot
  2. Avoiding rinsing, smoking and hot drinks for the first 24 hours Correct answer.
  3. Vigorous rinsing with chlorhexidine for the first day
  4. Returning to normal brushing over the socket the same evening

Explanation

The blood clot must be protected in the first day to support healing and reduce the risk of alveolar osteitis. Rinsing, smoking and hot fluids can dislodge the clot or encourage bleeding. Normal oral hygiene can resume gently after the initial period.

Question 30Dental Therapy (professional practice, assessment and treatment within scope)

What is the primary purpose of taking a bitewing radiograph in a patient at moderate caries risk?

  1. To detect approximal caries and monitor existing restorations Correct answer.
  2. To assess root morphology before endodontics
  3. To measure the angulation of impacted third molars
  4. To evaluate the temporomandibular joint

Explanation

Bitewing radiographs show the crowns of posterior teeth and are used to detect approximal caries and check the margins of restorations. They do not show the full root or surrounding structures needed for endodontic or surgical assessment. Selecting the correct view limits unnecessary radiation exposure.

Question 31Dental Therapy (professional practice, assessment and treatment within scope)

Which preventive measure is most appropriate for a child with a newly erupted permanent molar that has deep, sticky fissures?

  1. Prescription of a high-fluoride mouthrinse
  2. Immediate placement of an amalgam restoration
  3. Application of a resin fissure sealant Correct answer.
  4. Application of a fluoride varnish only

Explanation

A resin sealant physically occludes deep fissures that are difficult to clean, preventing bacteria and food from colonising the pit. It is indicated when the tooth is erupted enough for isolation and the fissure is retentive. Fluoride varnish supports remineralisation but does not block a deep anatomical fissure.

Question 32Dental Therapy (professional practice, assessment and treatment within scope)

Which record must be completed before a dental therapist begins a course of treatment for a new patient?

  1. A radiograph request form only
  2. A laboratory work authorisation
  3. A medical history and initial assessment record Correct answer.
  4. An anaesthetic chart only

Explanation

A documented medical history and clinical assessment underpin safe treatment planning, consent and any necessary precautions. Other records are completed only when the relevant procedure is planned. Comprehensive baseline records also protect both patient and clinician if questions arise later.

Question 33Dental Therapy (professional practice, assessment and treatment within scope)

Which action best protects a dental therapist's back during a long scaling appointment?

  1. Adjusting the chair and stool so the forearms are roughly parallel to the floor Correct answer.
  2. Twisting the trunk to reach the lingual surfaces
  3. Working with the patient positioned lower than the clinician's elbow
  4. Leaning forward to gain a closer view of the field

Explanation

Correct ergonomic positioning keeps the clinician's forearms near horizontal, the back supported and the feet flat, reducing sustained muscular load. Adjusting the patient chair and using indirect vision avoids awkward trunk twisting. Neutral posture throughout the appointment lowers the risk of work-related musculoskeletal injury.

Question 34Dental Therapy (professional practice, assessment and treatment within scope)

A patient reports taking warfarin and has an INR of 3.8 recorded within the last week. They need a simple extraction. What is the most appropriate action?

  1. Defer and liaise with the patient's anticoagulation team before proceeding Correct answer.
  2. Proceed with the extraction without further checks
  3. Stop the patient's warfarin for three days and then extract
  4. Double the local anaesthetic dose and proceed

Explanation

An INR above the usual therapeutic range raises bleeding risk, so planned surgery should be discussed with the clinician managing the anticoagulant before proceeding. Warfarin must never be stopped by the dental team without that liaison. Local measures and timing can then be planned safely.

Question 35Dental Therapy (professional practice, assessment and treatment within scope)

Which finding during a routine soft tissue examination should prompt an urgent referral?

  1. Fordyce spots on the buccal mucosa
  2. An ulcer present for eight weeks with indurated margins Correct answer.
  3. A transient red patch caused by a hot drink two days ago
  4. Bilateral retromolar pads of uniform colour

Explanation

An ulcer persisting beyond two to three weeks with firm, indurated edges is a red flag for malignancy and requires urgent referral under suspected cancer guidance. Most traumatic lesions heal within that timeframe. Documenting the lesion and referring promptly improves outcomes.

Question 36Dental Therapy (professional practice, assessment and treatment within scope)

A patient with a history of anaphylaxis to penicillin needs prophylaxis for a procedure. Which approach is most appropriate?

  1. Prescribe amoxicillin at a reduced dose
  2. Withhold all antibiotics and proceed regardless of history
  3. Prescribe a cephalosporin without further enquiry
  4. Avoid beta-lactams and select a suitable alternative after checking local guidance Correct answer.

Explanation

A documented anaphylactic reaction to penicillin is an absolute contraindication to penicillins, and cephalosporins carry a cross-reactivity concern. Local antimicrobial guidance should be consulted to select an appropriate alternative where prophylaxis is indicated. Accurate allergy documentation and patient discussion are essential.

Question 37Dental Therapy (professional practice, assessment and treatment within scope)

Which factor most affects the retention of a fissure sealant in the months after placement?

  1. The number of teeth in the arch
  2. The patient's handedness
  3. Adequate moisture control during placement Correct answer.
  4. The colour of the sealant material

Explanation

Saliva contamination during etching and placement prevents proper bonding, so isolation with a rubber dam or cotton roll technique is critical to retention. Sealant colour and unrelated patient factors do not influence bonding. Careful technique at placement is the strongest predictor of long-term success.

Question 38Dental Therapy (professional practice, assessment and treatment within scope)

Which measurement should be recorded to monitor whether nonsurgical periodontal therapy is improving a patient's condition over time?

  1. Bleeding on probing and probing depths at each site Correct answer.
  2. The patient's age at first visit
  3. The patient's preferred toothbrush brand
  4. The number of restorations present

Explanation

Bleeding on probing and probing depths recorded site by site provide objective evidence of inflammation and pocket resolution after therapy. Comparing these values at review shows whether treatment has been effective. Other listed items do not reflect periodontal status.

Question 39Dental Therapy (professional practice, assessment and treatment within scope)

A patient with a heavily restored dentition reports a sharp pain lasting a few seconds when drinking cold water, with no spontaneous pain. What is the most likely explanation?

  1. A fractured cusp requiring extraction
  2. Irreversible pulpitis
  3. Reversible pulpitis Correct answer.
  4. Periapical abscess

Explanation

Brief sharp pain provoked by a cold stimulus and resolving when the stimulus is removed suggests reversible pulpitis, often related to a leaking restoration or exposed dentine. Spontaneous or lingering pain would suggest irreversible disease. Management focuses on removing the cause and protecting the pulp.

Question 40Dental Therapy (professional practice, assessment and treatment within scope)

Which technique best reduces aerosol generation when removing deposits from the lower anterior teeth?

  1. Using a three-in-one syringe to dry the area repeatedly
  2. Using an air polisher at maximum power
  3. Using a high-speed air turbine bur
  4. Using a hand scaler with high-volume suction Correct answer.

Explanation

Hand instrumentation generates minimal aerosol, and combining it with high-volume suction further limits airborne contamination. High-speed rotary and air-polishing devices produce substantial splatter and aerosol. Minimising aerosol is important for infection control and staff safety.

Question 41Dental Therapy (professional practice, assessment and treatment within scope)

A child aged 9 attends with a grossly carious primary second molar that is causing recurrent pain. What is the most appropriate initial consideration?

  1. Leaving the tooth untreated until it exfoliates
  2. Placing a fissure sealant over the cavity
  3. Extracting the tooth without any assessment
  4. Assessing the tooth's restorability and the child's cooperation before choosing treatment Correct answer.

Explanation

Treatment planning for a carious primary molar depends on restorability, pulpal status, the child's cooperation and the developing occlusion. Assessment must precede any decision to restore or extract. This allows the least invasive effective option to be selected.

Question 42Dental Therapy (professional practice, assessment and treatment within scope)

Which statement best describes the role of a dental therapist within the dental team?

  1. They may only work in hospitals
  2. They are limited to sterilising instruments
  3. They may carry out all procedures a dentist performs without limitation
  4. They provide treatment within an agreed scope, often including restorative and preventive care for children and adults Correct answer.

Explanation

Dental therapists provide a defined range of care, commonly including preventive treatment, scaling, and restorative work for children and adults, subject to local regulations and prescribed arrangements. Their scope is set by the regulator and may require a dentist's prescription. Working within that scope protects patients and the clinician.

Question 43Dental Therapy (professional practice, assessment and treatment within scope)

What is the main reason for using a matrix band when placing a class II restoration?

  1. To restore the proximal contour and contain the material Correct answer.
  2. To reduce the setting time of the material
  3. To sterilise the cavity
  4. To whiten the restorative material

Explanation

A matrix band supports the restorative material during placement and recreates the proximal contour and contact point. This prevents overhangs and helps restore function. The band also protects the adjacent tooth during finishing.

Question 44Dental Therapy (professional practice, assessment and treatment within scope)

A patient's records show they declined a recommended radiograph. What is the most appropriate response?

  1. Discharge the patient immediately
  2. Record the refusal, explain the implications and continue with the agreed care Correct answer.
  3. Take the radiograph anyway as it is clinically indicated
  4. Record in the notes that the patient was uncooperative

Explanation

Valid refusal must be respected and documented, along with the discussion of risks and alternatives. Care can continue with clinical assessment and other available information. Accurate, respectful record keeping protects the patient and demonstrates professional conduct.

Question 45Dental Therapy (professional practice, assessment and treatment within scope)

Which patient would benefit most from a fluoride varnish application at recall?

  1. An adult with a dry mouth and several new white spot lesions Correct answer.
  2. An adult with a well-controlled diet and no restorations
  3. A patient who has just had a fissure sealant placed on a sound tooth
  4. A patient with no caries and excellent plaque control

Explanation

Fluoride varnish is indicated for patients at elevated caries risk, such as those with reduced salivary flow and active early lesions. High-risk patients benefit most from professional topical fluoride. Low-risk patients with sound dentition gain little additional benefit.

Question 46Dental Therapy (professional practice, assessment and treatment within scope)

A patient with type 2 diabetes attends for periodontal therapy. Which consideration most directly affects the treatment plan?

  1. The number of teeth present
  2. Glycaemic control and the risk of impaired healing and infection Correct answer.
  3. The patient's preferred appointment day
  4. The colour of the gingiva

Explanation

Poor glycaemic control is associated with impaired healing and increased infection risk, and periodontal inflammation in turn affects glycaemic control. Liaison with the diabetes team and timing of treatment may therefore be needed. This bidirectional relationship is central to planning periodontal care.

Question 47Dental Therapy (professional practice, assessment and treatment within scope)

Which radiographic finding would most strongly suggest that a primary molar has a normal exfoliation pattern ahead?

  1. Ankylosis of the primary tooth
  2. A successor tooth visible within the bone beneath the roots Correct answer.
  3. A large periapical radiolucency
  4. Gross root resorption with no successor

Explanation

A developing successor positioned beneath the primary roots indicates that normal resorption and exfoliation are likely. Absence of a successor or pathology such as ankylosis alters the plan. The radiographic picture is combined with clinical findings and the child's dental age.

Question 48Dental Therapy (professional practice, assessment and treatment within scope)

A patient reports a metallic taste and greyish discolouration of the gingiva adjacent to a large amalgam restoration. What is the most likely explanation?

  1. Gingival pigmentation from amalgam corrosion products Correct answer.
  2. Amalgam tattoo from previous surgery
  3. Physiological melanin pigmentation
  4. Acute necrotising ulcerative gingivitis

Explanation

Corrosion products from amalgam can leach into adjacent soft tissue, producing a greyish discolouration and sometimes a metallic taste. This is distinct from an amalgam tattoo, which is a focus of embedded amalgam particles. Diagnosis is clinical, and biopsy is reserved for lesions that are atypical or change.

Question 49Dental Therapy (professional practice, assessment and treatment within scope)

A patient with a history of head and neck radiotherapy attends with radiation-induced xerostomia. Which preventive programme is most appropriate?

  1. Immediate extraction of all remaining teeth
  2. No additional prevention beyond routine brushing
  3. High-concentration topical fluoride, frequent sips of water and regular review Correct answer.
  4. Frequent sugary lozenges to stimulate saliva

Explanation

Radiation-induced xerostomia greatly increases caries risk, so high-concentration topical fluoride and saliva substitutes or frequent water are used alongside frequent recall. Sugary products would worsen the risk. Retaining teeth with intensive prevention is usually preferable to wholesale extraction.

Question 50Dental Therapy (professional practice, assessment and treatment within scope)

A patient presents with a localised deep pocket of 8 mm on a single molar, bleeding on probing and 50 percent bone loss on the radiograph, while other sites are healthy. What is the most appropriate next step?

  1. Extract the tooth without further assessment
  2. Prescribe systemic antibiotics immediately
  3. Apply a fissure sealant to the molar
  4. Reassess after thorough subgingival debridement and consider further investigation Correct answer.

Explanation

A localised deep pocket with bleeding and bone loss requires thorough debridement and reassessment, since isolated defects may reflect a root fracture, endodontic involvement or an anatomical factor. Antibiotics are not indicated without adequate debridement. Investigation before irreversible treatment is essential.