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Free Integrated National Board Dental Examination Practice Questions

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Sample Practice Questions

Try these 10 sample questions from the Integrated National Board Dental Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

  1. 1A 68-year-old patient whose medical history lists warfarin for nonvalvular atrial fibrillation requires extraction of three mandibular teeth. The patient's anticoagulation has been stable. What does the evidence reviewed by the American Dental Association support regarding the warfarin regimen for this procedure?

    1. A. Continue the patient's regular warfarin dose and manage the sockets with local hemostatic measures
    2. B. Withhold the warfarin dose for three days before surgery and restart it the evening after surgery
    3. C. Reduce the warfarin dose by half for one week before surgery and resume the full dose afterward
    4. D. Replace warfarin with a short-acting injectable anticoagulant for the perioperative period only

    Answer: A

    Explanation: The ADA's review of the evidence states that "A 2009 systematic review and meta-analysis found no increased risk of bleeding associated with continuing regular doses of warfarin in comparison with discontinuing or modifying the dose for patients undergoing single and multiple tooth extraction." Because interrupting or reducing the regimen exposes the patient to thromboembolic risk without a demonstrated bleeding benefit, the regular dose is continued and any bleeding is handled locally. Withholding, dose reduction, and bridging are all modifications the cited evidence found unnecessary for extractions.

    Source: Oral Anticoagulant and Antiplatelet Medications and Dental Procedures | American Dental Association — Section on warfarin and antiplatelet agents, paragraph citing the 2009 systematic review and meta-analysis

  2. 2A tooth with a deep restoration is sensitive to cold and to sweets, but the discomfort disappears within a couple of seconds after the stimulus is removed and there is no spontaneous pain or periapical radiographic change. What is the pulpal diagnosis?

    1. A. Reversible pulpitis
    2. B. Symptomatic irreversible pulpitis
    3. C. Normal pulp
    4. D. Previously initiated therapy

    Answer: A

    Explanation: The AAE characterizes reversible pulpitis as a state in which "Discomfort is experienced when a stimulus such as cold or sweet is applied and goes away within a couple of seconds following the removal of the stimulus." It notes that typical etiologies include exposed dentin, caries or deep restorations, and that there are no significant periapical radiographic changes and no spontaneous pain, matching this presentation. Lingering pain would indicate the irreversible form, a normal pulp gives only a mild transient response without the sweet sensitivity described, and previously initiated therapy denotes a tooth already partly treated endodontically.

    Source: Aae Endo Diagnosis (2013) — Endodontic Diagnosis, Colleagues for Excellence, Fall 2013, Reversible Pulpitis

  3. 3A dentist has just removed gloves after a restorative procedure during which no blood or saliva contacted the hands, and the hands are not visibly soiled. Which hand hygiene method does CDC guidance permit in this situation?

    1. A. An alcohol-based hand rub applied according to the manufacturer's label
    2. B. A surgical hand scrub performed before donning the next pair of gloves
    3. C. A rinse with antiseptic mouthrinse solution poured over the hands
    4. D. Wiping the hands with a surface disinfectant wipe from the operatory

    Answer: A

    Explanation: CDC's key recommendations for hand hygiene in dental settings state: "Use soap and water when hands are visibly soiled (e.g., blood, body fluids); otherwise, an alcohol-based hand rub may be used." Because these hands are not visibly soiled, the alcohol-based rub is acceptable. A surgical hand scrub is reserved for surgical procedures, and neither mouthrinse nor an environmental surface disinfectant is a hand hygiene product for health care personnel.

    Source: Standard Precautions | Dental Infection Prevention and Control | CDC — Hand hygiene, Key Recommendations for HAND HYGIENE in Dental Settings

  4. 4After reviewing the medical history of a patient taking apixaban, a dentist judges that the anticoagulant regimen may need to be altered before an extensive surgical procedure. According to ADA guidance, how should that decision be reached?

    1. A. In consultation with and on the advice of the physician who manages the patient's anticoagulation
    2. B. By the dentist alone, on the basis of the extent and bleeding risk of the planned surgical procedure
    3. C. By the patient alone, after being informed of the competing risks of bleeding and thromboembolism
    4. D. By the dispensing pharmacist, on the basis of the drug's half-life and the timing of the last dose

    Answer: A

    Explanation: ADA guidance states that "Any suggested modification to the medication regimen prior to dental surgery should be done in consultation with and on advice of the patient’s physician". The prescribing or managing physician holds the information about thromboembolic risk that determines whether interruption is acceptable, so the decision is a shared one with that physician rather than one the dentist, the patient, or the pharmacist makes alone.

    Source: Oral Anticoagulant and Antiplatelet Medications and Dental Procedures | American Dental Association — Key points, statement on modification of the medication regimen prior to dental surgery

  5. 5An asymptomatic discolored central incisor gives no response to cold or electric pulp testing, while the adjacent teeth respond normally. Which diagnostic category does the American Association of Endodontists apply to this pulp?

    1. A. Pulp necrosis
    2. B. Asymptomatic irreversible pulpitis
    3. C. Condensing osteitis
    4. D. Chronic apical abscess

    Answer: A

    Explanation: The AAE defines pulp necrosis as a diagnostic category indicating death of the dental pulp in which "The pulp is non-responsive to pulp testing and is asymptomatic." Because the control teeth responded normally, the absence of response in the suspect tooth is a true negative rather than a testing artifact. Asymptomatic irreversible pulpitis retains a vital pulp that usually responds normally to thermal testing; condensing osteitis and chronic apical abscess are apical rather than pulpal diagnoses.

    Source: Aae Endo Diagnosis (2013) — Endodontic Diagnosis, Colleagues for Excellence, Fall 2013, Pulp Necrosis

  6. 6The ADA notes that a technological development has blurred the traditional division between direct and indirect restorative materials. Which development is it?

    1. A. Computer-aided design and manufacturing systems allowing in-office production of ceramic restorations
    2. B. Light-emitting diode curing units allowing deeper polymerization of conventional composite resins
    3. C. Self-adhesive luting cements allowing indirect restorations to be seated without surface treatment
    4. D. Digital radiography allowing restoration margins to be assessed without conventional film

    Answer: A

    Explanation: The ADA states that "With the introduction of computer-aided design/computer-aided manufacturing (CAD/CAM) systems, the line dividing direct from indirect restorative materials has been blurred, as this technology allows the in-office production of ceramic restorations." The other options describe real advances in curing, cementation and imaging, but none of them changes whether a restoration requires laboratory fabrication, which is the basis of the direct and indirect division.

    Source: Materials for Direct Restorations | American Dental Association — Introductory section, effect of CAD/CAM on the classification

  7. 7A patient's medication list includes dabigatran. In interpreting this entry before planning surgical treatment, the dentist should recognize dabigatran as which class of oral anticoagulant?

    1. A. Direct thrombin inhibitor
    2. B. Factor Xa inhibitor
    3. C. Vitamin K antagonist
    4. D. Thienopyridine antiplatelet agent

    Answer: A

    Explanation: The ADA describes the oral anticoagulants as follows: "Oral anticoagulants include the vitamin K antagonist warfarin (Coumadin®) and the newer direct-acting agents, including the direct thrombin inhibitor dabigatran (Pradaxa®) and the factor Xa inhibitors apixaban (Eliquis®), rivaroxaban (Xarelto®), and edoxaban". Dabigatran is therefore the direct thrombin inhibitor. Apixaban, rivaroxaban and edoxaban are the factor Xa inhibitors, warfarin is the vitamin K antagonist, and the thienopyridines are antiplatelet drugs rather than anticoagulants.

    Source: Oral Anticoagulant and Antiplatelet Medications and Dental Procedures | American Dental Association — Background section listing oral anticoagulant and antiplatelet agents

  8. 8A dentist is assigning a periodontitis stage for a new patient using the 2017 World Workshop classification. Which measurement should be used to determine the initial stage?

    1. A. Interdental clinical attachment loss at the site of greatest loss
    2. B. Maximum probing depth recorded anywhere in the dentition
    3. C. Percentage of sites that bleed on gentle periodontal probing
    4. D. Number of teeth showing detectable horizontal mobility

    Answer: A

    Explanation: The American Academy of Periodontology's staging and grading chart directs that "Initial stage should be determined using clinical attachment loss (CAL). If CAL is not available, radiographic bone loss (RBL) should be used." The chart records interdental CAL at the site of greatest loss as the severity measure for each stage. Maximum probing depth and furcation status are complexity factors that may shift the stage upward rather than set it, bleeding on probing belongs to grading and to gingival inflammation assessment, and tooth mobility appears only as a Stage IV complexity factor.

    Source: Aap Staging Grading — Periodontitis: Staging, introductory note and Severity row for interdental CAL

  9. 9The ADA reports that the use of metal in indirect restorations is decreasing. Besides the demand for tooth-coloured materials, what does the ADA identify as driving that decline?

    1. A. Increasing internet-fueled concerns regarding toxicity
    2. B. A shortage of noble metals in the global supply chain
    3. C. Regulatory prohibition of base metal alloys in dentistry
    4. D. Evidence that metal restorations fail sooner than ceramics

    Answer: A

    Explanation: The ADA states that all-ceramic restorations "have rapidly gained popularity due to appearance and increasing durability. The use of metal is further decreasing because of increasing internet-fueled concerns regarding toxicity." The driver is therefore patient perception rather than supply, regulation or demonstrated inferior longevity, and the ADA elsewhere describes noble metals as the standard by which other dental materials are judged.

    Source: Materials for Indirect Restorations | American Dental Association — Section comparing metals and ceramics

  10. 10Using the 2017 American College of Cardiology/American Heart Association categories cited by the ADA, a dentist recording a patient's blood pressure should classify the patient as hypertensive at or above which readings?

    1. A. Systolic 130 mm Hg or diastolic 80 mm Hg
    2. B. Systolic 140 mm Hg or diastolic 90 mm Hg
    3. C. Systolic 120 mm Hg or diastolic 70 mm Hg
    4. D. Systolic 160 mm Hg or diastolic 100 mm Hg

    Answer: A

    Explanation: The ADA reports that "hypertension is defined as a systolic pressure of 130 mmHg or greater or a diastolic blood pressure of 80 mmHg or greater" under the 2017 ACC/AHA blood pressure categories. The 140/90 figure is the older threshold from the Seventh Report of the Joint National Committee, which the ADA identifies as the superseded definition; 120/70 falls below any hypertension threshold, and 160/100 corresponds to a considerably more severe stage rather than the diagnostic cutoff.

    Source: Hypertension | American Dental Association — Section describing the 2017 ACC/AHA blood pressure categories, Table 1 discussion

Topics in this practice bank

These topics describe the available practice for Integrated National Board Dental Examination. Review the examination outline and its sources for scope and allocation details.

  • Diagnosis and Treatment Planning — includes all aspects of diagnosis, assessment, interpretation of laboratory results, physical evaluation of structure, appearance and function, as well as background, characteristics, circumstances, underlying conditions and psychological, social or behavioral influences to derive an accurate diagnosis and treatment plan, as well as identify reasonable and safe treatment alternatives for any patient (Clinical Content areas 1-15)
    • CC 1. Interpret patient information and medical data to assess and manage patients.
    • CC 2. Identify the chief complaint and understand the contributing factors.
    • CC 3. Perform head and neck and intraoral examinations, interpreting and evaluating the clinical findings.
    • CC 4. Use clinical and epidemiological data to diagnose and establish a prognosis for dental abnormalities and pathology.
    • CC 5. Recognize the normal range of clinical findings and distinguish significant deviations that require monitoring, treatment, or management.
    • CC 6. Predict the most likely diagnostic result given available patient information.
    • CC 7. Interpret diagnostic results to inform understanding of the patient’s condition.
    • CC 8. Recognize the manifestations of systemic disease and how the disease and its management may affect the delivery of dental care.
    • CC 9. Recognize the interrelationship between oral health and systemic disease, and implement strategies for improving overall health.
    • CC 10. Select the diagnostic tools most likely to establish or confirm the diagnosis.
    • CC 11. Collect information from diverse sources (patient, guardian, patient records, allied staff, and other healthcare professionals) to make informed decisions.
    • CC 12. Formulate a comprehensive diagnosis and treatment plan for patient management.
    • CC 13. Discuss etiologies, treatment alternatives, and prognoses with patients so they are educated and can make informed decisions concerning the management of their care.
    • CC 14. Understand how patient attributes (e.g., sex, age, race, ethnicity, and special needs), social background and values influence the provision of oral health care at all stages of life.
    • CC 15. Interact and communicate with patients using psychological, social, and behavioral principles.
  • Oral Health Management — includes all aspects of patient care delivery, including provision and modification of treatment, handling of complications, intervention outcomes assessment, and all developments that arise in the course of managing a patient’s oral health care (Clinical Content areas 16-38)
    • CC 16. Prevent, recognize, and manage medical emergencies (e.g., cardiac arrest).
    • CC 17. Prevent, recognize, and manage dental emergencies.
    • CC 18. Recognize and manage acute pain, hemorrhage, trauma, and infection of the orofacial complex.
    • CC 19. Prevent, diagnose, and manage pain during treatment.
    • CC 20. Prevent, diagnose, and manage pulpal and periradicular diseases.
    • CC 21. Prevent, diagnose, and manage caries.
    • CC 22. Prevent, diagnose, and manage periodontal diseases.
    • CC 23. Prevent, diagnose, and manage oral mucosal and osseous diseases.
    • CC 24. Recognize, manage, and report patient abuse and neglect.
    • CC 25. Recognize and manage substance abuse.
    • CC 26. Select and administer or prescribe pharmacological agents in the treatment of dental patients.
    • CC 27. Anticipate, prevent, and manage complications arising from the use of therapeutic and pharmacological agents in patient care.
    • CC 28. Diagnose endodontic conditions and perform endodontic procedures.
    • CC 29. Diagnose and manage the restorative needs of edentulous and partially edentulous patients.
    • CC 30. Restore tooth function, structure, and esthetics by replacing missing and defective tooth structure, while promoting soft and hard tissue health.
    • CC 31. Perform prosthetic restorations (fixed or removable) and implant procedures for edentulous and partially edentulous patients.
    • CC 32. Diagnose and manage oral surgical treatment needs.
    • CC 33. Perform oral surgical procedures.
    • CC 34. Prevent, diagnose, and manage developmental or acquired occlusal problems.
    • CC 35. Prevent, diagnose, and manage temporomandibular disorders.
    • CC 36. Diagnose and manage patients requiring modification of oral tissues to optimize form, function and esthetics.
    • CC 37. Evaluate outcomes of comprehensive dental care.
    • CC 38. Manage the oral esthetic needs of patients.
  • Practice and Profession — includes the understanding, implementation and monitoring of effective systems, procedures, and policies that support professional practice integrity, quality control and self or organizational performance assessment, as well as systems, procedures, and policies that enable skillful integration of new knowledge, products and technology, and that minimize risk and enhance the quality of care provided or improve community oral health (Clinical Content areas 39-56)
    • CC 39. Evaluate and integrate emerging trends in health care.
    • CC 40. Evaluate social and economic trends and adapt to accommodate their impact on oral health care.
    • CC 41. Evaluate scientific literature and integrate new knowledge and best research outcomes with patient values and other sources of information to make decisions about treatment.
    • CC 42. Practice within the general dentist’s scope of competence and consult with or refer to professional colleagues when indicated.
    • CC 43. Evaluate and utilize available and emerging resources (e.g., laboratory and clinical resources, information technology) to facilitate patient care, practice management, and professional development.
    • CC 44. Conduct practice activities in a manner that manages risk and is consistent with jurisprudence and ethical requirements in dentistry and healthcare.
    • CC 45. Recognize and respond to situations involving ethical and jurisprudence considerations.
    • CC 46. Maintain patient records in accordance with jurisprudence and ethical requirements.
    • CC 47. Conduct practice related business activities and financial operations in accordance with sound business practices and jurisprudence (e.g., OSHA and HIPAA).
    • CC 48. Develop a catastrophe preparedness plan for the dental practice.
    • CC 49. Manage, coordinate, and supervise the activity of allied dental health personnel.
    • CC 50. Assess one's personal level of skills and knowledge relative to dental practice.
    • CC 51. Adhere to standard precautions for infection control for all clinical procedures.
    • CC 52. Use prevention, intervention, and patient education strategies to maximize oral health.
    • CC 53. Collaborate with dental team members and other health care professionals to promote health and manage disease in communities.
    • CC 54. Evaluate and implement systems of oral health care management and delivery that will address the needs of patient populations served.
    • CC 55. Apply quality assurance, assessment, and improvement concepts to improve outcomes.
    • CC 56. Communicate case design to laboratory technicians and evaluate the resultant restoration or prosthesis.

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These are independent study questions, not actual examination items. For examination requirements and official information, view Integrated National Board Dental Examination details.