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QE Practice Test > AAPD QE Practice Test > Flashcards

AAPD QE Practice Test Flashcards

1
Q

How do the plaques from caries-active subjects and caries-free subjects compare?
a. Caries-free plaques have significantly higher proportions of Mutans streptococci.
b. In the caries-active plaques, pH levels of 5.0 or lower may persist for several hours after
sugar exposure.
c. Non-cariogenic plaques per unit of plaque protein are slightly more acidogenic than
cariogenic plaques.
d. Streptococcus salivarius of only the caries-active plaques readily convert sucrose to lactic acid at pH 5.

A

B

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2
Q

Which of the following appears to be important primarily in smooth-surface decay?

a. Actinobacillus actinomycetemcomitans
b. Lactobacillus species
c. Streptococcus sanguis
d. Streptococcus sobrinus

A

D

Source: may contribute to smooth surface decay from Emily dental school notes

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3
Q

Critical pH for dissolution of enamel has been shown to be about:

a. 5.0.
b. 5.2.
c. 5.5.
d. 5.7.

A

C

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4
Q

Epidemiologic evidence suggests which permanent tooth surface is most prone to caries?

a. Buccal
b. Interproximal
c. Lingual
d. Occlusal

A

D

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5
Q

Which best describes the transmission of Mutans streptococci from primary caregiver to child?

a. Diagonal
b. Horizontal
c. Tangential
d. Vertical

A

D

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6
Q

Which drug is known to induce gingival hyperplasia?

a. Azathioprine
b. Cyclosporine
c. Diazepam
d. Methotrexate

A

B

Drugs causing gingival hyperplasia:

  • Calcium channel blockers (amlodipine, nefedipine)
  • Cyclosporines
  • Anticonvulsants (dilantin, phenytoin)
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7
Q

Under the 2017 classification scheme for periodontal and peri-implant diseases and conditions,
stages of periodontal disease are based upon:
a. age at onset and chronicity.
b. anticipated treatment response.
c. risk of rapid progression.
d. severity and complexity.

A

D

Source: AAPD periodontal policy

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8
Q

The primary parameter to define gingivitis cases is:

a. bleeding on probing.
b. erythema.
c. loss of stippling
d. visible plaque.

A

A

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9
Q

Early-onset periodontitis patients having high concentrations of which antibody have significantly
less attachment loss than patients who lack this antibody?
a. IgA
b. IgE
c. IgG
d. IgM

A

C

IgA is most abundant in saliva
IgG is most abundant overall
IgM is largest antibody
IgE involved in hypersensitivity

Source: reference manual page 476 (blue)

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10
Q

Which type of vaccine is the human papilloma virus vaccine?

a. Inactivated
b. Live-attenuated
c. Recombinant
d. Toxoid

A

C

Inactivated = flu shot, Hep A, polio, rabies
Live-attenuated = flu mist, yellow fever, MMR, chicken pox
Recombinant = HPV, Hep B, shingles, pneumococcal
Toxoid = diphtheria, Tetanus

Source: CDC

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11
Q

Innate immunity differs from other types of immune responses due to:

a. inability to discriminate between a group of related pathogens.
b. increase with repeated exposure to a given pathogen.
c. its presence in all individuals at all times.
d. mediation by clonal selection of antigen-specific lymphocytes.

A

C

Innate immunity: skin, complement, mucous membranes, saliva, tears
Adaptive immunity: memory cells

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12
Q

Acquired immune responses depend upon:

a. granulocytes.
b. lymphocytes.
c. macrophages.
d. polymorphonuclear leukocytes

A

B

B and T cells are responsible for memory of antigens

Granulocytes (eosinophils, basophils, etc.), macrophages, and polymorphonuclear leukocytes (PMNs or neutrophils) are part of innate

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13
Q

Opsonization is a process in which antibodies contribute to immunity through:

a. activating the proteins of the complement system.
b. binding to and neutralizing the pathogen to prevent cell entry.
c. coating the surface of a pathogen to enhance phagocytosis.
d. lysing microorganisms directly by forming pores in their membranes.

A

C

Opsonization = putting on antibodies

Lysing microorganisms directly by forming pores = complement system

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14
Q

Which of the following is a primary organ of the immune system?

a. Bone marrow
b. Lymph nodes
c. Mucosa
d. Spleen

A

A

Primary organs: bone marrow and thymus
Secondary organs: spleen, mucosa, lymph nodes, tonsils

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15
Q

Presence of a positive odds ratio indicates:

a. a particular exposure does not affect the odds of the outcome.
b. a particular exposure is associated with higher odds of the outcome.
c. a particular exposure is associated with lower odds of the outcome.
d. an association between exposure and outcome is statistically significant.

A

B

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16
Q

Which of the following reflects expectations for clinical practice guidelines (CPG)?

a. CPG are based upon a consensus of expert opinions.
b. CPG are designed to produce minimal standards of care.
c. CPG are informed by a systematic review of evidence.
d. Deviations should be fairly rare and often cannot be justified.

A

C

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17
Q

When biological variables are distributed in a bell shaped curve, approximately what percentage
of the population lies within one standard deviation of the mean?
a. 25
b. 35
c. 50
d. 70

A

D

A bell shaped curve has:

  • 68% within 1 SD of the mean (34% on either side)
  • 95% within 2 SD of the mean (48% on either side)
  • 99.7% within 3 SD of the mean
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18
Q

What epidemiologic term refers to the extent to which a study is free from bias?

a. Blind allocation of subjects
b. External validity
c. Internal validity
d. Precision

A

C

External validity: how generalizable the study is to the population
Internal validity: how good the design of the study is (ex: selection bias, methods, etc.)

Precision: how close values are to each other
Accuracy: how close values are to true value

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19
Q

The researcher’s ability to offer each study participant an equal chance of being assigned to any
study group is unique to which study design?
a. Prospective cohort study
b. Prospective case control study
c. Randomized clinical trial
d. Retrospective case control study

A

C

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20
Q

A test’s ability to accurately determine the presence of caries when it is present is a measure of:

a. false positive rate.
b. sensitivity.
c. specificity.
d. true negative rate.

A

B

Sensitivity: ability of a test to identify disease when it is present (true positive rate)
Specificity: ability of a test to identify disease-free when it is not present (true negative rate)

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21
Q

The standard set for drinking water by the Environmental Protection Agency and the measure
recommended by the Centers for Disease Control and Prevention for dental unit water used in
nonsurgical procedures is how many colony forming units per milliliter (CFU/mL)?
a. ≤150
b. ≤500
c. ≤1000
d. ≤1500

A

B

Source: Dr. Yepes lecture AAPD 2020

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22
Q

Which of the following is consistent with the Centers for Disease Control and Prevention’s
recommendations for infection control for handpieces used for dental prophylaxis?
a. All non-disposable components of the handpiece should always be heat sterilized between
patients.
b. All non-disposable components of the handpiece should be sterilized between patients, but
using a barrier for the motor is an acceptable alternative.
c. Sterilize all reusable prophylaxis heads and the nose cones and perform high-level
disinfection of the handpiece motor between patients.
d. Use only disposable prophylaxis heads and perform high-level disinfection of the nose cone
and motor of the handpiece between patients.

A

A

Source: CDC

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23
Q

Which of the following is most resistant to germicidal chemicals?

a. Bacterial spores
b. Fungi
c. Mycobacteria
d. Non-lipid viruses

A

A

Bacterial spores > mycobacteria > non-lipid viruses > fungi > vegetative bacteria > lipid viruses

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24
Q

Mycobacterium abscessus:

a. can form a biofilm and replicate within waterline tubing.
b. displays high susceptibility to commonly used disinfectants.
c. is a slow-growing non-tuberculous mycobacterium.
d. is commonly associated with acute necrotizing ulcerative gingivitis.

A

A

Remember the ferric sulfate pulpotomy cases

Mycobacterium is hard to kill

Mycobacterium is a FAST growing organism

Spirochetes associated with ANUG

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25
Q

How many children in the United States aged 2 – 5 years are affected by caries?

a. 1 in 2
b. 1 in 3
c. 1 in 4
d. 1 in 5

A

C

23% per CDC NHANES data 2011-2012

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26
Q

Of the following, which is the best predictor of caries risk?

a. Fluoride exposure
b. Frequency of tooth brushing
c. Past caries experience
d. Presence of visible plaque

A

C

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27
Q

Active surveillance of enamel lesions is based on the concept that:

a. economic credentialing may limit access to the operating room.
b. parents have the right to refuse restorative treatment for their children.
c. pre-cooperative behaviors in the very young often necessitate deferral of care.
d. treatment may only be necessary if there is disease progression.

A

D

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28
Q

Which is considered a confounding variable in the development of caries lesions?

a. Diet
b. Fluoride exposure
c. Salivary flow
d. Socioeconomic status

A

D

*No source was found for this question

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29
Q

White spot lesions on primary teeth are classified as:

a. disease indicator.
b. indicator of poor oral hygiene.
c. risk factor.
d. risk indicator

A

A

Also a disease indicator for permanent teeth - see caries risk assessment for patients older than 6 in the reference manual

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30
Q

Linear enamel hypoplasia is normally seen on:

a. cervical third of primary maxillary central incisors.
b. cervical third of primary maxillary first molars.
c. incisal edge of mandibular primary incisors.
d. middle third of primary maxillary central incisors.

A

D

Seen on middle third of maxillary primary central incisors and incisal third on maxillary primary lateral incisors.
More common in malnourished children.

Source: AAPD video prevention/anticipatory guidance

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31
Q

According to evidence-based recommendations, practitioners should avoid using an explorer to:

a. assess the quality of dentin in a prepared tooth.
b. detect marginal discrepancies of existing restorations.
c. probe questionable occlusal surfaces.
d. remove plaque from buccal and lingual tooth surfaces.

A

C

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32
Q 
Carbonated soda consumption is negatively associated with intake of which vitamin in all age
strata?
a. A
b. C
c. D
d. E
A

A (vitamin A)

Source: AAPD School Snacks Policy

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33
Q

Deficiency of which vitamin is most likely to occur when following a vegetarian diet?

a. B-12
b. C
c. Folate
d. Riboflavin

A

A

Sources of B12: exclusive animal products
Sources of C: citrus, fruit, vegetables
Sources of folate: leafy vegetables, enriched cereals
Sources of riboflavin: milk, green vegetables, enriched cereals

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34
Q

Studies on oral health benefits associated with the use of xylitol:

a. are conclusive for significant reduction of incidence of caries in children.
b. consistently show long term Mutans streptococci reduction.
c. demonstrate that xylitol is readily metabolized by oral bacteria.
d. use large doses and high frequency unrealistic for clinical practice

A

D

Source: AAPD policy on xylitol (p. 68 of blue reference manual)

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35
Q

What is the daily recommended intake of calcium for a toddler (1-3 year old)?

a. 250 milligrams
b. 500 milligrams
c. 700 milligrams
d. 1000 milligrams

A

C

0-6 months: 200mg
6-12 months: 260mg
1-3 years: 700mg
4-8 years: 1000mg
9-13 years: 1300mg
13-18 years: 1300mg
19-50 years: 1000mg

Source: AAP

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36
Q 
The World Health Organization recommends no more than what percentage of adult’s calories
should come from sugars?
a. 5
b. 10
c. 16
d. 20
A

B

No more than 10%, ideally less than 5%

Source: AAPD 2020 video prevention

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37
Q

The American Academy of Pediatrics recommends limiting juice for children under 3 years to:

a. 4 ounces daily.
b. 8 ounces daily.
c. 12 ounces daily.
d. 16 ounces daily.

A

A

Less than 1 year: no juice
1-3: <4oz daily
4-6: 4-6oz daily
7-18: 8oz daily

Source: AAP

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38
Q

Food insecurity is a risk factor for:

a. anemia.
b. child abuse.
c. diabetes.
d. obesity in adolescents.

A

D

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39
Q

The recommended level of Vitamin D supplementation for infants under 12 months is:

a. 10 IU/d.
b. 400 IU/d.
c. 600 IU/d.
d. none unless signs of Ricketts

A

B

Vitamin D supplementation is part of routine care for all infants

600 IU/d is recommended for patients 12-24 months

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40
Q

Toxic effects of fluoride are seen at:

a. 0.25 mg F/kg .
b. 5 mg F/kg.
c. 10 mg F/kg.
d. 15 mg F/kg.

A

B

Source: handbook

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41
Q

The lethal dose of fluoride for a child is:

a. 5 mg F/kg.
b. 10 mg F/kg.
c. 15 mg F/kg.
d. 20 mg F/kg

A

C

Source: handbook

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42
Q

The main effect of fluoride is:

a. antibacterial.
b. increased pH from topical exposure.
c. incorporation into enamel from systemic supplement.
d. remineralization from topical exposure

A

D

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43
Q

When infants are fed formula reconstituted with fluoridated water, it is recommended to:

a. avoid using fluoridated toothpaste until age 2.
b. prescribe a systemic fluoride supplement.
c. use a pea-sized amount of toothpaste starting at age 1.
d. use a smear of toothpaste until age 3.

A

D

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44
Q

A functional indicator of effectiveness of silver diamine fluoride therapy is:

a. no post-operative sensitivity.
b. no post-operative soft tissue changes.
c. prevention of new caries lesion development.
d. visible staining on dentinal carious surfaces.

A

D

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45
Q

What is the fluoride content of silver diamine fluoride?

a. 3,800 parts per million
b. 4,400 parts per million
c. 38,000 parts per million
d. 44,000 parts per million

A

D

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46
Q

What is the Department of Health and Human Services’ recommended standard for community
water fluoridation [milligram fluoride ion/liter]?
a. 0.6
b. 0.7
c. 1.0
d. A range of 0.7 to 1.2

A

B

Previously was 0.7-1.2, but changed in 2015

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47
Q

Improving enamel crystallinity is the mechanism of action for which agent?

a. Fluoride tablets/drops
b. Fluoride toothpaste
c. Fluoride varnish
d. Silver diamine fluoride

A

A

Improving enamel crystallinity is part of systemic mechanism of fluoride

Source: Ch. 4 handbook

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48
Q

The certainly lethal dose of fluoride is estimated to be:

a. 5 mg fluoride/kg.
b. 8 mg fluoride/kg.
c. 12 mg fluoride/kg.
d. 16 mg fluoride/kg.

A

D

16-32mg/kg in handbook (also 15mg/kg)

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49
Q

Most fluoride varnish sold in the United States contains:

a. 5000 ppm fluoride.
b. 25 mg fluoride.
c. 5% sodium fluoride.
d. 1% stannous fluoride.

A

C

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50
Q

Silver diamine fluoride (SDF) is:

a. approved by the Food and Drug Administration for caries prevention.
b. approved by the Food and Drug Administration for treatment of dentin hypersensitivity.
c. cleared for use as a remineralizing agent.
d. used off-label for caries management.

A

B

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51
Q

Maternal fluoride exposure can be expected to cause:

a. caries prevention for the mother.
b. caries prevention in the baby’s primary teeth.
c. fluorosis in the baby’s primary incisors.
d. fluorosis in the baby’s primary molars.

A

A

No data to suggest maternal fluoride helps prevent caries in baby

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52
Q

Maxillary permanent incisors are most susceptible to fluorosis:

a. after the incisors have erupted.
b. between birth and 3 years of life.
c. between 3 and 4 years of age.
d. between 5 and 6 years of age

A

B

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53
Q

A pea-sized amount of 1000 ppm fluoridated toothpaste contains how much fluoride?

a. 0.1 mg
b. 0.25 mg
c. 0. 5 mg
d. 1 mg

A

B

Smear of toothpaste has ~0.12mg of fluoride

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54
Q

The dark zone of a demineralized/remineralized enamel lesion represents what?

a. Diffusion into the enamel of lactic acid produced by plaque microbes
b. Large hydroxyapatite crystals due to remineralization
c. Presence of less acid-soluble fluoride compounds, including fluorapatite
d. Small hydroxyapatite crystals due to demineralization.

A

D

*no good source for this question
Dark zone is the advancing front of the lesion

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55
Q

Research on MI paste has demonstrated that:

a. MI paste was inferior to fluoride varnish for caries prevention.
b. MI paste was more effective for enamel remineralization than fluoride varnish.
c. MI paste was superior to fluoride varnish for caries prevention.
d. There was no difference between MI paste and fluoride varnish for caries prevention.

A

A

Per handbook, caries prevention is not established (p.109)

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56
Q

The American Dental Association’s evidence-based clinical practice guideline on nonrestorative
treatments for noncavitated carious lesions in primary teeth recommends:
a. the use of 5% sodium fluoride (NaF) varnish to arrest or reverse noncavitated lesions.
b. the use of 10% calcium phosphopeptide-amorphous calcium phosphate (CPP-ACP) to arrest
or reverse noncavitated lesions.
c. the use of silver diamine fluoride (SDF) to reverse noncavitated lesions.
d. the use of xylitol toothpaste to arrest noncavitated lesions.

A

A

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57
Q

To arrest or reverse noncavitated caries lesions on occlusal surfaces of permanent teeth,
clinicians should prioritize the use of:
a. 0.2% sodium fluoride mouthrinse (once per week).
b. 1.23% acidulated phosphate fluoride gel (application every 3-6 months).
c. 5% sodium fluoride varnish (application every 3-6 months).
d. sealants.

A

D

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58
Q

The greatest concentration of bisphenol A is found in which of the following?

a. The outermost layer of a recently completed sealant
b. The outermost layer of a sealant that is several years old
c. The innermost layer of a recently completed sealant
d. The middle of a recently completed sealant

A

A

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59
Q

Which of the following is the most likely source of bisphenol A (BPA) in dental sealants?

a. BPA is a primary ingredient in the manufacture of sealant materials.
b. Bisphenol A dimethacrylate (Bis-DMA) is hydrolyzed to BPA.
c. Bisphenol A glycidyl dimethacrylate (Bis-GMA) is hydrolyzed to BPA.
d. Triethylene glycol dimethacrylate (TEGDMA) is hydrolyzed to BPA

A

C

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60
Q 
Which of the following is an example of a class III mouthguard according to the American Society
for Testing and Materials?
a. Heat-pressure lamination mouthguard
b. Mouth-formed mouthguard
c. Stock mouthguard
d. Vacuum-formed mouthguard
A

C

Type I: custom
Type II: mouth-formed (boil and bite)
Type III: stock

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61
Q 
A mandibular mouthguard would be more suitable than a maxillary mouthguard for an athlete
when:
a. he has a sensitive gag reflex.
b. he has a transpalatal appliance.
c. he is in class III malocclusion.
d. the permanent incisors are erupting.
A

C

Source: handbook p. 187

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62
Q

A “cluster of cognitive, behavioral, and physiological symptoms indicating that an individual
continues using a substance despite significant substance-related problems” is known as:
a. substance abuse.
b. substance addiction.
c. substance use disorder.
d. maladaptive substance use.

A

C

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63
Q 
Two of the strongest factors associated with smoking initiation in children and adolescents are
parental smoking and
a. low socioeconomic status.
b. parental nicotine dependence.
c. peer pressure.
d. poor academic performance
A

All?

According to AAPD Policy on Tobacco:
“Aggressive marketing of tobacco products by manufacturers, smoking by parents, peer influence, a functional belief in the benefits and normalcy of tobacco, availability and price of tobacco products, low socioeconomic status, low academic achievement, lower self-image, and a lack of behavioral skills to resist tobacco offers all contribute to the initiation of tobacco use during childhood and adolescence.”

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64
Q

Changes in behavior such as irritability, fatigue and lack of coordination could be signs of:

a. allergies.
b. depression.
c. puberty.
d. substance abuse.

A

D

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65
Q

Binge drinking is described as:

a. 4 drinks within 1 hour.
b. chugging beer.
c. drinking over a period of 4 hours.
d. more than 5 drinks on one occasion

A

D

Source: AAPD Policy on Substance Abuse in Adolescents

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66
Q

Which of the following is formed by endochondral ossification?

a. Body of mandible
b. Cranial base
c. Cranial vault
d. Nasomaxillary complex

A

B

Body of mandible = intramembranous
Cranial vault = intramembranous
Nasomaxillary complex = intramembranous

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67
Q

The second pharyngeal arch gives rise to which of the following?

a. Mandible
b. Maxilla
c. Muscles of facial expression
d. Muscles of mastication

A

C

Arch 1: trigeminal nerve, maxilla, mandible, muscles of mastication, Meckel’s cartilage
Arch 2: facial nerve, muscles of facial expression, stapes, some of hyoid bone, Reichert’s cartilage
Arch 3: glossopharyngeal nerve (CN IX), carotid arteries, some of hyoid bone
Arch 4: vagus nerve (CN X), thyroid

Pouch 1: tympanic membrane/middle ear
Pouch 2: pharyngeal tonsils
Pouch 3: thymus, parathyroid

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68
Q

A cleft lip occurs due to failure of fusion of which two processes?

a. Lateral nasal and maxillary
b. Maxillary and maxillary
c. Medial nasal and maxillary
d. Medial nasal and medial nasal

A

C

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69
Q

Which of the following is defined as radiating ossification of mesenchymal condensation?

a. Appositional
b. Endochondral
c. Interstitial
d. Intramembranous

A

D

Intramembranous bone forms directly from mesenchymal cells
Endochondral ossification forms from cartilage precursor
Apposition is deposition of bone at exterior surface
Interstitial is growth at growth plates (end of long bones)

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70
Q

The first sign of ossification of the mandible is:

a. endochondral ossification within Meckel’s cartilage.
b. initial osteogenesis lateral to Meckel’s cartilage.
c. intramembranous ossification at the midline of the mandible.
d. mesenchymal condensation at the future site of the condyle.

A

B

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71
Q

Which structure develops via mixed intramembranous and endochondral ossification?

a. Cranial base
b. Cranial vault
c. Mandible
d. Maxilla

A

C

Cranial base = endochondral
Cranial vault = intramembranous
Maxilla = intramembranous

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72
Q

Displacement/translation of the maxilla occurs in which direction?

a. Downward and backward
b. Downward and forward
c. Upward and backward
d. Upward and forward

A

B

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73
Q

When does fusion of the mandibular suture occur?

a. During the perinatal period
b. 3 to 4 months of age
c. 5 to 6 months of age
d. 7 to 8 months of age

A

A

Occurs at week 5 in utero

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74
Q

Bolton analysis assesses:

a. anteroposterior growth.
b. intermaxillary tooth size.
c. transverse growth.
d. vertical growth

A

B

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75
Q 
A flush terminal plane in the primary dentition most often results in what molar relationship in
the permanent dentition?
a. Class I
b. End-on Class II
c. Full Class II
d. Class III
A

A

Mesial step: 68% become class I, 19% class III
Flush: 56% become class I, 44% stay end-on or class II
Distal: usually class II or end-on
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76
Q

What is the late mesial shift?

a. Mandibular primary molars close primate space behind canines
b. Mesial migration of the mandibular first permanent molars into leeway space
c. Relieving of the anterior diastema due to eruption of canines
d. Replacement of the incisors with increase in labial inclination

A

B

Early mesial shift is mandibular primary molars closing primate space

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77
Q

At which stage is there an equal number of primary and permanent teeth?

a. First inter-transitional period
b. First transitional period
c. Second inter-transitional period
d. Second transitional period

A

C

Inter-transitional period: when teeth are stable
Transitional period: when teeth are exfoliating/erupting

First inter-transitional period: 3-6 years; primate space closes
First transitional period: 6-8 years; replacement of incisors
Second inter-transitional period: 8-10 years (12 permanent teeth, 12 primary teeth)
Second transitional period: 10-12 years; replacement of canines/molars

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78
Q 
Which primary molar relation is most frequently associated with subsequent Class II molar
relation in the permanent dentition?
a. Distal step
b. Flush terminal plane
c. Mesial step
d. There is no correlation.
A

A

Mesial step: 68% become class I, 19% class III
Flush: 56% become class I, 44% stay end-on or class II
Distal: usually class II or end-on
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79
Q

At what stage is the anterior-posterior depth of the mandibular arch the greatest?

a. After eruption of the permanent first
b. During the eruption of the premolars
c. Prior to the early mesial shift
d. Subsequent to eruption of the incisors

A

C

Source: AAPD 2020 G&D video

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80
Q

Because growth has little effect in this area, an overall view of patient growth may be gained by
evaluation of serial cephalometric radiographs superimposing which of the following?
a. Basion-nasion plane and facial axis
b. Frankfort horizontal plane and pterygoid vertical plane
c. Palatal plane and pterygoid vertical plane
d. Sella-nasion plane and facial axis

A

D

Source: Proffit textbook Ch. 6 - talks about superposition of sella a lot (doesn’t really mention facial axis)

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81
Q

Which is true of the mandibular plane angle?

a. Excess values may indicate counter clockwise (i.e., dolichofacial) growth patterns.
b. It changes with growth, increasing approximately one degree every four years.
c. It is formed by the intersection of the basion-nasion plane with the mandibular plane.
d. Values exceeding one standard deviation below the norm imply vertical deficiency

A

D

Excess values may indicate a CLOCKWISE growth pattern

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82
Q

Which is true regarding the association between nonnutritive sucking behavior and
malocclusions?
a. Digital sucking and pacifier sucking have similar risks for developing most malocclusion
features.
b. Digital sucking is more significantly associated with posterior crossbite than pacifier sucking.
c. Pacifier suckers are more likely than digit suckers to develop an increased overjet.
d. Pacifiers, compared with digit sucking, were associated with a higher risk of developing most
malocclusion features.

A

A

Source: p. 206 handbook

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83
Q

Half of all children with a non-nutritive sucking habit will discontinue this habit as early as age:

a. 19-23 months.
b. 24-28 months.
c. 29-33 months.
d. 34-38 months.

A

B

Source: p. 206 handbook

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84
Q 
For patients undergoing rapid maxillary expansion, the greatest increase in width typically occurs
at which suture?
a. Intermaxillary
b. Internasal
c. Maxillonasal
d. Pterygomaxillary
A

A

*no actual source for this quesiton

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85
Q

Which of the following is true regarding increase in midpalatal suture width for patients
undergoing rapid maxillary expansion?
a. The greatest increase occurs at the central incisor level.
b. The greatest increase occurs at the canine level.
c. The greatest increase occurs at the first molar level.
d. There is uniform increase in width at all levels.

A

C

*no actual source for this question

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86
Q

Primate spaces in the primary dentition are located:

a. between canines and first molars in both arches.
b. between laterals and canines in both arches.
c. distal to mandibular laterals and maxillary canines.
d. distal to maxillary laterals and mandibular canines.

A

D

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87
Q

Developmental deficiencies occurring during the morphodifferentiation stage can lead to:

a. hypodontia.
b. hypomaturation amelogenesis imperfecta.
c. hypoplastic amelogenesis imperfecta.
d. microdontia.

A

D

Hypodontia: initiation/proliferation stage
Hypomaturation AI: mineralization stage
Hypoplastic AI: apposition stage

Source: Ch. 2 handbook

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88
Q

Formation of enamel and dentin matrices:

a. is characterized by apposition.
b. is completed before mineralization begins.
c. occurs sequentially, dentin prior to enamel.
d. progresses from cervical to incisal regions.

A

A

Enamel and dentin matrices are not completed before mineralization begins
Matrices form simultaneously
Formation progresses incisal to cervical

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89
Q

Which of the following represents the typical eruption pattern of the permanent dentition?
a. Mandibular arch: first molar, central incisor, lateral incisor, first premolar, canine, second
premolar, second molar
b. Mandibular arch: first molar, central incisor, lateral incisor, first premolar, second premolar,
canine, second molar
c. Maxillary arch: first molar, central incisor, lateral incisor, first premolar, canine, second
premolar, second molar
d. Maxillary arch: first molar, central incisor, lateral incisor, first premolar, second premolar,
canine, second molar

A

D

Permanent maxilla: 6, 1, 2, 4, 5, 3, 7
Permanent mandible: 6, 1, 2, 3, 4, 5, 7
Primary arches: A, B, D, C, E

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90
Q

The last permanent incisor to begin calcification is the:

a. mandibular central.
b. mandibular lateral.
c. maxillary central.
d. maxillary lateral.

A

D

Source: AAPD dental growth and development reference manual

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91
Q

In a healthy child, the last primary tooth to exfoliate is usually the:

a. mandibular canine.
b. mandibular second molar.
c. maxillary canine.
d. maxillary second molar.

A

B

Source: AAPD dental growth and development reference manual

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92
Q

At what age is the root formation of maxillary lateral incisors typically completed?

a. 9
b. 10
c. 11
d. 12

A

C

Source: AAPD dental growth and development reference manual

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93
Q

Which developmental disturbance occurs with the greatest frequency?

a. Congenitally missing permanent teeth
b. Ectopically erupting first permanent molars
c. Mesiodens
d. Palatally impacted permanent canines

A

A

Congenitally missing permanent teeth: 1.5-10% (Ch. 2 handbook) or >4% (Ch. 10 handbook)
Ectopically erupting first permanent molars: 3-4% (Ch. 10 handbook) but 25% in CLP
Mesiodens: 0.1-3.8% (Ch. 2 handbook)
Palatally impacted canines: 1-2% (Ch. 2) or up to 10% (Ch. 10) - more common in females

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94
Q

What is the order of most frequent to least frequent congenitally missing permanent teeth?
a. Mandibular second premolars, maxillary and mandibular third molars, maxillary lateral
incisors
b. Maxillary and mandibular third molars, mandibular second premolars, maxillary lateral
incisors
c. Maxillary and mandibular third molars, maxillary lateral incisors and mandibular second
premolars
d. Maxillary lateral incisors, maxillary second premolars, mandibular second premolars

A

B

Source: p. 214 Handbook

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95
Q

In which of the following dental conditions do the primary and permanent teeth exhibit normal
crown color and shape along with short constricted roots?
a. Dentin dysplasia Type I
b. Dentin dysplasia Type II
c. Dentinogenesis imperfecta Type I
d. Dentinogenesis imperfecta Type II

A

A or B

Source: Ch. 2 Handbook

*none of the answers really fit this question?

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96
Q

The mechanism of action of formocresol is:

a. bactericidal.
b. coagulation.
c. hemostasis.
d. tissue fixation.

A

D

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97
Q

Which is a disadvantage of biodentine as a pulp capping agent?

a. Greater solubility in oral fluids than calcium hydroxide
b. Lack of long term clinical trials to evaluate success rates
c. Long setting time compared to mineral trioxide aggregate
d. Provokes pulpal inflammation that discourages hard tissue regeneration

A

B

Less soluble than calcium hydroxide
Shorter setting time than MTA
Promotes hard tissue regeneration

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98
Q

Which acid is commonly used in glass ionomer restorative products?

a. Carboxylate
b. Hydrofluoric
c. Phosphoric
d. Polyacrylic

A

D

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99
Q

Which component of an amalgam is incorporated to scavenge oxygen?

a. Copper
b. Mercury
c. Tin
d. Zinc

A

D

Copper: prevents corrosion, reduces fracture
Mercury: wets alloy, initiates setting reaction
Tin: controls dimensional change
Zinc: scavenges oxygen

Source: AAPD 2020 video restorative

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100
Q

The gamma-2 phase of amalgam refers to a combination of which two metals?

a. Copper and mercury
b. Copper and zinc
c. Mercury and tin
d. Silver and zinc

A

C

Copper replaces the gamma 2 phase

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101
Q

The eta phase of amalgam refers to a combination of which two metals?

a. Copper and tin
b. Mercury and zinc
c. Silver and tin
d. Silver and zinc

A

A

Mercury reacts with silver and tin to form gamma 1 (Ag2Hg3) and gamma 2 (Sn8Hg).
Gamma 2 reacts with silver-copper to form eta phase (Cu6Sn5). The copper eliminates the gamma 2 phase.

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102
Q

Photoinitiators in command-cure dental products are most activated by which wavelength light?

a. 330-349 nanometers
b. 450-469 nanometers
c. 570-589 nanometers
d. 690-709 nanometers

A

B

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103
Q

Borosilicate or zirconia particles are generally added to composite to improve:

a. color.
b. finish.
c. handling.
d. radiopacity

A

D

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104
Q

Decreasing filler content of composite can lead to:

a. decreased wear.
b. high finish.
c. improved strength.
d. increased shrinkage.

A

D

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105
Q

Which correctly describes the hybrid layer?

a. Adhesive monomers bond chemically to resin based composite.
b. Adhesive monomers infiltrate into dentin and polymerize.
c. Glass ionomer liner bonds to resin based composite.
d. It is created when the smear layer is removed by polyacrylic acid.

A

B

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106
Q

Which dental material chemically adheres to enamel and dentin?

a. Compomer
b. Flowable composite
c. Glass ionomer
d. Microhybrid composite

A

C

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107
Q

Which acid etchant is used in the resin infiltration technique?

a. Carboxylate
b. Hydrochloric
c. Hydrofluoric
d. Phosphoric

A

B

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108
Q

Stainless steel crowns may be contraindicated in patients who:

a. frequently receive ultrasound imaging for botox injections.
b. have inflamed gingival tissue and poor hygiene related to graft vs host disease.
c. have received bleomycin sulfate infusions for pediatric cancer treatment.
d. undergo regular magnetic resonance imaging for neurologic assessment.

A

D

Contraindications for SSCs:

  • Nickel allergy
  • Teeth exfoliating in 6-12 months

Source: AAPD 2020 restorative video

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109
Q

Which type of cement is not recommended for cementation of stainless steel crowns?

a. Glass ionomer
b. Polycarboxylate
c. Resin modified glass ionomer
d. Resin

A

B

Resin cement is ok - it has increased tensile strength and retention but difficult to isolate

Source: AAPD 2020 restorative video

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110
Q

Calcium hydroxide may be used as an effective base/liner, but:

a. its acidic pH can facilitate growth of aciduric bacteria.
b. its alkaline pH can cause pulp irritation.
c. it frequently causes coronal discoloration.
d. it may experience hydrolysis and washout.

A

D

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111
Q

Resin polymerization can be impaired by:

a. calcium hydroxide.
b. eugenol.
c. methyl methacrylate.
d. zinc oxide.

A

B

Source: AAPD 2020 restorative video

112
Q

When a primary canine has been extracted to encourage eruption of an ectopic permanent
canine, what is the minimum length of time one should observe the canine position for
improvement before additional intervention?
a. 3 months
b. 6 months
c. 9 months
d. 12 months

A

D

Source: Dr. Purcell discussion, google
*no good source

113
Q

With which clinical presentation would antibiotics be indicated for an odontogenic infection?

a. Associated parulis
b. Facial cellulitis
c. Fever of 101.0 degrees Fahrenheit
d. Unrelenting pain

A

B

But also fever of 101

114
Q

There is no evidence to support or refute removal of third molars when:

a. pathology is present.
b. they are healthy but impacted.
c. they are healthy but malpositioned.
d. they are healthy but non-functional.

A

B

“Evidence supports removal when pathology is associated, when the tooth is malpositioned or is nonfunctional (ex: unopposed tooth)”
Source: AAPD Policies on Oral Surgery

115
Q

Which of the following is an indication for antibiotic administration?

a. Draining fistula
b. Facial cellulitis
c. Persistent dental pain
d. Temperature of 100 degrees Fahrenheit

A

B

116
Q

Which of the following describes the natural course of a typical odontogenic infection?

a. Mild pain and abscess leading to spontaneous resolution
b. Mild pain with purulent drainage leading to large, tender lesion
c. Severe pain and cellulitis leading to less pain and localized abscess
d. Severe pain with fluctuant lesion followed by less pain and hard, diffuse lesion

A

C

117
Q

Which primary tooth type typically causes a canine space infection?

a. Mandibular canine
b. Mandibular incisor
c. Maxillary incisor
d. Maxillary molar

A

D

Canine space can lead to orbital cellulitis and cavernous sinus thrombosis

In permanent teeth, usually the maxillary canine or premolar causes canine space infection

118
Q

The sublingual space contains which anatomical structure?

a. Carotid artery
b. Hypoglossal nerve
c. Stenson’s duct
d. Submandibular salivary gland

A

B

Carotid artery is in the neck
Stenson’s duct is in parotid gland
Submandibular salivary gland is in submandibular space

119
Q

Internal wound closure would be best managed by which type of suture?

a. Braided polyester
b. Chromic gut
c. Monofilament nylon
d. Silk

A

B

The other options are not resorbable

120
Q 
For patients with ectodermal dysplasia, mandibular implants can first be considered as a
treatment option for which age group?
a. Preschool (0-6 years)
b. School age (7-12 years)
c. Adolescence (13-skeletal maturity)
d. Adulthood
A

B or C

*no source for this question

121
Q 
Which area seems to hold the greatest potential for early use of an implant-supported
prosthesis?
a. The mandibular anterior
b. The mandibular posterior
c. The maxillary anterior
d. The maxillary posterior
A

A

Early implant in mandibular posterior can lead to lingual tipping of implant
Early implant in maxilla can lead to growth deficiencies

122
Q

A hydroxyl-free radical by-product of hydrogen peroxide or carbamide peroxide dental bleaching
agents has been associated with which of the following side effects?
a. Increased enamel solubility
b. Increased marginal leakage of restorations
c. Metallic or bitter taste lasting several days
d. Periodontal tissue damage and root resorption

A

B and D?

Best answer is probably B

D is more associated with internal bleaching

Source: AAPD video 2020

123
Q

The enamel microabrasion technique for removing brown and white spots uses:

a. highly concentrated hydrochloric acid.
b. highly concentrated phosphoric acid.
c. low concentration hydrochloric acid.
d. low concentration hydrofluoric acid.

A

C

6.6% hydrochloric acid is used
Compared to ~15% hydrochloric acid in ICON

124
Q

Posterior pediatric zirconia crowns perform better than stainless steel crowns in regard to:

a. durability.
b. marginal fit.
c. periodontal health.
d. retention.

A

C

125
Q

The Hall Technique includes use of:

a. a fitted crown.
b. caries removal.
c. local anesthesia.
d. tooth preparation.

A

A

126
Q 
According to manufacturer instructions, caries lesions of this depth and greater are inappropriate
for resin infiltration.
a. E2
b. D1
c. D2
d. D3
A

C

ICON can go up to D1 lesions

127
Q

Which characteristic describes an ideal primary molar class II amalgam preparation?

a. Beveled gingival margin
b. Box extended past line-angles
c. Narrow cervical box
d. Occlusally convergent

A

D

Do not want to bevel gingival margin
Should not extend past line angles

128
Q

The sandwich technique for a class II restoration may:

a. increase marginal leakage while improving esthetics.
b. increase post-op sensitivity while decreasing marginal leakage.
c. reduce polymerization shrinkage while increasing post-op sensitivity.
d. reduce post-op sensitivity while decreasing marginal leakage.

A

D

Source: AAPD restorative video 2020

129
Q

Which of the following is true regarding primary tooth anatomy?

a. Dentin tubules decrease in size and number near the pulp.
b. Enamel rods in cervical area slope occlusally.
c. Enamel thickness is relatively greater than permanent teeth.
d. Pulp horns are relatively less prominent than for permanent teeth.

A

B

Dentin tubules INCREASE in size and number near pulp
Enamel is thinner
Pulp horns are more prominent

130
Q

Which of the following is true of primary molar roots (in comparison to permanent teeth)?

a. Are less flared
b. Contain fewer accessory canals
c. Have less constricted apical foramina
d. Relatively shorter and less slender

A

C

Roots are more flared
Roots contain more accessory canals
Roots are longer and thinner

131
Q

The greatest dimension of the primary maxillary first molar is:

a. buccal-lingual.
b. mesial-distal.
c. occlusal-buccal.
d. occlusal-gingival.

A

A

132
Q

Which primary tooth has the narrowest mesial-distal dimension?

a. Mandibular central incisor
b. Mandibular lateral incisor
c. Maxillary central incisor
d. Maxillary lateral incisor

A

A

Source: AAPD 2020 Restorative video

133
Q

Which primary tooth has an “S-Curve” of the gingival tissues?

a. Mandibular first molar
b. Mandibular second molar
c. Maxillary first molar
d. Maxillary second molar

A

A

134
Q

When obtaining intraoral radiographic imaging, what distance from the x-ray tube head is
considered the minimum for safe operator’s positioning?
a. 4 feet
b. 6 feet
c. 8 feet
d. 10 feet

A

B

Source: AAPD 2020 Radiology Dr. Yepes

135
Q

The most frequent congenitally missing tooth is the:

a. mandibular first premolar.
b. mandibular second premolar.
c. maxillary lateral incisor.
d. maxillary second premolar.

A

B

Source: handbook

Third molars > 2nd Mn PM > Mx Lat > 2nd Mx PM

136
Q

According to the American Dental Association caries classification system, with a moderate caries
lesion, an associated radiolucency:
a. extends into inner 1/3 of dentin.
b. extends to middle 1/3 of dentin.
c. is limited to outer 2/3 of the enamel.
d. may extend to dentinoenamel junction or outer 1/3 of dentin

A

B

137
Q

Rectangular collimation reduces absorbed radiation dose by approximately what percentage?

a. 25
b. 33
c. 50
d. 66

A

C

Source: Handbook Ch. 5

138
Q

Dens evaginatus:

a. is a heritable defect of pre-dentin matrix.
b. is an anomaly of proliferation.
c. may be associated with Rubenstein-Taybi syndrome.
d. usually involves the posterior teeth.

A

C

Source: Handbook Ch. 2

Dens evaginatus is abnormality of morphodifferentiation
Dens evaginatus usually involves anterior teeth (maxillary lateral)

139
Q

Molar-incisor hypoplasia has been attributed to:

a. ameloblast dysfunction after full matrix completion.
b. excessive fluoride intake by mother during prenatal development.
c. irregular development of dentin tubules which contain inclusions.
d. multiple inheritance patterns, but mainly autosomal recessive.

A

A

*No source for this question

140
Q

What is the primary mechanism of action for tetracycline staining of teeth?

a. Tetracycline binds to phosphates.
b. Tetracycline blocks formation of fluorapatite.
c. Tetracycline bound to hemoglobin is deposited into dentin.
d. Tetracycline chelates with calcium ions.

A

D

*no good source for this question

141
Q

Bohn’s nodules are:

a. epithelial inclusion cysts.
b. found at palatal midline.
c. remnants of minor salivary glands.
d. white papules that eventually slough.

A

C

Source: Ch. 3 handbook

Epstein pearls are at palatal midline
Natal oral cysts are white papules that slough

142
Q

Which is true regarding congenital epulis of the newborn?

a. Incomplete margins at excision result in recurrence.
b. It has a marked predilection for males.
c. It is also known as granular cell tumor.
d. Multiple lesions occur in approximately 40% of cases.

A

C

More common in females (90%)
Source: handbook Ch. 3

Multiple lesions can be found in 5-16% of cases

143
Q

Which of the following medications should be avoided in a breastfeeding mother?

a. Acetaminophen
b. Ibuprofen
c. Lidocaine
d. Naproxen

A

D

All these medications are actually safe for breastfeeding mothers, but naproxen is the best answer due to longer half life

Handbook says “choose another NSAID”

Avoid NSAIDs in 1st and 3rd trimester pregnancy

144
Q

Which drug is contraindicated for patients with Type I allergic reactions to penicillin antibiotics?

a. Azithromycin
b. Cephalexin
c. Clindamycin
d. Doxycycline

A

B

145
Q

Precautions for systemic administration of fluconazole for oral candidiasis include:

a. it can act as an inhibitor of pancreatic enzymes.
b. it can cause arrhythmias in patients with conduction defects.
c. it is not approved by the Food and Drug Administration for this use.
d. its absorption is decreased at increased gastric pH.

A

B (most likely) or A

It is approved by FDA for this use
Its absorption is not affected by gastric pH

146
Q

In oral cancers, which strain of human papilloma virus is of primary concern?

a. 6
b. 11
c. 16
d. 18

A

C

70% oral cancers caused by HPV 16 - CDC
18 is also concerning, but 16 is most concerning
Source: handbook

147
Q

Herpangina is caused by:

a. coxsackie virus.
b. group A β-hemolytic streptococcus.
c. herpes simplex virus-1.
d. varicella-zoster virus.

A

A

Source: handbook, Dr. Yepes Pathology Video

Group A B-hemolytic strep = strep throat
HSV1 = herpetic gingivostomatitis (primary) or recurrent herpes (cold sores)
Varicella-zoster = chicken pox (primary) or shingles (recurrent)

148
Q

Herpes labialis results from which of the following pathways?

a. Herpes simplex type I virus reactivated by a stimulus such as sunburn
b. Primary infection of the lip caused by herpes simplex type VI
c. Reactivation of the Coxsackie virus residing in the trigeminal ganglion
d. Release of the herpes virus from the nodose ganglion

A

A

149
Q 
Which form of hepatitis can be transmitted by a needle stick and presently has no immunization
available?
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis E
A

C

There are vaccines for Hep A and B
Hep C has no vaccine, but does have treatment now

150
Q

When interpreting hepatitis B serologic test results, IgM antibody to hepatitis B core antigen (IgM
anti-HBc) positivity indicates:
a. acute infection.
b. chronic infection.
c. immunity due to hepatitis B immunization.
d. immunity due to natural infection.

A

A

Acute infection: HBsAg+, Anti-HBc IgM +, HBsAb -
Infection resolved: HBsAg-, Anti-HBc IgG +, HBsAb +
Chronic infection: HBsAg+, Anti-HBc IgG +, HBsAb -
Vaccinated: HBsAg-, Anti-HBc -, HBsAb +

151
Q

What is measured by partial thromboplastin time?

a. Clotting potential
b. Extrinsic clotting of blood
c. Intrinsic clotting of blood
d. Quality of platelets

A

C

PTT = intrinsic; factors Xii, XI, VIII, IX
PT = extrinsic; factors VII, II
152
Q

An increased C-reactive protein (CRP) level can be indicative of:

a. a clotting disorder.
b. diabetes.
c. infection.
d. pregnancy

A

C

CRP is a measure of inflammation

153
Q

When assessing the temporomandibular joint, a panoramic radiograph is reliable for evaluating:

a. condylar head morphology.
b. condylar joint space.
c. condylar motion.
d. joint soft tissues.

A

A

Source: AAPD policy on TMD

The other anatomy would require MRI or CT

154
Q

Sign and symptoms of temporomandibular disorder (TMD) in children and adolescents are:

a. manifestations of a disease state.
b. of undetermined relevance.
c. preclinical features.
d. predictors of TMD in adulthood.

A

B

“Whether these signs and symptoms warrant treatment as predictors of TMD in adulthood is questionable.” - AAPD Policy on TMD

155
Q

The depth of chest compressions during cardiopulmonary resuscitation of a child should be:

a. about 3 centimeters.
b. about 4 centimeters.
c. about 5 centimeters.
d. about one-quarter of the anterior-posterior diameter of the chest

A

C

Depth should be 2 inches (5cm) or 1/3 of AP diameter of chest

156
Q

Which of the following drugs is most appropriate to administer to a patient following an
inadvertent intravascular injection of local anesthesia?
a. Epinephrine
b. Flumazenil
c. Oxygen
d. Phentolamine mesylate

A

C

Phentolamine mesylate is inappropriate

157
Q 
The maximum cumulative dose of flumazenil when used to manage a benzodiazepine overdose
is:
a. 0.02 mg/kg.
b. 0.05 mg/kg.
c. 0.2 mg.
d. 0.5 mg.
A

C

Source: handbook Ch. 13

158
Q

Which is true for cardiopulmonary resuscitation (CPR) by a single rescuer for an unresponsive
child?
a. Call for the automated external defibrillator after one minute of CPR.
b. Use a compression to ventilation ratio of 15 to 2.
c. With an unwitnessed collapse, call 911 before initiating CPR.
d. With a witnessed collapse, call 911 before initiating CPR.

A

D

For unwitnessed collapse, give 2 minutes of compressions/breaths before activating emergency response system

Single rescuer CPR is 30:2

159
Q

In sickle cell anemia, the sickle-shaped cells are the result of:

a. deoxygentation of hemoglobin A2.
b. deoxygenation of hemoglobin S.
c. elevated levels of hemoglobin C.
d. elevated levels of hemoglobin F.

A

B

160
Q

Which of the following congenital heart conditions exhibits right to left shunting?

a. Atrial septal defect
b. Patent ductus arteriosus
c. Tricuspid atresia
d. Ventral septal defect

A

C

Right to left shunting = cyanotic 
Other right to left shunts include:
-Tetralogy of Fallot
-Pulmonary Atresia
-Pulmonary HTN of newborn
-Eisenmenger syndrome

ASD, VSD and PDA are left to right shunts

161
Q

Which best reflects the inheritance of hemophilia A?
a. If an unaffected male has children with a carrier of hemophilia, hemophilia will occur in each
male offspring.
b. If an unaffected male has children with a carrier of hemophilia, each female offspring will be
a carrier.
c. If an unaffected female has children with a male with hemophilia, there is a 50 percent
chance that each male offspring will be unaffected.
d. If an unaffected female has children with a male with hemophilia, all female offspring will be
obligate carriers.

A

D

X-linked recessive

Option A: 50% chance hemophilia would occur in males
Option B: 50% chance that the females would be carriers
Option C: No male would be affected

162
Q

The rate of newborns affected by cleft lip and/or palate is one of every:

a. 600.
b. 1000.
c. 1200.
d. 1800.

A

A

Per handbook:
Cleft lip: 1 in 700
Cleft palate: 1 in 1000
Cleft lip w/ or w/out palate: 1 in 300-500

163
Q

Which of the following are hallmark features of hypophosphatasia?

a. Alkaline phosphatase deficiency and delayed eruption of permanent teeth
b. Alkaline phosphatase deficiency and premature loss of primary teeth
c. Autosomal disease and cementum hyperplasia
d. Cementum aplasia and delayed eruption of permanent teeth

A

B

Hypophosphatasia is one of the systemic conditions involving premature exfoliation of teeth

Source: Dr. Yepes Lecture AAPD 2020

164
Q 
Palmar and plantar keratosis, severe periodontal disease, and an autosomal recessive trait are
found in which syndrome?
a. Chediak-Higashi syndrome
b. Ehler-Danlos syndrome
c. Marfan syndrome
d. Papillon-Lefèvre syndrome
A

D

Remember the papillon dog - paw pads that are rough, little dogs lose teeth early

165
Q

Which of the following best defines childhood obesity?

a. A body mass index at or above the 85th percentile for children of the same age and sex
b. A body mass index at or above the 95th percentile for children of the same age and sex
c. A weight at or above the 85th percentile for children of the same age and sex
d. A weight at or above the 95th percentile for children of the same age and sex

A

B

BMI > 95% (not weight alone)

166
Q

What is the most common sexually transmitted infection in the United States?

a. Chlamydia
b. Gonorrhea
c. Herpes
d. Human papilloma virus

A

D

Source: CDC

167
Q

Type 1 diabetes is associated with:

a. hemoglobin A1C level < 5.7% and fasting glucose < 100mg/dL.
b. insulin resistance followed by impairment of insulin secretion.
c. pancreatic function unable to overcome anti-insulin hormones.
d. T-cell mediated immune destruction of pancreatic β cells.

A

D

HbA1C less than 5.7% is not diabetes (normal)
Option B is type II diabetes
Option C is type II diabetes

168
Q

Which of the following clinical characteristics is present in patients with Lesch-Nyhan syndrome?

a. Early eruption of teeth
b. Intellectual disability
c. Macroglossia
d. Micrognathia

A

B

Also know that Lesch-Nyhan has high potential for self-mutilation

169
Q

A potential dental implication of patients with Sturge-Weber syndrome is:

a. bleeding after dental procedures.
b. early eruption of teeth.
c. mandibular dental crowding.
d. maxillary dental crowding.

A

A (feature of hemangiomas)

Features of SWS are port-wine stain, seizures
Note: per Dr. Yepes lecture, SWS can have early eruption of teeth

170
Q

Which syndrome is recognized at birth by natal teeth and polydactyly?

a. Apert syndrome
b. Ellis-van Creveld syndrome
c. Hallerman-Steiff syndrome
d. Saethre-Chotzen syndrome

A

B

Apert: syndactyly, craniosynostosis, mitten hands, supernumerary teeth, shovel-shaped incisors
Ellis-Van Creveld: extra fingers, heart defects, clefts, microdontia, multiple frenula, natal teeth
Hallerman-Steiff: hyperdontia
Saethre-Chotzen: craniosynostosis, maxillary hypoplasia, cleft palate

Source: handbook Ch. 2

171
Q

Which of the following characteristics are associated with oro-facial-digital syndrome?

a. Cleft palate, fine hair, and polydactyly
b. Multiple hyperplastic frenae, cleft lip, and polydactyly
c. Natal teeth, fine hair, and syndactyly
d. Supernumerary teeth, coarse hair, and syndactyly

A

D

Hyperdontia
Oral frenula
Clefts
Syndactyly 
Bifid tongue
Dry, rough, sparse hair

Source: Smith’s

172
Q

A condition associated with hyperdontia and osteomas of the jaws is:

a. Apert syndrome.
b. Cleidocranial dysplasia.
c. Craniofacial dysostosis.
d. Gardner syndrome.

A

D

173
Q

Which of the following is common in patients with ectodermal dysplasia?

a. Dentin dysplasia
b. Hyperdontia
c. Hypodontia
d. Pulpal dysplasia

A

C

174
Q

An approach of repetitive tasking and familiarization in dentistry that may help patients with
autism spectrum disorder cooperate for procedures is known as:
a. D-Termined Program.
b. functional inquiry.
c. motivational interviewing.
d. Positive Youth Development (PYD).

A

A

Source: handbook Ch. 23

175
Q

In which of the following situations is prophylaxis for infective endocarditis indicated?
a. Adjusting a Nance appliance in a patient with history of cyanotic atrial septal defect
b. Extraction of tooth # S in patient with history of mitral valve prolapse with regurgitation
c. Placing a mesio-occlusal composite in tooth # K in patient with hypertrophic
cardiomyopathy
d. Placing a stainless steel crown on tooth # C in a patient with unrepaired cyanotic heart
disease

A

D

Ortho appliance adjustments do not require SBE
Mitral valve prolapse with regurgitation does not require SBE
Hypertrophic cardiomyopathy does not require SBE

176
Q

The 4 components of effective motivational interviewing are engaging, focusing, evoking, and

a. accepting.
b. collaborating.
c. planning.
d. trusting.

A

C

177
Q

Which of the following precautions is applicable when using sedation or general anesthesia to
manage an uncooperative three year old child with a mitochondrial disorder and severe early
childhood caries?
a. Avoid muscle relaxants and cardiac suppressants.
b. Local anesthetics cannot be used.
c. Nitrous oxide and propofol infusion are preferred agents.
d. No special precautions are required.

A

A

Patients will not be able to metabolize/tolerate muscle relaxants and cardiac suppressants

Features of mitochondrial disorders include seizures, movement disorders, cardiac conduction defects, hearing deficits, diabetes, renal disease.

Patients with mitochondrial disorders are more susceptible to malignant hyperthermia

There is no contraindication for local anesthetic, propofol, and nitrous oxide

178
Q 
According to Piaget, the stage of cognitive development in which a child can think abstractly is
termed:
a. concrete operations.
b. formal operations.
c. preoperational.
d. sensorimotor
A

B

Sensorimotor: 0-2 years; object permanence, causality, ability to categorize
Preoperational: 2-7 years; language, egocentric, self-control, conscience, aggression, gender ID
Concrete operations: 7-11 years; logical thinking, literacy, social norms, delayed gratification, peer influence
Formal operations: 11+ years: abstract thinking, rebel, egocentric, loving relationships, information analysis

179
Q 
During which of the following stages is a child most likely to begin showing an understanding of
social norms for behavior?
a. Concrete operations
b. Formal operations
c. Preoperational
d. Sensorimotor
A

A

Sensorimotor: 0-2 years; object permanence, causality, ability to categorize
Preoperational: 2-7 years; language, egocentric, self-control, conscience, aggression, gender ID
Concrete operations: 7-11 years; logical thinking, literacy, social norms, delayed gratification, peer influence
Formal operations: 11+ years: abstract thinking, rebel, egocentric, loving relationships, information analysis

180
Q

Which best describes the trajectory seen in a body mass index chart for girls ages 2-20 years?

a. A repeated pattern of linear increasing and leveling
b. A steady ascension throughout the years
c. A steady increase until plateauing at puberty
d. An initial decrease then an increase through adolescence

A

D

Same trajectory in boys?

181
Q

During which of the following stages does a child first start demonstrating self-control?

a. Concrete operations
b. Formal operations
c. Preoperational
d. Sensorimotor

A

C

Sensorimotor: 0-2 years; object permanence, causality, ability to categorize
Preoperational: 2-7 years; language, egocentric, self-control, conscience, aggression, gender ID
Concrete operations: 7-11 years; logical thinking, literacy, social norms, delayed gratification, peer influence
Formal operations: 11+ years: abstract thinking, rebel, egocentric, loving relationships, information analysis

182
Q 
According to Erikson’s stages of man, feelings of shame develop from a failure to develop which
of the following?
a. Autonomy
b. Belonging
c. Identity
d. Skills
A

A

Basic trust: 0-18 months; failure = mistrust
Autonomy: 18 months-3 years; failure = shame
Initiative: 3-6 years; failure = guilt
Industry: 7-11 years; failure = inferiority
Personal ID: 12-17 years: failure = role confusion
Intimacy: young adult; failure = isolation

183
Q

At which age is a child most likely to try to impose power over others?

a. 2 years
b. 3 years
c. 4 years
d. 5 years

A

C

Milestones
2 years: gross motor skills, parent attachment, plays alone
3 years: less egocentric, likes to please, active imagination
4 years: imposes power, small social groups, reaches out from parent
5 years: deliberate, takes pride in possessions, plays cooperatively

184
Q

Which motor skill is latest to develop?

a. Drawing a circle
b. Standing on tiptoe
c. Throwing a ball
d. Turning a somersault

A

D

CDC milestones
Drawing circle: 36 months
Standing on tiptoe: 24 months
Throwing a ball: 24 months
Turning somersault: 60 months
185
Q

A 6-year-old child follows directions, but only after glancing at her mother after each request,
and being prompted toward compliance. Which classification represents this behavior?
a. Frankl 1
b. Frankl 2
c. Frankl 3
d. Frankl 4

A

C

186
Q

A father gives instructions to his child consistent with the provider’s direction and gives praise on

compliance. Which classification represents this behavior?
a. Authoritarian
b. Authoritative
c. Indulgent/Permissive
d. Uninvolved

A

B

Authoritarian: high control, low warmth
Authoritative: high control, high warmth
Indulgent/permissive: low control, high warmth
Uninvolved: low control, low warmth

187
Q

Having a word for most everything is expected by what age in a child’s development?

a. 1 up to 2 years
b. 2 up to 3 years
c. 3 up to 4 years
d. 4 up to 5 years

A

B

*no good source for this question

188
Q 
The communication technique that helps parents explore and resolve their ambivalence about
changing behaviors is known as:
a. ask-tell-ask.
b. functional inquiry.
c. memory restructuring.
d. motivational interviewing.
A

D

189
Q 
Which type of nerve fibers requires the lowest concentration of anesthetics for conduction
blockage?
a. Motor
b. Pain
c. Pressure
d. Touch
A

B

Pain > Touch > Pressure > Motor

190
Q

What is the expected duration of pulpal anesthesia when using 2 percent lidocaine with

1: 100,000 epi for a mandibular block?
a. 30 minutes
b. 45 minutes
c. 60 minutes
d. 85 minutes

A

D

Source: handbook p. 247

191
Q

Which of the following best describes the aim of multimodal analgesia?
a. To improve pain relief by using two or more drugs that act by different mechanisms to
provide analgesia
b. To minimize post-operative pain experience by administering a local anesthetic agent
during a general anesthetic
c. To pre-empt pain through the administration of an analgesic agent in addition to an
anesthetic before a surgical insult
d. To prevent pain by minimizing sensitization induced by noxious stimuli throughout the
perioperative period

A

A

192
Q

The primary action of phentolamine mesylate in oral health care applications is:

a. as a vasopressor.
b. as an α-adrenergic agonist.
c. neuraxial blockade.
d. vasodilation.

A

D

193
Q

Articaine has the shortest half-life of dental anesthetics due to its:

a. anti-inflammatory effects allowing rapid absorption.
b. characteristic structure containing an ester side-chain.
c. pH approximating that of injection site tissues.
d. synergy with bradykinin and histamine.

A

B

Majority of articaine is metabolized in plasma as opposed to liver

194
Q

Sensation of the teeth and supporting structures is from cranial nerve:

a. 4.
b. 5.
c. 7.
d. 10.

A

B

CN 5 is trigeminal nerve

195
Q

Local anesthetics:

a. enter the nerve only when in ionized form.
b. inhibit conduction of nerve action potentials.
c. irreversibly block sodium channels.
d. reversibly block potassium channels.

A

B

Enter nerve in nonionized form
Reversibly block sodium channels

196
Q

For a local anesthetic to be effective, it must do which of the following things?

a. Block channels outside the nerve sheath
b. Combine with hydrogen chloride to become hydrophilic
c. Convert from cationic form to nonionized base
d. Inactivate its lipophilic side chain

A

C

197
Q

In the conventional inferior alveolar nerve injection, local anesthetic is deposited:

a. adjacent to the neck of the mandibular condyle.
b. anterior to the mandibular lingula.
c. lateral to the deep tendon of the temporalis.
d. lateral to the pterygomandibular raphe.

A

D

Option A is too superior
Option B should be posterior to the lingula
Option C is medial to deep tendon of temporalis

198
Q

The mandibular foramen in a child is generally located:

a. anterior and medial to the mandibular lingula.
b. more posteriorly than it is in adults.
c. relatively lower on the mandible than it is in adults.
d. slightly above the plane of occlusion.

A

C

The foramen is posterior to the lingula
The foramen is more anterior than adults
The foramen is either lower or on-plane with occlusion

199
Q

. Which injection technique uses extraoral landmarks to guide anesthetic placement?

a. Akinosi inferior alveolar nerve block
b. Gow-gates inferior alveolar nerve block
c. Mental nerve block
d. Posterior-superior alveolar nerve block

A

B

Gow-gates utilizes the tragus of the ear

Akinosi is for clenched jaw, uses mucosal landmarks

200
Q

Which is true regarding anesthetic needles?

a. Larger gauge needles are easier to aspirate through but are prone to deflection.
b. Larger gauge needles are less likely to break but have been shown to cause more pain.
c. Smaller gauge needles are harder to aspirate through and more likely to break.
d. Smaller gauge needles are more likely to break and less likely to deflect.

A

C

Larger gauge needles are easier to aspirate through
Larger gauge needles are LESS prone to deflection
There is no evidence that shows more pain with larger gauge
Smaller gauge needles are more likely to break
Smaller gauge needles are more likely to deflect

201
Q

Lidocaine is primarily metabolized in the:

a. kidneys.
b. liver.
c. local tissues.
d. plasma.

A

B

Amides are metabolized in liver
Esters are metabolized in plasma

202
Q

Articaine differs from other amide local anesthetics in that it:

a. contains a short amine group at its hydrophilic terminus.
b. contains an additional benzene ring off its intermediate chain.
c. contains an ester group at the lipophilic terminus.
d. is metabolized primarily in the liver.

A

C

203
Q

Methemoglobinemia can be induced by a metabolite of which injectable local anesthetic?

a. Articaine
b. Bupivacaine
c. Lidocaine
d. Prilocaine

A

D

204
Q

Methemoglobinemia is treated by administration of:

a. gentian violet.
b. methylene blue.
c. picric acid.
d. surfactant.

A

B

205
Q 
How many micrograms of epinephrine are found in a 1 mL solution of 2% local anesthetic with
1/100,000 parts epinephrine?
a. 10
b. 100
c. 1,000
d. 100,000
A

A

0.01mg/mL = 10ug

206
Q

What is the maximum dosage of 4% articaine that a 22 kg patient can safely receive?

a. 2.2 mg
b. 96 mg
c. 154 mg
d. 308 mg

A

C

22kg x 7mg/kg = 154mg

207
Q

Which product is inappropriate for management of a local anesthetic overdose?

a. Balanced salt solution
b. Lipid emulsion
c. Phentolamine mesylate
d. Oxygen

A

C

208
Q

Which local anesthetic is considered by the Food and Drug Administration to present the lowest
risk to pregnant women and the unborn fetus?
a. Articaine
b. Bupivacaine
c. Lidocaine
d. Mepivicaine

A

C

Lidocaine is class B
Other anesthetics are class C
209
Q

Which of the following behavior guidance techniques is considered to be unconstructive?

a. Deferred care
b. Escape
c. Rhetorical questions
d. Voice control

A

C

210
Q

A commonly used behavior guidance technique that has only weak evidence to support its use is:

a. distraction.
b. hypnosis.
c. positive pre-visit imagery.
d. tell-show-do.

A

D

Distraction has excellent evidence
Hyponosis has excellent evidence
Positive pre-visit imagery has good evidence

211
Q

What is the reversal agent for chloral hydrate?

a. Epinephrine
b. Flumazenil
c. Naloxone
d. None

A

D

Reversal for benzodiazepines = flumazenil
Reversal for narcotics = naloxone

212
Q

The Mallampati grading system was designed to:

a. classify views obtained by direct laryngoscopy based on the structures seen.
b. predict the degree of difficulty of direct laryngoscopy.
c. record and communicate changes in tonsil size.
d. record the ease or difficulty of orotracheal intubation.

A

B

Option C is Brodsky

213
Q

Hydroxyzine is a/an:

a. antihistamine.
b. barbiturate.
c. benzodiazepine.
d. narcotic.

A

A

214
Q

What is the mechanism of action of dantrolene?

a. Blocking neuromuscular transmission
b. Decreasing calcium in muscle cells
c. Increasing adenosine triphosphate hydrolysis
d. Reversing muscle relaxant triggering agents

A

B

Dantrolene is a muscle relaxant; it’s unique from other muscle relaxants in that it is used to decrease the calcium to prevent contraction of muscle cells

Other muscle relaxants work at the synapse to block acetylcholine (option A)

215
Q

For a 25 kg child, what would be the hourly rate for fluid replacement?

a. 25 mL/hour
b. 50 mL/hour
c. 65 mL/hour
d. 75 mL/hour

A

C

I think this question is asking about fluid maintenance, rather than replacement. Replacement would need to know how much was lost.

Fluid maintenance rule: 4-2-1
4mL/kg/hour for first 10kg = (10kgx4) = 40mL
2mL/kg/hour for next 10kg = (10kgx2) = 20mL
1mL/kg/hour for remainder = (5kgx1) = 5mL
Total = 65mL/kg/hour

216
Q

The minimum alveolar concentration (MAC) of nitrous oxide is:

a. 5%.
b. 55%.
c. 105%.
d. 115%.

A

C

Source: Dr. Nelson AAPD lecture

217
Q

Oxygen makes up approximately what percent of room air?

a. 10
b. 20
c. 30
d. 40

A

B

Oxygen is 21% room air

218
Q

Where is nitrous oxide metabolized?

a. Most is exhaled without being metabolized.
b. Most is metabolized in the brain.
c. Most is metabolized in the kidney.
d. Most is metabolized in the liver.

A

A

Tiny amount is metabolized in the GI system

219
Q

Which of the following conditions is a potential indication for nitrous oxide?

a. Cobalamin deficiency
b. First trimester of pregnancy
c. Severe emotional disturbance
d. Strong gag reflex

A

D

Other options are contraindications

220
Q

Which enzyme is inactivated by nitrous oxide?

a. Carbonic anhydrase
b. Methionine synthase
c. Phenylalanine hydroxylase
d. S1 nuclease

A

B

This is the same reason why patients with MTHFR deficiency are contraindication

221
Q

What reading is displayed on an oxygen “E” cylinder that is ½ empty?

a. 500 psi
b. 750 psi
c. 1000 psi
d. 2000 psi

A

C

Oxygen tanks have 2000psi when full, and show the actual decrease of gas

222
Q

What reading is displayed on a portable nitrous oxide cylinder that is ½ empty?

a. 375 psi
b. 750 psi
c. 1000 psi
d. 2000 psi

A

B

Nitrous oxide tanks have 750 until they are mostly empty

223
Q

Diffusion hypoxia results when:

a. nitrous oxide displaces oxygen at carrying sites on hemoglobin.
b. nitrous oxide passes out of the bloodstream and into the lungs.
c. oxygen concentration in the brain is too great, reducing the rate of breathing.
d. oxygen concentrations in the lungs are too great, reducing the rate of breathing.

A

B

224
Q

What American Society of Anesthesiologists Physical Status Classification is generally considered
too great a risk for in-office moderate procedural sedation?
a. II or greater
b. III or greater
c. IV or greater
d. V or greater

A

B

Source: AAPD policy on sedation

225
Q 
Which dosing scalar is most appropriate for dosing sedation medications for overweight
patients?
a. Body mass index
b. Lean body weight
c. Mean weight for age
d. Total body weight
A

B?

Per Dr. WIlson, D?

Should dose on “ideal body weight”

226
Q

Which of the following is true of the pediatric airway compared with the adult airway?

a. Glottis is more posterior
b. Increased airway resistance
c. Larynx is lower
d. Relatively smaller tongue

A

B

Increased airway resistance is a function of decreased diameter (resistance=4r^2)

The glottis is more anterior
The larynx is higher
The tongue is relatively larger

227
Q

A child consumed 8 ounces of water at 8:00 AM. He presents for sedation at 9:00 AM. How long
should you wait prior to sedating the child?
a. 2 hours
b. 3 hours
c. 4 hours
d. No delay is necessary

A

A (but should be 1 hour)

Clear liquids: 2 hours
Breast milk: 4 hours
Other milk/formula/light meal: 6 hours
Heavy meal: 6-8 hours

228
Q 
A child consumed a piece of toast at 8:00 AM. He presents for sedation at 9:00 AM. How would
you manage this situation?
a. Wait 2 hours before sedating
b. Wait 3 hours before sedating
c. Wait 6 hours before sedating
d. Wait 7 hours before sedating
A

C (but should be 5 hours)

Clear liquids: 2 hours
Breast milk: 4 hours
Other milk/formula/light meal: 6 hours
Heavy meal: 6-8 hours

229
Q

Which term describes the interaction of a drug and receptors in the site of action?

a. Pharmacodynamics
b. Pharmacogenetics
c. Pharmacokinetics
d. Pharmacotherapeutics

A

A

Pharmacodymanics: how drugs affect the brain; mechanism of action
Pharmacokinetics: how drugs are absorbed and distributed in the body
Pharmacotherapeutics: how drugs work/side effects (toxicity, efficacy, onset, duration of action)

230
Q

Which common oral sedation medication is contraindicated in patients with seizure disorders?

a. Chloral hydrate
b. Hydroxyzine
c. Midazolam
d. Meperidine

A

D

Meperidine lowers the seizure threshold
It also should not be used in patients with asthma

Source: handbook Ch. 13

231
Q

Two clusters of pediatric odontogenic infections recently were caused by contaminated water
which introduced what organism into the pulp chamber during pulpotomies?
a. Legionella species
b. Mycobacterium abscessus
c. Pseudomonas species
d. Ralstonia pickettii

A

B

232
Q

The primary organic component of dentin is:

a. alkaline phosphatase.
b. phosphoryn.
c. Type I collagen.
d. Type V collagen.

A

C

233
Q

Dentin that forms in response to irritation and is made by original odontoblasts is:

a. irregular dentin.
b. reactionary dentin.
c. reparative dentin.
d. secondary dentin.

A

B

Reactionary dentin is formed by odontoblasts
Reparative dentin is formed by odontoblast-like cells (fibroblasts)

234
Q

Which of the following would be considered a mild pulpal insult?

a. A cavity preparation with 0.25 mm dentin remaining
b. Caries that extends into the pulp
c. Caries that is limited to the outer 1/3 of dentin
d. Dry cutting to remove caries

A

C

Mild insult
-cavity preparation without pulp exposure
-caries into dentin
Severe insult
-chronic pulp inflammation
-dry cutting
-endotoxins from bacteria
-pulp exposure
235
Q

The formation of reparative dentin can be triggered by:

a. formocresol.
b. glutaraldehyde.
c. sodium hypochlorite.
d. transforming growth factor β.

A

D

TGF-B stimulates odontoblasts

Source: pulp lecture AAPD

236
Q

The most common protein found in the pulp is:

a. collagen type I.
b. elastin.
c. fibroblasts.
d. odontoblasts.

A

A

Elastin 2nd most (found in arterioles)
Fibroblasts are the most common cell (not protein)

237
Q

Pulpitis pain is most likely transmitted by which type of fiber?

a. A-beta fibers
b. A-delta fibers
c. C fibers
d. Myelinated fibers

A

C

A fibers are myelinated (both beta and delta)
A fibers responsible for sharp pain
C fibers responsible for dull ache

238
Q

Cavity preparation that leaves less than 0.25 mm of dentin leads to:

a. poor repair activity and inflammation.
b. pulp protection.
c. reactionary dentin.
d. reparative dentin.

A

A

More than 0.5mm would lead to reactionary dentin
0.25-0.5mm leads to reparative dentin

239
Q

In vital primary teeth with deep caries lesions requiring pulp therapy, is one particular therapy
(indirect pulp cap, direct pulp cap, pulpotomy) more successful than others?
a. No, the success rates are similar.
b. Yes, direct pulp cap is more successful.
c. Yes, indirect pulp treatment is more successful.
d. Yes, pulpotomy is more successful.

A

C

Source: AAPD pulp therapy policy

240
Q

For vital primary teeth with deep caries treated with pulpotomy due to pulp exposure during
caries removal, recommendation has been made against using which of the following
medicaments due to consistently inferior success rates?
a. Calcium hydroxide
b. Ferric sulfate
c. Sodium hypochlorite
d. Tricalcium silicate

A

A

Source: AAPD pulp therapy guidelines; 2020 pulp video

241
Q

The main reason for underutilization of mineral trioxide aggregate (MTA) for pulpotomy in
primary teeth has been:
a. higher cost relative to alternative materials.
b. limited quality of evidence to support its use.
c. lower long term success rates.
d. unintended grayish discoloration of teeth treated with MTA.

A

A

242
Q

Furcation radiolucency in primary molars is a sign of:

a. external root resorption.
b. irreversible pulpitis.
c. pulp necrosis.
d. reversible pulpitis.

A

C

243
Q

A direct pulp cap is indicated in a primary tooth in which situation?

a. A deep carious exposure
b. A small mechanical exposure in a vital tooth
c. Evidence of furcation radiolucency
d. Symptoms of irreversible pulpitis

A

B

244
Q

Formocresol is best described as:

a. coagulant.
b. fixative.
c. obturator.
d. palliative sealer.

A

B

245
Q

To stimulate dentin bridge formation, one should use:

a. ferric sulfate.
b. formocresol.
c. mineral trioxide aggregate.
d. sodium hypochlorite.

A

C

246
Q

Treatment recommended for an immature permanent tooth with a small carious exposure is:

a. direct pulp cap using formocresol.
b. direct pulp cap using mineral trioxide aggregate .
c. pulpectomy with vitapex.
d. pulpotomy using sodium hypochlorite.

A

B

247
Q

Treatment recommended for a necrotic immature permanent tooth is:

a. extraction.
b. pulp revascularization.
c. pulpectomy using vitapex.
d. pulpotomy using calcium hydroxide.

A

B

248
Q

Periapical bone regeneration after treatment of a necrotic tooth is evident after:

a. 3 months.
b. 6 months.
c. 1 year.
d. 2 years.

A

C

AAPD 2020 pulp video
“Continuous bone deposition increases the bone density along the periapical area resulting in a diminished periapical lesion size after 1 year.” PA bone regeneration at 1.2mm per month.

249
Q

The most common injury to permanent teeth is:

a. avulsion.
b. crown fracture.
c. luxation.
d. subluxation.

A

B

Uncomplicated crown fracture is the most common injury in permanent teeth
Luxation is most common in primary teeth

250
Q

The use of the Glascow Coma Scale is intended to assess:

a. cranial nerve function following head trauma with loss of consciousness.
b. eye movement, hearing, verbal response, and motor response.
c. impairment of conscious level in response to defined stimuli.
d. pupillary reactivity as a reflection of brain stem function.

A

B

Option C is the sedation scale

251
Q

Recommendations have been made against using which of the following when stimulation is
necessary for assessment of responses with the Glascow Coma Scale?
a. Pressure on the finger tip
b. Pressure on the supraorbital notch
c. Sternal rub
d. Trapezius pinch

A

C

Per glasgowcomascale.org, sternal rub can cause bruising and response are difficult to interpret

252
Q

Which of the following overjet measurements has been suggested as the threshold for initiating
preventive orthodontic treatment in early- to middle-mixed dentition to potentially reduce the
severity of traumatic injuries to permanent incisors?
a. Greater than 3 millimeters
b. Greater than 4 millimeters
c. Greater than 5 millimeters
d. Greater than 6 millimeters

A

A

From: Policy Prevention of Sports-related Orofacial Injuries :
The frequency of dental trauma is significantly higher for children with increased overjet (greater than 6 millimeters) and inadequate lip coverage. A dental professional may be able to modify these risk factors. Initiating preventive orthodontic treatment in early- to middle-mixed dentition of patients with an overjet greater than three millimeters has the potential to reduce the severity of traumatic injuries to permanent incisors.

253
Q 
Which cranial nerves are evaluated when you ask a child to follow your finger to all four
quadrants including across the midline?
a. 1, 2, and 4
b. 2, 4, and 6
c. 3, 4, and 6
d. 4, 6, and 7
A

C

1: Olfactory
2: Optic (eye sight, not movement)
3: Occipital (eye movement)
4: Trochlear (eye movement)
5: Trigeminal
6: Abducens (eye movement)
7: Facial
8: Vestibulocochlear
9: Glossopharyngeal
10: Vagus
11: Accessory
12: Hypoglossal

254
Q

The most commonly injured teeth are:

a. mandibular central incisors.
b. maxillary canines.
c. maxillary central incisors.
d. maxillary lateral incisors.

A

A

255
Q

Wearing a well-fitting mouthguard during sports has been shown to:

a. interfere with breathing and speaking.
b. prevent jaw fractures.
c. protect against concussions.
d. reduce the number and severity of dental injuries.

A

D

256
Q

A traumatic injury to the chin increases the likelihood of:

a. mandibular alveolar fracture.
b. maxillary alveolar fracture.
c. molar tooth fracture.
d. subcondylar/condylar fracture.

A

D

257
Q

The best management for a primary incisor avulsion is:

a. evaluation at the next recall visit.
b. evaluation within 24 hours.
c. immediate replantation of the tooth
d. immediate visit to the emergency department.

A

B

258
Q

Premature loss of a primary incisor may lead to:

a. ankylosis of permanent successor.
b. anterior crossbite.
c. delayed eruption of permanent successor.
d. speech delay.

A

C

259
Q

When should an intruded primary incisor be allowed to re-erupt?

a. If the child is medically complicated
b. If the tooth has a complicated crown fracture
c. When root has perforated the buccal plate
d. When root is displaced away from permanent tooth bud

A

D

260
Q

Yellow discoloration of a traumatized primary incisor indicates:

a. calcific metamorphosis.
b. enamel hypoplasia.
c. irreversible pulpitis.
d. pulp necrosis.

A

A

Dark-gray discoloration may fade and the tooth regain its normal shade or may become yellow, reflecting calcification of the pulp.

Both pink and yellow discolorations do not reflect devitalization of the pulp, and no treatment is indicated according to most authors.

261
Q

The most common complication of trauma to primary teeth is:

a. ankylosis of permanent successor.
b. dilaceration of permanent successor.
c. enamel defects in permanent successor.
d. failure of eruption of permanent successor

A

C

262
Q

What percentage of discolored primary incisors remained vital?

a. 10
b. 40
c. 50
d. 80

A

C?

AAPD Trauma Guidelines
“PCO in 35-50% and indicates ongoing pulp vitality”

263
Q

Two key questions related to treatment of permanent tooth avulsion are:

a. extra-oral dry time and apex development.
b. place of injury and whether or not it was witnessed.
c. status of tetanus immunization and age of patient.
d. time and place of the injury.

A

A

Source: video trauma AAPD 2020

264
Q

The best transport medium for an avulsed tooth is:

a. cold water.
b. contact lens solution.
c. GatoradeTM.
d. Hank’s balance salt solution.

A

D

265
Q

What benefit does oral tetracycline provide compared to penicillin V potassium following tooth
avulsion?
a. Inhibits osteoblast function
b. Less likely to cause staining of the tooth
c. Prevents ankylosis
d. Reduces inflammatory root resorption

A

D

Source: video AAPD 2020 trauma

266
Q

The most common sequela for avulsed permanent teeth following root canal therapy is:

a. ankylosis.
b. enamel discoloration.
c. inflammatory root resorption.
d. tooth loss.

A

C?

*No good source for this question

267
Q

Treatment recommended for an immature permanent tooth with intrusion less than 7 mm is:

a. extraction.
b. orthodontic repositioning.
c. spontaneous repositioning.
d. surgical repositioning.

A

C

268
Q

Which consumer sports product is most often correlated to dental injuries in children?

a. Bicycle
b. Playground equipment
c. Skates, including inline skates
d. Trampoline

A

A

AAPD Policy on Prevention of Sports-Related Orofacial Injury

Bicycle > playground > skates > trampoline

269
Q

Which sport is most frequently associated with dental injuries in 7 to 12 year olds?

a. Baseball
b. Basketball
c. Gymnastics
d. Soccer

A

A

AAPD policy on Prevention of Sports-Related Orofacial Injury
Baseball most common in 7-12 year olds
Basketball most common in 13-17 year olds

270
Q

Which sport is most frequently associated with dental injuries in 13 to 17 year olds?

a. Baseball
b. Basketball
c. Gymnastics
d. Soccer

A

B

AAPD policy on Prevention of Sports-Related Orofacial Injury
Baseball most common in 7-12 year olds
Basketball most common in 13-17 year olds

271
Q

Of the following, which is the most common site for inflicted oral injuries?

a. Gingiva
b. Oral mucosa
c. Teeth
d. Tongue

A

B

AAPD Best Practices Oral and Dental Aspects of Child Abuse/Neglect

Lips > oral mucosa > teeth > gingiva > tongue

272
Q

In cases of suspected sexual abuse, culture testing, as opposed to nucleic acid amplification tests,

a. has been considered the gold standard.
b. has greater sensitivity.
c. is less expensive.
d. is less invasive.

A

A

AAPD Best Practices Oral and Dental Aspects of Child Abuse/Neglect
“Culture testing has been the gold standard. Nucleic acid amplification testing are now more common because they are more sensitive, less invasive, and less expensive.”

273
Q

Boys and men may count for as high as what percent of victims of human trafficking?

a. 25
b. 33
c. 40
d. 50

A

D

AAPD Best Practices Oral and Dental Aspects of Child Abuse/Neglect

Average age of children exploited for sex = 12 years
Child trafficking victims have 2x risk for dental problems

274
Q

The perpetrators of child abuse are most likely to be:

a. grandparents.
b. parents.
c. siblings.
d. teachers.

A

B

275
Q

A bruise on the forehead of a 2-year-old child would most likely have resulted from:

a. a bleeding disorder.
b. child abuse.
c. falling.
d. fighting

A

C

276
Q

The TEN 4 mnemonic refers to:

a. bruises to torso, ears and neck in children under 4 years.
b. common signs of skull fracture in young children.
c. injuries that are common and unlikely to be from abuse.
d. torn frenum, black eye, and neck rash that lasts for 4 days.

A

A

277
Q

Munchausen syndrome by proxy is:

a. a condition in which a child snacks frequently and secretly.
b. a condition that typically involves use of a poisonous substance.
c. also known as medical child abuse.
d. most frequently caused by a child’s step-father.

A

C

Most often caused by child’s mother

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