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SLMC ERPDS practice questions

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Question 1Dentistry (content domains not enumerated by source)

A patient presents with a chief complaint of pain in the lower right first molar. Under the SLMC ERPDS record-keeping standard, which component of the problem-oriented dental record captures this statement verbatim in the patient's own words?

  1. The plan section of the SOAP note
  2. The subjective section of the SOAP note Correct answer.
  3. The assessment section of the SOAP note
  4. The objective section of the SOAP note

Explanation

The subjective section records information reported by the patient, including the chief complaint in the patient's own words, history of present illness, and relevant medical history. Objective findings are clinician-observed data such as examination results and radiographs. Assessment synthesizes the data into diagnoses, and the plan lists intended interventions.

Question 2Dentistry (content domains not enumerated by source)

During periodontal charting, a probe reading of 5 mm is recorded with 2 mm of gingival recession on the same site. What is the clinical attachment level at that site?

  1. 2 mm
  2. 7 mm Correct answer.
  3. 3 mm
  4. 5 mm

Explanation

Clinical attachment level equals probing depth plus recession when the gingival margin is apical to the cementoenamel junction. Here 5 mm plus 2 mm gives 7 mm of attachment loss. Probing depth alone would understate the true destruction of the attachment apparatus.

Question 3Dentistry (content domains not enumerated by source)

Which local anaesthetic property best explains why articaine provides effective pulpal anaesthesia in some cases where lidocaine infiltration has failed in a mandibular molar?

  1. Presence of a thiophene ring improving tissue diffusion and bone penetration Correct answer.
  2. Higher pKa producing a larger unionised fraction
  3. Longer plasma half-life than lidocaine
  4. Greater lipid solubility allowing deeper nerve penetration

Explanation

Articaine contains a thiophene ring that increases lipid solubility and tissue diffusion, which is thought to improve penetration through bone and soft tissue in infiltration techniques. Its pKa is similar to other amides, so the unionised fraction at tissue pH is not the distinguishing factor. Half-life differences do not explain success at the injection site.

Question 4Dentistry (content domains not enumerated by source)

A 9-year-old child has a permanent maxillary central incisor with a complicated crown fracture exposing the pulp within six hours of injury. The apex is wide open. Which treatment is most appropriate?

  1. Root canal treatment with apexification in a single visit
  2. Partial pulpotomy (Cvek pulpotomy) Correct answer.
  3. Extraction and space maintenance
  4. Direct pulp capping with calcium hydroxide

Explanation

In a young patient with an open apex and a recent vital pulp exposure, partial pulpotomy preserves pulp vitality and allows continued root development. Direct pulp capping is less predictable when the exposure is large and contaminated. Extraction and apexification are reserved for non-vital or unsalvageable teeth.

Question 5Dentistry (content domains not enumerated by source)

Which radiographic feature most reliably distinguishes a periapical cyst from a periapical granuloma on a conventional periapical radiograph?

  1. None; the two lesions cannot be reliably distinguished radiographically Correct answer.
  2. Presence of a radiopaque central mass
  3. A well-defined sclerotic border and size greater than 10 mm
  4. Loss of the lamina dura around the apex

Explanation

Periapical cysts and granulomas both appear as periapical radiolucencies associated with a non-vital tooth, and radiographic features overlap substantially. Definitive distinction requires histopathological examination. Size and cortication are suggestive but not reliable diagnostic criteria.

Question 6Dentistry (content domains not enumerated by source)

Which instrument is most appropriate for removing supragingival calculus from the facial surfaces of the anterior teeth?

  1. Periodontal probe
  2. Area-specific Gracey curette
  3. Universal sickle scaler Correct answer.
  4. Dental hatchet

Explanation

Sickle scalers have a pointed tip and two cutting edges and are designed for supragingival calculus removal on crown surfaces. Gracey curettes are area-specific and intended for subgingival scaling and root planing. A probe measures pocket depth, and a hatchet is a restorative hand instrument.

Question 7Dentistry (content domains not enumerated by source)

In a Class II cavity preparation for an amalgam restoration, what is the primary purpose of the proximal box?

  1. To extend the preparation into the adjacent embrasure to remove caries and establish a cleansable margin Correct answer.
  2. To provide resistance form against occlusal forces
  3. To increase retention by creating a dovetail
  4. To protect the pulp from thermal insult

Explanation

The proximal box extends the preparation through the marginal ridge into the proximal surface to remove carious dentine and establish a margin that the patient can clean. Resistance form and retention are provided by other features such as the pulpal floor and dovetail. Pulpal protection is achieved with liners and bases.

Question 8Dentistry (content domains not enumerated by source)

Which factor most strongly increases the risk of osteoradionecrosis after tooth extraction in a patient who has received head and neck radiotherapy?

  1. A cumulative radiation dose above 60 Gy to the mandible Correct answer.
  2. Use of a plain radiograph for preoperative assessment
  3. Patient age over 40 years
  4. Extraction under local anaesthesia

Explanation

Osteoradionecrosis risk rises sharply with higher cumulative radiation dose, particularly above 60 Gy, because of obliterative endarteritis and reduced bone vascularity. Age and the type of anaesthetic are not primary determinants. Radiographic assessment is a diagnostic tool, not a risk factor.

Question 9Dentistry (content domains not enumerated by source)

Which primary tooth is most commonly affected by nursing bottle caries (early childhood caries) in its earliest pattern?

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

Explanation

Early childhood caries classically affects the maxillary primary incisors first because they erupt early and are bathed in pooled fermentable liquid during prolonged bottle or breastfeeding. Mandibular incisors are relatively protected by the tongue and salivary flow from the sublingual glands.

Question 10Dentistry (content domains not enumerated by source)

A patient on warfarin has an INR of 3.8 and requires extraction of a periodontally involved tooth. What is the most appropriate management?

  1. Refer to the physician for INR optimisation before extraction Correct answer.
  2. Double the warfarin dose to stabilise the INR
  3. Proceed with extraction without modification
  4. Stop warfarin for five days before extraction

Explanation

An INR of 3.8 exceeds the usual threshold for safe minor oral surgery, so the physician should be consulted to optimise anticoagulation before extraction. Abrupt cessation of warfarin without medical advice risks thromboembolism. Increasing the dose would worsen bleeding risk.

Question 11Dentistry (content domains not enumerated by source)

Which clinical finding is most characteristic of a necrotic pulp in a mature permanent tooth?

  1. Sharp pain lasting seconds after stimulus removal
  2. Exaggerated response to cold testing
  3. No response to cold or electric pulp testing with a periapical radiolucency Correct answer.
  4. Normal response to electric pulp testing

Explanation

A necrotic pulp produces no response to thermal or electric pulp testing, and periapical radiolucency may develop as infection spreads. Exaggerated or lingering responses suggest reversible or irreversible pulpitis rather than necrosis. A normal response indicates vital pulp.

Question 12Dentistry (content domains not enumerated by source)

A patient reports a clicking sound in the temporomandibular joint with jaw opening and no pain. Which diagnosis is most consistent with this presentation?

  1. Osteoarthritis of the temporomandibular joint
  2. Disc displacement with reduction Correct answer.
  3. Myofascial pain with referral
  4. Disc displacement without reduction

Explanation

A reciprocal click on opening and closing with no pain is the hallmark of disc displacement with reduction, where the disc reduces to a normal position during opening. Disc displacement without reduction typically presents with limited opening and no click. Osteoarthritis shows crepitus and degenerative changes, while myofascial pain presents with muscle tenderness.

Question 13Dentistry (content domains not enumerated by source)

Which suture material is most appropriate for closing a mucosal flap where minimal tension exists and the sutures will be removed in five to seven days?

  1. Polydioxanone
  2. Polyglactin 910
  3. Chromic gut
  4. Silk Correct answer.

Explanation

Silk is a non-resorbable braided suture with good handling and knot security, suitable for short-term mucosal closure with planned removal. Chromic gut and polyglactin resorb over weeks and are less suited when easy removal is intended. Polydioxanone is long-acting resorbable and unnecessary for this indication.

Question 14Dentistry (content domains not enumerated by source)

What is the principal mechanism by which topical fluoride varnish reduces caries?

  1. Direct bactericidal killing of all oral streptococci
  2. Formation of calcium fluoride deposits that act as a fluoride reservoir Correct answer.
  3. Systemic incorporation into developing enamel
  4. Neutralisation of salivary bicarbonate

Explanation

Topical fluoride varnish forms calcium fluoride and fluorapatite deposits on the enamel surface, creating a reservoir that releases fluoride during acid challenges and promotes remineralisation. Its action is topical rather than systemic. It does not sterilise the oral flora or act primarily by neutralising bicarbonate.

Question 15Dentistry (content domains not enumerated by source)

In a fixed partial denture, what is the primary function of the connector between a pontic and a retainer?

  1. To provide a path for cement escape only
  2. To allow slight movement of the pontic under load
  3. To join the components rigidly so the prosthesis functions as a single unit Correct answer.
  4. To serve as a guide plane for seating

Explanation

Connectors join retainers and pontics into a rigid unit that distributes occlusal forces across abutments. Rigidity prevents flexure that would strain the cement seal. Cement escape and guide planes are functions of other design features.

Question 16Dentistry (content domains not enumerated by source)

Which of the following best describes the purpose of the Frankfort horizontal plane in cephalometric analysis?

  1. It locates the centre of resistance of the maxilla
  2. It marks the occlusal plane for assessing curve of Spee
  3. It defines the long axis of the mandibular ramus
  4. It establishes a reproducible cranial reference for measuring angular relationships Correct answer.

Explanation

The Frankfort horizontal plane, drawn from porion to orbitale, provides a reproducible cranial reference against which angular measurements such as the SNA and SNB angles are compared. It is not the occlusal plane or the ramal axis. The centre of resistance is a biomechanical concept unrelated to this plane.

Question 17Dentistry (content domains not enumerated by source)

A patient with a history of anaphylaxis to penicillin requires antibiotic prophylaxis before dental extraction. Which agent is most appropriate?

  1. Clindamycin or azithromycin per current guidance Correct answer.
  2. Cephalexin regardless of reaction type
  3. Amoxicillin
  4. Ampicillin

Explanation

For patients with a documented penicillin anaphylaxis, alternative agents such as clindamycin or a macrolide are selected according to current prophylaxis guidance. Cephalosporins carry a risk of cross-reactivity and are not chosen when the reaction was anaphylactic. Amoxicillin and ampicillin are penicillins and are contraindicated.

Question 18Dentistry (content domains not enumerated by source)

Which clinical sign most strongly suggests aggressive periodontitis rather than chronic periodontitis in a young adult?

  1. Rapid attachment loss and bone destruction inconsistent with the amount of local irritants Correct answer.
  2. Generalised heavy calculus with mild bone loss
  3. Widespread gingival enlargement with halitosis
  4. Deep pockets limited to teeth adjacent to restorations

Explanation

Aggressive periodontitis is characterised by rapid attachment loss and bone destruction that appear disproportionate to the amount of plaque and calculus present. Chronic periodontitis typically shows destruction consistent with long-standing local factors. Heavy calculus and localised defects are more typical of chronic disease.

Question 19Dentistry (content domains not enumerated by source)

Which property of glass ionomer cement makes it useful as a restorative material in primary teeth?

  1. Ability to be used without any moisture control
  2. High fracture toughness comparable to amalgam
  3. Complete insolubility in oral fluids
  4. Sustained fluoride release and chemical bonding to tooth structure Correct answer.

Explanation

Glass ionomer cement releases fluoride over time and bonds chemically to enamel and dentine, which is advantageous in primary teeth and high-caries-risk patients. Its fracture toughness is lower than amalgam, and it is susceptible to moisture during setting, so isolation is still required.

Question 20Dentistry (content domains not enumerated by source)

A patient reports a burning sensation on the tongue and angular cheilitis. Which nutritional deficiency is most likely?

  1. Vitamin D deficiency
  2. Vitamin C deficiency
  3. Vitamin B12 or folate deficiency Correct answer.
  4. Iron excess

Explanation

Glossitis, burning tongue, and angular cheilitis are classic oral signs of vitamin B12 or folate deficiency, which impair epithelial turnover. Vitamin C deficiency causes scurvy with bleeding gums rather than angular cheilitis. Vitamin D deficiency affects bone mineralisation, and iron excess is not a typical cause of these signs.

Question 21Dentistry (content domains not enumerated by source)

Which radiographic view is most appropriate for assessing the position of an impacted mandibular third molar in relation to the inferior alveolar canal?

  1. Periapical radiograph of the first molar
  2. Bitewing radiograph
  3. Panoramic radiograph alone
  4. Cone beam computed tomography Correct answer.

Explanation

Cone beam computed tomography provides three-dimensional assessment of the relationship between an impacted third molar and the inferior alveolar canal, which a panoramic radiograph cannot reliably show. Bitewings and periapical views of other teeth do not demonstrate this relationship.

Question 22Dentistry (content domains not enumerated by source)

What is the primary purpose of carving an amalgam restoration before it fully sets?

  1. To reduce the need for polishing later
  2. To improve the material's corrosion resistance
  3. To restore occlusal anatomy and remove marginal excess Correct answer.
  4. To increase the compressive strength of the material

Explanation

Carving is performed while amalgam is still workable to restore anatomic contours and remove excess at the margins, which prevents plaque traps and occlusal interference. It does not increase compressive strength or alter corrosion resistance. Polishing is a separate later step.

Question 23Dentistry (content domains not enumerated by source)

A patient with poorly controlled diabetes has a dental extraction. Which factor most increases the risk of delayed healing and infection?

  1. Placement of a resorbable suture
  2. Elevated blood glucose impairing neutrophil function and wound healing Correct answer.
  3. Preoperative use of a chlorhexidine rinse
  4. Use of local anaesthetic with adrenaline

Explanation

Hyperglycaemia impairs neutrophil chemotaxis and phagocytosis and reduces collagen synthesis, delaying healing and increasing infection risk. Adrenaline in local anaesthetic, chlorhexidine rinses, and resorbable sutures do not independently increase infection risk in this manner.

Question 24Dentistry (content domains not enumerated by source)

Which feature distinguishes a gingival cyst of the adult from a lateral periodontal cyst histologically?

  1. Presence of a keratinised lining with ghost cells
  2. Presence of a stratified squamous lining with mucous cells
  3. Presence of a fibrous capsule without epithelial lining
  4. Presence of a thin, non-keratinised lining with focal plaque-like thickenings Correct answer.

Explanation

Both lesions show a thin non-keratinised epithelial lining, but the lateral periodontal cyst characteristically has focal plaque-like thickenings, and the gingival cyst of the adult shows similar lining with occasional plaque-like areas. Ghost cells suggest a calcifying odontogenic cyst. A fibrous capsule without epithelium would indicate a pseudocyst rather than either entity.

Question 25Dentistry (content domains not enumerated by source)

Which is the most appropriate initial management for a patient with a suspected mandibular fracture after trauma?

  1. Immediate open reduction and internal fixation in the dental chair
  2. Prescription of antibiotics alone
  3. Clinical assessment, imaging, and referral for maxillofacial evaluation Correct answer.
  4. Extraction of all teeth in the fracture line

Explanation

A suspected mandibular fracture requires clinical assessment of occlusion, mobility, and neurosensory status, followed by imaging and referral to a maxillofacial unit for definitive management. Open reduction is not performed in a dental chair setting. Extraction of teeth in the fracture line is not routine and antibiotics alone do not address the fracture.

Question 26Dentistry (content domains not enumerated by source)

A 9-year-old child has a permanent maxillary central incisor with a complicated crown fracture exposing the pulp; the fracture occurred 6 hours ago and the apex is wide open. Which treatment is most appropriate?

  1. Complete root canal treatment with gutta-percha
  2. Application of fluoride varnish only
  3. Partial pulpotomy with calcium hydroxide or MTA Correct answer.
  4. Extraction and immediate implant placement

Explanation

In an immature permanent tooth with recent pulp exposure, vital pulp therapy such as partial pulpotomy preserves pulp vitality and allows continued root development and apexogenesis. Full pulpectomy with gutta-percha is contraindicated in an open apex because it arrests root formation.

Question 27Dentistry (content domains not enumerated by source)

Which local anesthetic property best explains why articaine provides effective pulpal anesthesia in mandibular molars more reliably than lidocaine in some patients?

  1. Its slower systemic clearance by the liver
  2. Its greater vasodilator effect
  3. Its higher lipid solubility and increased protein binding Correct answer.
  4. Its lower pKa relative to tissue pH

Explanation

Articaine is highly lipid soluble and strongly protein bound, which improves diffusion through the nerve sheath and prolongs binding at the sodium channel. This contributes to its greater success in achieving pulpal anesthesia in mandibular posterior teeth.

Question 28Dentistry (content domains not enumerated by source)

Which radiographic feature most reliably distinguishes a periapical cyst from a periapical granuloma?

  1. A well-defined radiolucency with a sclerotic border Correct answer.
  2. Attachment to the root apex
  3. Presence of internal calcifications
  4. A size greater than 10 mm

Explanation

A periapical cyst typically shows a well-defined, corticated radiolucency with a sclerotic margin, reflecting slow expansion and bony reaction. Granulomas tend to be less sharply demarcated, so border characteristics are the most useful radiographic discriminator.

Question 29Dentistry (content domains not enumerated by source)

Which mechanism explains the analgesic action of ibuprofen in postoperative dental pain?

  1. Inhibition of cyclooxygenase and reduced prostaglandin synthesis Correct answer.
  2. Inhibition of serotonin reuptake in the descending pain pathway
  3. Blockade of voltage-gated sodium channels in peripheral nerves
  4. Blockade of mu-opioid receptors in the central nervous system

Explanation

Ibuprofen is a nonselective nonsteroidal anti-inflammatory drug that inhibits cyclooxygenase enzymes, reducing prostaglandin synthesis at the site of tissue injury. Lower prostaglandin levels decrease sensitization of peripheral nociceptors and produce analgesia.

Question 30Dentistry (content domains not enumerated by source)

During surgical extraction of a mandibular third molar, brisk arterial bleeding occurs from the lingual soft tissue. Which structure is most at risk of injury?

  1. Lingual nerve Correct answer.
  2. Inferior alveolar nerve
  3. Chorda tympani
  4. Mylohyoid nerve

Explanation

The lingual nerve lies close to the lingual cortex of the mandible in the third molar region and is vulnerable when the lingual flap is elevated or when lingual soft tissue is injured. Careful retraction and avoidance of lingual bone removal reduce this risk.

Question 31Dentistry (content domains not enumerated by source)

Which feature of a removable partial denture design most effectively reduces torque on abutment teeth from a distal extension base?

  1. A stress-releasing clasp assembly such as an RPI design Correct answer.
  2. Complete palatal coverage extending to the vibrating line
  3. Rigidly cast circumferential clasps on all abutments
  4. A continuous bar clasp engaging all lingual surfaces

Explanation

Distal extension bases tend to rotate around the abutments under occlusal load, and stress-releasing designs such as the RPI system allow controlled movement and reduce torque. Rigid clasping concentrates rotational forces on the abutment.

Question 32Dentistry (content domains not enumerated by source)

Which clinical finding is most consistent with a diagnosis of reversible pulpitis?

  1. No response to electric pulp testing with periapical radiolucency
  2. A sinus tract with suppuration at the buccal gingiva
  3. Sharp pain provoked by cold that resolves promptly after stimulus removal Correct answer.
  4. Spontaneous throbbing pain that wakes the patient at night

Explanation

Reversible pulpitis produces sharp, brief pain provoked by thermal or osmotic stimuli that subsides quickly once the stimulus is removed. Spontaneous or nocturnal pain and a sinus tract indicate irreversible pulpitis or necrosis.

Question 33Dentistry (content domains not enumerated by source)

Which organism is most strongly associated with the initiation of early childhood caries?

  1. Aggregatibacter actinomycetemcomitans
  2. Treponema denticola
  3. Streptococcus mutans Correct answer.
  4. Porphyromonas gingivalis

Explanation

Streptococcus mutans is a principal acidogenic and aciduric organism implicated in the initiation and progression of early childhood caries, often acquired through vertical transmission from caregivers. The other listed organisms are primarily periodontal pathogens.

Question 34Dentistry (content domains not enumerated by source)

A patient with a confirmed severe allergy to latex requires dental treatment. Which precaution is most appropriate?

  1. Use powdered latex gloves with double gloving
  2. Premedicate with an antihistamine and proceed with standard latex gloves
  3. Schedule as the first appointment and use a latex-free protocol with non-latex gloves and dam Correct answer.
  4. Cancel treatment permanently and refer to an emergency department

Explanation

Latex-allergic patients should be treated in a latex-free environment, ideally early in the day when airborne latex particles are lowest, using non-latex gloves, latex-free rubber dam, and latex-free instruments. Premedication does not prevent a severe reaction.

Question 35Dentistry (content domains not enumerated by source)

Which radiographic appearance is most characteristic of a dentigerous cyst?

  1. A radiolucency at the apex of a nonvital tooth
  2. A well-defined radiolucency attached at the cementoenamel junction of an impacted tooth Correct answer.
  3. A multilocular radiolucency with soap-bubble appearance in the posterior mandible
  4. A diffuse radiolucency with sunray periosteal reaction

Explanation

A dentigerous cyst encloses the crown of an unerupted tooth and attaches at the cementoenamel junction, producing a well-defined radiolucency. This attachment point distinguishes it from other pericoronal and periapical lesions.

Question 36Dentistry (content domains not enumerated by source)

Which factor most increases the retention of a complete maxillary denture?

  1. A highly polished intaglio surface
  2. A reduced posterior palatal seal area
  3. A thicker layer of relief over the midpalatal suture
  4. An accurately extended denture border in the functional sulcus Correct answer.

Explanation

Retention of a maxillary denture depends on border seal, adhesion, cohesion, and atmospheric pressure, all of which require the denture border to extend into the functional sulcus. Loss of border seal permits air entry and destroys retention.

Question 37Dentistry (content domains not enumerated by source)

Which periodontal parameter best reflects the cumulative history of periodontal attachment loss?

  1. Clinical attachment level Correct answer.
  2. Bleeding on probing
  3. Plaque index
  4. Gingival margin position alone

Explanation

Clinical attachment level measures the distance from the cementoenamel junction to the base of the pocket and reflects cumulative attachment loss over time. Bleeding on probing indicates current inflammation rather than past destruction.

Question 38Dentistry (content domains not enumerated by source)

Which mechanism best explains the anticaries effect of professionally applied 5% sodium fluoride varnish?

  1. Permanent occlusion of all dentinal tubules
  2. Immediate neutralization of salivary acid by the varnish resin
  3. Bactericidal elimination of all oral streptococci
  4. Formation of calcium fluoride-like deposits that release fluoride during acid challenges Correct answer.

Explanation

High-concentration fluoride varnish forms calcium fluoride-like deposits on enamel that act as a fluoride reservoir, releasing fluoride when pH drops and promoting remineralization. The effect is topical and sustained rather than a one-time sterilization.

Question 39Dentistry (content domains not enumerated by source)

A patient with chronic kidney disease on hemodialysis needs a dental extraction. Which preoperative consideration is most important?

  1. Use aspirin as the sole analgesic after the procedure
  2. Schedule extraction immediately before dialysis to reduce bleeding risk
  3. Withhold all antibiotics because renal clearance is reduced
  4. Coordinate treatment with the dialysis team and schedule on the day after dialysis Correct answer.

Explanation

Patients on hemodialysis often receive heparin during sessions and have residual anticoagulation, so scheduling dental surgery the day after dialysis reduces bleeding risk and allows coordination with the medical team. Antibiotic dosing may need adjustment, not omission.

Question 40Dentistry (content domains not enumerated by source)

Which feature is most characteristic of an ameloblastoma on imaging?

  1. A ground-glass radiopacity of the maxilla
  2. A unilocular radiolucency at the cementoenamel junction of an impacted third molar
  3. A well-circumscribed radiopacity with a radiolucent halo
  4. A multilocular radiolucency with a soap-bubble appearance in the posterior mandible Correct answer.

Explanation

Ameloblastoma classically presents as a multilocular, soap-bubble or honeycomb radiolucency in the posterior mandible. The lesion is locally aggressive and often causes expansion and root resorption.

Question 41Dentistry (content domains not enumerated by source)

Which occlusal scheme is most appropriate for a single implant-supported crown in the posterior region?

  1. Complete disclusion of the implant crown in all mandibular positions
  2. Contact only in maximum intercuspation with lateral forces directed buccally
  3. Heavy centric contacts and full group function on the implant crown
  4. Light centric contacts with no excursive contacts on the implant crown Correct answer.

Explanation

Implant crowns should have light centric contacts and be free of excursive contacts because implants lack a periodontal ligament and cannot adapt to heavy or lateral loads. This reduces the risk of screw loosening, fracture, and peri-implant bone loss.

Question 42Dentistry (content domains not enumerated by source)

Which clinical test is most useful for confirming the vitality of a tooth with a questionable response to cold testing?

  1. Electric pulp testing Correct answer.
  2. Percussion testing
  3. Periodontal probing
  4. Transillumination

Explanation

Electric pulp testing assesses the responsiveness of pulpal sensory nerves and can help confirm vitality when thermal testing is equivocal. It should be interpreted alongside the clinical and radiographic findings.

Question 43Dentistry (content domains not enumerated by source)

Which mechanism explains why a glass ionomer restoration releases fluoride over time?

  1. Fluoride ions are loosely bound within the glass particle matrix and diffuse out Correct answer.
  2. The material absorbs fluoride from saliva and releases it unchanged
  3. Fluoride is added only as a surface coating that dissolves immediately
  4. The resin component hydrolyzes to produce free fluoride

Explanation

Glass ionomer cements contain fluoroaluminosilicate glass particles in which fluoride is loosely bound, allowing gradual diffusion into the surrounding tooth and saliva. This provides a sustained fluoride reservoir and helps inhibit secondary caries.

Question 44Dentistry (content domains not enumerated by source)

Which oral manifestation is most characteristic of bulimia nervosa?

  1. Black hairy tongue
  2. Erosion of the palatal surfaces of maxillary anterior teeth Correct answer.
  3. Cervical caries restricted to mandibular molars
  4. Diffuse gingival enlargement

Explanation

Repeated self-induced vomiting exposes the palatal surfaces of the maxillary anterior teeth to gastric acid, producing characteristic erosion. Mandibular teeth are relatively spared because the tongue protects them.

Question 45Dentistry (content domains not enumerated by source)

Which nerve block is most appropriate for anesthesia of the mandibular anterior teeth when an inferior alveolar nerve block fails?

  1. Greater palatine nerve block
  2. Nasopalatine nerve block
  3. Incisive nerve block Correct answer.
  4. Long buccal nerve block

Explanation

The incisive nerve block anesthetizes the mental and incisive branches, providing anesthesia to the mandibular anterior teeth and premolars on the ipsilateral side. It is a useful alternative when the inferior alveolar block does not provide adequate anterior anesthesia.

Question 46Dentistry (content domains not enumerated by source)

Which factor most strongly predicts the success of a direct pulp cap in a mature permanent tooth?

  1. Presence of a periapical radiolucency
  2. A large exposure with suppuration
  3. A history of spontaneous nocturnal pain
  4. A small exposure with no contamination and absence of spontaneous pain Correct answer.

Explanation

Direct pulp capping succeeds best when the exposure is small, clean, and free of symptoms of irreversible pulpitis, allowing the pulp to heal and form a dentin bridge. Spontaneous pain or periapical pathosis indicates irreversible disease.

Question 47Dentistry (content domains not enumerated by source)

Which feature distinguishes a gingival cyst of the adult from a lateral periodontal cyst in its typical location?

  1. Lateral periodontal cyst occurs only in the maxillary anterior region
  2. Gingival cyst of the adult occurs in the gingival soft tissue, whereas the lateral periodontal cyst is within bone Correct answer.
  3. Gingival cyst of the adult contains keratin, whereas the lateral periodontal cyst does not
  4. Gingival cyst of the adult is always multilocular

Explanation

The gingival cyst of the adult arises in the gingival soft tissue and may cause a shallow cupping of the underlying bone, whereas the lateral periodontal cyst is an intraosseous lesion located laterally along a vital tooth root. Location is the key distinguishing feature.

Question 48Dentistry (content domains not enumerated by source)

Which behavior change technique is most effective for improving oral hygiene adherence in an adult with periodontitis?

  1. Setting specific goals with self-monitoring and scheduled follow-up Correct answer.
  2. Restricting feedback to annual examinations
  3. Using fear-based warnings about tooth loss at every visit
  4. Providing a single instructional pamphlet at the first visit

Explanation

Goal setting, self-monitoring, and frequent follow-up are core components of behavioral counseling that improve adherence to oral hygiene. One-time information alone rarely produces sustained behavior change.

Question 49Dentistry (content domains not enumerated by source)

Which radiographic finding is most suggestive of external root resorption?

  1. A well-defined radiolucency at the apex of a nonvital tooth
  2. A ragged radiolucent defect on the root surface with loss of root outline Correct answer.
  3. Generalized horizontal bone loss
  4. A widened periodontal ligament space with intact lamina dura

Explanation

External root resorption appears as irregular radiolucent defects along the root surface with loss of the normal root outline, often after trauma or orthodontic movement. The defect is not centered on the apex as in apical pathosis.

Question 50Dentistry (content domains not enumerated by source)

Which local hemostatic measure is most appropriate for persistent bleeding from a gingival socket after extraction in a patient without a bleeding disorder?

  1. Firm pressure with a gauze soaked in tranexamic acid for 20 minutes Correct answer.
  2. Rinsing vigorously with saline
  3. Applying a hot compress to the cheek
  4. Suctioning the socket repeatedly

Explanation

Sustained pressure with gauze, often soaked in tranexamic acid, promotes clot formation and is effective for local hemostasis in a patient without coagulopathy. Vigorous rinsing or suctioning disturbs the clot.