INBDE case studies
INBDE · Put your knowledge to work in context.
The Integrated National Board Dental Examination (INBDE) is the current national licensure examination for dentists in the United States, administered by the Joint Commission on National Dental Examinations (JCNDE) of the American Dental Association. It replaced the older two-part NBDE format and is designed to test whether a candidate can apply biomedical, behavioral, and clinical science knowledge to realistic patient care rather than recall isolated facts. The INBDE case studies are 5 cases and about 3,744 words.
1Asymptomatic apical radiolucency on a previously treated molar
R, 58, presents for a second-opinion consult on tooth #19. The tooth was root canal treated six years ago and carries a full-coverage crown; he reports no pain, no swelling, and no chewing discomfort.
609 words, about 3 min2Four extractions in a patient on a direct oral anticoagulant who is leaving the country
L, 67, needs extraction of #3, #4 and #5 (gross caries, one with a periapical radiolucency and mild tenderness to percussion) and a non-restorable #31. She takes apixaban 5 mg twice daily for atrial fibrillation, plus metoprolol and atorvastatin.
853 words, about 4 min3Requests for strong pain relief in a patient on an SNRI and tramadol who discloses hopelessness
K, 44, presents with two days of pain from a necrotic #14, buccal swelling, and a temperature of 37.9 °C. He has taken ibuprofen 400 mg occasionally and says it "does nothing." He asks for "something strong." Medications: duloxetine 60 mg daily for depression, tramadol 50 mg as needed for chronic low back pain (he took one this morning), lisinopril.
763 words, about 4 min4Production pressure, questionable diagnoses, and a request to document what the plan wants to see
N is three months into an associateship at a practice owned by a management company. At her monthly review, the regional manager tells her that her production is 40% below the office average and that "the doctor before you diagnosed two or three crowns a week on teeth like these." He points to three patients on today's schedule: a 19-year-old with shallow occlusal staining and no radiographic caries; a 62-year-old with a 15-year-old amalgam on #30 showing slight marginal ditching, no symptoms, and a normal pulp; and a patient whose plan pays 50% for crowns only with "radiographic evidence of fracture." The manager suggests she "document what the plan needs to see." She has a 90-day probation clause in her contract.
797 words, about 4 min5Rampant cervical caries in a patient with medication-induced xerostomia who asks for full maxillary extraction
G, 71, has nine remaining maxillary teeth and eleven mandibular teeth. In the last 18 months she has developed six new cervical and root-surface lesions; two are cavitated and one on #8 is within 1 mm of the pulp.
722 words, about 4 min