Example 1

A 46-year-old male smoker presents as a new patient complaining of

bleeding gums, bad breath and a BPE score as follows:
3 1 3
1 4 3
Select the most appropriate initial radiographic examination.

A. Bitewings
B. Bitewings and periapical views of selected teeth
C. Full mouth periapicals
D. Periapicals of the lower incisors
E. Vertical bitewings


Example 2
Which one of the following is most commonly used to bleach vital teeth:
1. Ethyl chloride
2. Hydrogen chloride
3. Hydrogen peroxide
4. Sodium bicarbonate
5. Sodium hypochlorite



(Source 2: Questions candidates have remembered from the past are
below)

Health and Safety Legislation requires that a dental practice categorise
and dispose of waste correctly. Which of the following are examples of
special waste?

a) Blood stained gauze
b) Radiographic fixer solution
c) Used face masks
d) Non-latex gloves
e) Inter-occlusal records



After oral administration of 3 g Amoxicillin, a patient collapses in
reception. The reception staff lie the patient flat in the correct position
but there is no recovery. You notice the patient is flushed and wheezing;
what would be your first line action/treatment?

a) Administer 0.3 ml 1: 1000 adrenaline intramuscularly
b) Administer 0.5 ml 1:1000 adrenaline intramuscularly
c) Administer Hydrocortisone sodium succinate 2mg intramuscularly
d) Administer 10mls Hydrocortisone sodium succinate intravenously
e) Attempt immediate CPR



Which of the following is most likely to contribute to successful molar
endodontics?

a) Achieving patency in the canals.
b) The use of a bacteriocidal luting agent during obturation.
c) Thorough cleaning using rubber dam throughout the
procedure.
d) Assessment using a good quality parallel long-cone periapical
radiograph.
e) Straight-line access to all canals.



A 14 year old female patient attends in a distressed state with an acute
periapical abscess and gross facial swelling associated with heavily
filled UL1. She is unaccompanied by an adult. What should
your first action be?

a) Open and drain the abscess via palatal access
b) Try to ascertain whether she is able to give legal consent
c) Attempt to contact the childs parents or guardian to obtain consent
for emergency treatment
d) Prescribe a suitable antibiotic and ask the child to return with a
parent or guardian
e) Re-appoint the child and ask her to return with a parent or guardian



During the restoration of a deep carious cavity in UL6, to minimise the
risk of bacteria gaining access to the pulp, the dentist may

a) Carry out direct pulp capping
b) Carry out indirect pulp capping
c) Remove the caries from the floor of the cavity before the cavity wall
d) Give the patient a course of antibiotics for a week
e) Ask the patient to rinse with a fluoride mouthwash one hour prior
the cavity preparation



Which of the following is a bacteriostatic antibiotic?

a) Amoxicillin
b) Cephalosporins
c) Metronidazole
d) Tetracycline
e) Naproxen



Patients on Oral Bisphosphonates

a) Must not be treated in general dental practice
b) Will develop osteonecrosis of the jaw after undergoing tooth
extraction
c) Require antibiotic prophylaxis with 3g Amoxicillin provided they are
not allergic to penicillin
d) Most probably have metastatic bone disease or osteoporosis
e) Must have their bisphosphonate medication stopped 24 hours prior
to dental treatment



During surgery on the submandibular gland

a) An incision on the lower border of the mandible is safe
b) The submandibular gland is seen to wrap around the posterior
border of mylohyoid
c) The facial artery and vein are divided as they course through the
deep part of the gland
d) The hypoglossal nerve is seen to loop under the submandibular
duct
e) Damage to the lingual nerve will cause loss of sensation to the
posterior third of the tongue



A 15 year old female patient has a 8mm overjet and bilateral impacted
canines

a) The patient would be placed in the Index of Orthodontic Treatment
Need DHC grade 5
b) The patient is at an appropriate age to commence functional
appliance therapy
c) The canine position is best assessed by using a lateral
cephalometric radiograph
d) The canines are almost certainly buccally placed
e) Bilateral impacted canines are seen more frequently then unilateral
impacted canines



A 35 year old female patient requires replacement of 6 upper anterior
crowns with a conformative occlusal scheme. What would be the most
appropriate way to articulate study and working casts?

a) Average value articulator with incisal guidance table.
b) Fully adjustable articulator
c) Plane line articulator.
d) Semi adjustable articulator with facebow transfer and custom incisal
guidance table.
e) Semi adjustable articulator with facebow transfer.

A 15 year old boy presents with a long standing history of a painless
midline swelling in the neck. This has increased in size over the years.
Examination reveals the lump to be in the midline of the neck, soft and
fluctuant. It moves on swallowing and protrusion of the tongue. The
most likely diagnosis is:

a) Branchial cyst
b) Enlarged lymph node
c) Nodule in the thyroid isthmus
d) Prominent thyroid cartilage
e) Thyroglossal cyst



Antimicrobials should be prescribed for one of the following clinical
scenarios:

a) After apicectomies
b) If there is a sinus present
c) After periodontal surgery
d) For surgical removal of mandibular third molars
e) After surgical removal of retained roots and teeth where there is a
history of dry sockets



Regarding root fractures, which of the following statements are LEAST
appropriate

a) Vertical root fractures occur most commonly in sound teeth as a
result of direct physical trauma
b) They occur more commonly in endodontically treated teeth
c) They could occur due to corrosion of metal posts
d) Wedging effects during post cementation are known to cause
vertical root fracture
e) Horizontal root fractures are most commonly the results of direct
physical trauma to the dentition



NSAIDs do not interact with

a) Phenytoin
b) Antihypertensive drugs
c) Methotrexate
d) Systemic Corticosteroids
e) Fluoxetine



Regarding clinical consideration for bridgework, which of the following
statement is MOST appropriate

a) Where abutment teeth are heavily restored, conventional retainers
may be a better option than adhesive bridges
b) Adhesive bridges are a good option in patients who have bruxist or
parafunctional activity.
c) Lack of clinical crown height is an indication for adhesive bridges.
d) The metal framework for adhesive bridges should be kept 0.2mm
thick so that it is not bulky
e) In adhesive bridges, the retainers should cover as less as the
abutment tooth as possible for their success.



Regarding inhalation sedation, which of the following statements is
MOST appropriate

a) Nitrous oxide sedation is only useful for children under 12 years of
age.
b) Nitrous oxide should not be used on patients with liver and kidney
disease.
c) Flumazenil may be used to reverse sedation produced by nitrous
oxide.
d) 100% oxygen should be administered to the patient for 3-5 minutes
once the nitrous oxide has been terminated.
e) Nitrous oxide should not be used on patients with cerebral palsy



A mother says her teenage daughter has developed
peculiar eating habits. She has been secretly vomiting as a form of
weight control. The daughter will not confirm this behaviour. Which
physical finding best supports a diagnosis of bulimia?

a) Erosion of tooth enamel
b) Hoarseness
c) Lanugo hair
d) Striae
e) Superficial wrist lacerations



Secondary research papers in which all the primary studies on a
particular subject have been hunted out and critically appraised
according to rigorous criteria are called

a) Randomised controlled trials
b) Case control studies
c) Systemic reviews and meta-analysis
d) Cross sectional surveys
e) Cohort studies



Regarding tumours of the salivary glands, which of the following
statement is true.

a) About 20% of all salivary gland tumours are pleomorphic adenoma
b) Most tumours affecting intra oral minor salivary glands are malignant.
c) The adenolymphoma is a rare salivary lymphoma
d) Squamous cell carcinoma is the most common type of malignant
salivary tumour.
e) A carcinoma may arise in a pleomorphic adenoma



Surgical endodontic treatment

a) Is indicated for all failed RCTs
b) Has a success rate of 20%
c) Is indicated if there is a periapical radiolucency seen on the
radiograph
d) Is indicated to prevent removal of extensive coronal restorative work
e) Is contraindicated in all multi-rooted teeth



When should handpieces be placed and sealed in an autoclave
pouch/bag?

a) Whenever they are autoclaved
b) Never
c) Once a day at the end of the session
d) When autoclaved in a vacuum autoclave
e) When autoclaved in a downward displacement type autoclave



Regarding periodontitis, which statement is MOST appropriate.

a) Gingivitis and mild periodontitis are rare.
b) More that 50% of the population exhibit advanced periodontitis
c) Gingivitis precedes periodontitis and all sites with gingivitis develop
periodontitis.
d) Periodontitis is a natural consequence of aging
e) In some patients, periodontitis may progress with episodes of
disease activity and periods of quiescence, in a non-linear manner.



The maxillary sinus

a) Is totally enclosed within the bone of the maxilla
b) Has a lining of ciliated columnar epithelium
c) Drains predominantly by gravitational forces
d) Derives its blood supply largely from the facial artery
e) Is a constant unchanging feature throughout life



You have made a set of upper and lower complete dentures for a
patient who then has difficulty in saying the letters f and v.
The most likely problem with the dentures is

a) Incorrect overbite
b) Incisors too far back palatally
c) Lack of retention
d) Palatal vault too high
e) Palate too thick



Regarding hepatitis B which statement is false

a) It is due to an DNA virus
b) It has an incubation period of 2 to 6 days
c) It can be transmitted via blood products
d) About 1% of the UK population are Hepatitis B Surface Antigen
positive
e) About 10% of infected patients become chronic carriers



With regards to shade selection

a) Metamerism is the phenomena by which the colour of an object
appears different in different lights
b) The value is the strength of the colour
c) The chroma is the brightness or darkness
d) If a tooth shade falls between two tabs, correct shade selection is
that with the higher chroma and lower value
e) Shade selection should be made at the end of the appointment
after tooth preparation



Which of the following is NOT an ideal requirement for an interocclusal
record

a) Does not displace teeth during intercuspation
b) May shrink to about 5% after setting
c) Should reproduce occlusal and incisal surfaces accurately
d) Remain rigid after setting
e) Offers minimal resistance during closure in order to reduce
mandibular flexion or displacement



Which of the following is classed as pharmacy medicine?

a) Fluoride mouthwash 2% (En-de-Kay Fluorinse)
b) Fluoride mouthwash 0.2% (Duraphat)
c) Corsodyl mouthwash 0.12%
d) Fluoride mouthwash 0.05% (Fluorigard)
e) Toothpaste containing < 1500 ppm fluoride



Which of the following is NOT a potential consequence of submerged
deciduous teeth

a) Over eruption
b) Centre line shift
c) Tipping of adjacent teeth
d) Premature exfoliation
e) Increased difficulty of extraction



Which of the following statement about MRSA is true

a) It is a variant of the bacterium Staphylococcus aureus
b) Is the abbreviation for methyl-resistant Staphylococcus aureus
c) Is uncommon in hospitals
d) Affects elderly people
e) Beta lactams are the treatment of choice



Which of the following statements about periodontal-endodontic lesions
is true

a) All perio-endo lesions require joint therapy
b) Root canals only communicate with the periodontium at their
terminal
c) Vitality test are entirely reliable special investigations
d) A non vital pulp always lead to periodontal involvement in the form
of widening of apical ligament space
e) In combined lesions root canal therapy should be performed first



A 56 year old female attends complaining of dry mouth. She is
hypertensive, recently been to Southern India on holiday and is taking
antibiotics for a chest infection.
She is taking other medication for her heart condition. Which of the
following drugs is most likely to be the cause of her dry mouth.

a) ACE Inhibitors
b) Aspirin
c) Atropine
d) Amoxicillin
e) Anti-malarials



Which of the following disorders are most strongly associated with
recurrent multiple discreet oral ulcers.

a) Sjogrens syndrome
b) Bechets disease
c) Tuberculosis
d) Erosive lichen planus
e) Graft versus host disease



Which of the following is NOT a feature of Pagets disease

a) Hypercementosis of teeth, which causes difficulties when
extractions are needed
b) Alveolar ridges may increase in size so that new dentures need
to be made
c) Radiographs of bone may show radiolucent areas along with
sclerotic areas
d) Patients may suffer from symptoms of compression of cranial
nerves
e) Development of osteosarcoma is a common consequence of
Pagets disease



Which of the following lesion is caused by infection with Candida

a) Lichen planus
b) Thrush
c) Leukoplakia
d) Leukodema
e) Apthous stomatitis



Regarding drug metabolism, which statement is FALSE?

a) Many are metabolised in the liver
b) The liver may bio-transform inert pro-drugs into more active
metabolites
c) The kidney is the main site for drug excretion
d) After absorption of a drug in the GIT, it is distributed in the blood
stream bound to haemoglobin
e) Some drugs such as Benzyl Penicillin are deactivated by gastric
acid and can only be given by injection



Which is a late presentation of oral squamous cell carcinoma

a) Red patch
b) Small ulcer
c) Ulcer with rolled margins
d) White patch
e) Smooth surfaced nodule



Which of the following feature suggest that a swelling is due to a
dentigerous cyst

a) The patient is a seven year old female
b) The affected tooth is an impacted maxillary canine
c) The lesion has recurred for the third time
d) Part of the associated tooth is resorbed
e) On excision the cyst is attached to the middle third of the root



A patient presents with a radiolucency in the posterior maxilla region.
You suspect an ameloblastoma. Which of the following feature might
support your suspicion.

a) a.The patient is 17 years old
b) b. The radiolucency is multilocular
c) c. There is evidence of calcification within the radiolucency
d) d. There is no evidence of tooth resorption
e) e. There is parasthesia in the region of the distributionof the
infraorbital nerve



Regarding swelling of salivary glands, which of the following statements
is true

a) Sjogrens syndrome is a common cause of salivary gland swelling
in elderly men
b) Chronic sialadenitis rarely follows duct obstruction
c) Mumps is the most common cause of parotid swelling
d) Salivary calculi never occur in the parotid duct
e) Dry mouth may result from obstruction of a submandibular duct due
to a calculus



A 20 year old girl attends your surgery. In her medical history she tells
you that she suffers from asthma. She uses salbutamol inhalers but still
doesnt quite get relief. Her GP has added some new medication on
which she cant remember.
The add-on treatment is most likely to be

a) Home oxygen
b) Oral diazepam
c) Oral prednisolone
d) Oral ipratropium bromide
e) Inhaled beclometasone



A dentate patient presents to you with generalised toothwear. Your
treatment would involve increasing the occlusal vertical dimension.
Which of the following factors would NOT influence the amount of OVD
increased.

a) What the technician considers appropriate
b) Whether one or both arches have to be restored
c) The chosen restorative technique
d) The properties of the restorative material
e) The patients ability to adapt



EMQ (Extended MatchingQuestions)


Example 1
Choose from the options above the period of time which should elapse
before the next radiographic review in the scenarios below. Each option
may be used once, more than once, or not at all.
A. 1 month
B. 3 months
C. 6 months
D. 12 months
E. 24 months
F. 36 months

1. A 13-year-old patient designated a shaving a high caries risk.
2. A 15-year-old patient considered to be at moderate risk of future
caries.
3. A 32-year-old patient still considered as at high risk of future caries.
4. A 9-year-old patient at low caries risk.
5. A 25-year-old patient at moderate risk of future caries.
6. A38-year-oldpatientwhohashadafullcoveragecrownplaced.
7. A 27-year-old patient who has had orthograde endodontic treatment
to UL6.
8. A7-year-oldwhohashadavitalpulpotomyfollowingtraumatoUL1.



Example 2
For each of the following clinical scenarios identify the most appropriate
skin/nail condition from those provided. Each option may be used once,
more than once, or not at all
A. Clubbing
B. Erythematous palms
C. Evidence of widespread scratching
D. Flattened nails (koilonychias)
E. Keratotic striations
F. Pittednails
G. Purpura
H. 'Target' lesions.

1. A 45 year old woman with known liver disease.
2. A 56-year-old psoriasis sufferer.
3. A woman with a hypochromicmicrocytic anaemia.
4. A heavy smoker with haemoptysis.
5. A patient with a history of gallstones presenting with dark urine and
jaundice.





(Source 2: Questions candidates have remembered from the past are
below)

TOPIC: PAEDODONTICS

A. Behaviour Shaping
B. Distraction
C. Enhancing Control
D. Modelling
E. Negative Reinforcement
F. Systematic Desensitization
G. Tell-show-do

Match the best descriptions for the different Child Behavioural
Management Techniques:

1) Patient given a degree of control through the use of a stop signal
2) Progress through small clear defined steps towards ideal behaviour
3) Demonstrated via positive outcome on a third party and illustrate
rewards for performing appropriately
4) Repeated contacts to hierarchy of fear-producing stimuli gradually
5) Strengthening pattern of behaviour by removing unpleasant stimulus
as long as required behaviour exhibited

TOPIC: ANTIBIOTIC PRESCRIBING

A. Aciclovir
B. Amoxicillin
C. Clindamycin
D. Erythromycin
E. Metronidazole
F. Miconazole
G Nystatin

Match the first choice of antimicrobials that you would consider for the
following conditions:

1) Prophylactic antimicrobial for the removal of retained roots where
there is a clear history of dry sockets following exodontias and allergy to
Penicllins
2) Reflux of fluids into the nose from the oral cavity after upper molar
extraction
3) Primary herpetic gingivostomatitis
4) Oral white plaques which could be dislodged leaving raw areas
associated with inhaler treatment in an asthmatic patient
5) Acutely inflamed bleeding gum with necrosis and loss of interdental
papillae with halitosis

TOPIC: ENDODONTICS

A. Anticurvature filing
B. Apical force technique
C. Balanced force technique
D. Lateral force technique
E. Standardised technique
F. Stepback technique
G. Steptdown technique

For each of the following scenarios, choose the most appropriate term
from the list above

1. You are preparing the coronal part of a sclerosed mesiobuccal
canal on UL6 before taking a working length radiograph.
2. You have determined on a radiograph that the mesiobuccal canal
of an UR7 has a significant curve to the distal.
3. An UL2 requires RCT, you are preparing the apical part of the
canal to a round cross-section.
4. You are preparing the three canals found in LL7, and have already
prepared the apical part of the canals.
5. You have run out of your normal Ni Ti files and need to use hand
K files to prepare the very curved root canals of LL6.


TOPIC: ORTHODONTICS

A. 0
B. 1
C. 2
D. 3
E. 4
F. 5
G. 6
H. 7

For each of the following scenarios, choose the most appropriate IOTN
category from the list above

1. Increased overjet greater than 9mm
2. Minor malocclusions including minor contact point displacements
less than 1mm
3. Reverse overjet greater than 1mm but less than 3.5mm with
incompetent lips
4. Increased and complete overbite with gingival or palatal trauma
5. Point contact displacements greater than 1mm but less than or
equal to 2mm

TOPIC: ORAL LESIONS

A) Shingles
B) Recurrent apthous stomatitis
C) Pemphigus
D) Lichen planus
E) Crohns disease
F) Acute necrotising ulcerative gingivitis
G) Erythema multiforme
H) Candidiosis

Match the oral manifestations you may expect to see for the above
conditions

1) Cobble stoning of mucosa and mucosal tags
2) Iris or target lesions, crusted lips
3) White striae
4) Multiple oral ulcers lasting 1 week to 1 month
5) Unilateral vesiculating rash
6) Blisters which could be blood filled. Nikolskys sign
7) White plaques which can be wiped off leaving a red base
8) Ulcers at the tips of interdental papillae

TOPIC: PERIODONTICS

1. 0
2. 1
3. 2
4. 3
5. 4
6. *

For each of the following scenarios choose the most appropriate BPE
score from the options above.

1. The black band of the WHO probe is partly visible and there is 4mm
of recession present
2. There is a ledge on an MO composite on UL4, but no bleeding
3. The whole of the black band of the WHO probe is visible, but there
is bleeding on gentle probing
4. Some but not all of the black band of the WHO probe is visible
5. There is bleeding on probing near the buccal exposed furcation of
UR6
TOPIC: ANATOMY

A. Lateral pterygoid
B. Masseter
C. Medial pterygoid
D. Temporalis

For each of the following descriptions, choose the most appropriate
muscle from the options above. You may use each option once, more
then once or not at all.

1. Inserts on the lateral surface of the angle and lower ramus of the
mandible
2. Inserts on the pterygoid fovea below the condylar process of the
mandible and the intra-articular cartilage of the tempero-mandibular
joint
3. Inserts on the medial and anterior aspect of the coronoid process of
the mandible
4. Action: elevates the mandible and posterior fibres retract
5. Action: elevates, protracts and laterally displaces the mandible to the
opposite side for chewing

TOPIC: AUTOCALVES

A) The Reporting of Injuries, Diseases and Dangerous Occurrences
Regulations
B) Management of Health & Safety at Work Regulations
C) Provision and Use of Work Equipment Regulations
D) Control of Substances Hazardous to Health
E) The Personal Protective Equipment at Work Regulations
F) Health & safety (First Aid) Regulations
G) Pressure Systems and Transportable Gases Regulations
H) Electricity at Work Regulations

Match the following statements about autoclaves with the above
regulations under which they fall.

1. Dental nurses require training on how to operate an autoclave
2. A competent person should draw up a scheme of examination for
an autoclave
3. Dental practices have to notify the HSE in the event of an
explosion of an autoclave
4. Dental practices have to assess the risks to staff from operating
an autoclave
5. An autoclave must be tested periodically for electrical safety

TOPIC: ODONTOGENIC CYSTS

1. Radicular Cyst
2. Dermoid Cyst
3. Nasopalatine cyst
4. Odontogenic Keratocyst
5. Aneurysmal bone cyst
6. Solitary bone cyst
7. Dentigerous cyst
8. Branchial cyst

Match the following key histological features with the above cysts.

1. A cyst wall containing prominent neurovascular bundles
2. A cyst with keratin in the lumen
3. Aggregates of multinucleate giant cells associated with dilated
vascular channels
4. The presence of sebaceous glands in the cyst wall
5. A cyst lining composed of ciliated, pseudostratified columnar
epithelium with mucous glands
6. Rushton bodies
7. A thin cyst lining composed only of fibrous tissue
8. A palisaded basal epithelial layer


TOPIC: DIET

a) Dietary fibre
b) Dietary protein
c) Folic acid
d) Thiamine
e) Vitamin A
f) Vitamin D
g) Vitamin K

Deficiency of which of the above causes the following clinical
presentation?

1) Macrocytic anaemia
2) Night blindness
3) Bleeding diathesis
4) Osteomalacia
5) Peripheral neuropathy

TOPIC: CHEST PAIN

1. Angina
2. Aortic aneurysm
3. Myocardial infarction
4. Oesophagitis
5. Pericarditis
6. Pneumonia
7. Pulmonary embolism
8. Herpes zoster

For each of the following scenarios, choose the most appropriate
diagnosis from above

1) A 60 year old with acute severe chest pain radiating through to the
back with a wide mediastinum on the chest x-ray
2) A 75 year old smoker with central chest pain radiating to the jaw
when he walks to the shops. The pain resolves at rest.
3) A 40 year old woman with right sided chest pain, worse on
breathing in. There is associated coughing and haemoptysis.
4) A 53 year old man with sudden onset chest pain, radiating to the left
arm, associated with sweating and nausea. This pain has been present
for 2 hours
5) A 76 year old obese man with episodes of low retrosternal burning
pain and difficulty in swallowing


TOPIC: DENTAL PAIN

A. Acute periapical abscess
B. Cracked tooth syndrome
C. Dentine hypersensitivity
D. Irreversable pulpitis
E. Lateral periodontal abscess
F. Reversable pulpitis

For each of the following problems, choose the most likely diagnosis
from above

1) Tooth usually mobile with lateral TTP & associated localised or
diffuse swelling of the adjacent periodontium
2) The tooth is usually extruded with apical TTP. It may be associated
with a localised or diffuse swelling. Radiographic changes show
widening of the periodontal ligament
3) Sharp pain on biting. Short duration
4) Diagnosis by elimination and using cold or hot to elicit symptoms
5) Exaggerated response to pulp testing. Carious cavity or leaking
restoration present
6) Fleeting pain/sensitivity to hot, cold or sweet with immediate onset.
Pain is usually sharp and maybe difficult to locate. Quickly subsidises
after the removal of stimulus