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Free National Board Dental Hygiene Examination Practice Questions

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Sample Practice Questions

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

  1. 1A dental hygienist is charting the site of a mucosal lesion seen on the dorsum of the tongue and must record whether the site lies in the oral cavity or in the pharynx. Using the National Cancer Institute's anatomic division of head and neck sites, what portion of the tongue is contained within the oral cavity?

    1. A. The front two-thirds of the tongue
    2. B. The front one-third of the tongue
    3. C. The front one-half of the tongue
    4. D. The front three-fourths of the tongue

    Answer: A

    Explanation: The National Cancer Institute assigns the anterior tongue to the oral cavity: "Oral cavity: Includes the lips, the front two-thirds of the tongue, the gums, the lining inside the cheeks and lips, the floor (bottom) of the mouth under the tongue, the hard palate (bony top of the mouth), and the small area of the gum behind the wisdom teeth." The remaining posterior portion is assigned elsewhere, because the oropharynx is described as including "the base of the tongue". A lesion anterior to that boundary is therefore charted as an oral cavity site, so the two-thirds figure is the one that governs.

    Reference: Head and Neck Cancers - NCI — Head and Neck Cancers fact sheet, 'Cancers of the head and neck can form in the:' list, Oral cavity and Throat (pharynx) entries

  2. 2Demineralized enamel that has remineralized in the presence of fluoride differs in composition from the crystal structure that was originally lost. According to CDC, how does the newly formed enamel crystal structure compare with the original?

    1. A. It is more acid resistant and contains more fluoride and less carbonate
    2. B. It is more acid resistant and contains more carbonate and less fluoride
    3. C. It is less acid resistant and contains more fluoride and more carbonate
    4. D. It is less acid resistant and contains less fluoride and less carbonate

    Answer: A

    Explanation: CDC describes the composition of the rebuilt crystal: "The released fluoride and the fluoride present in saliva are then taken up, along with calcium and phosphate, by demineralized enamel to establish an improved enamel crystal structure. This improved structure is more acid resistant and contains more fluoride and less carbonate." Both halves of the change matter: fluoride content rises and carbonate content falls, and it is that substitution that produces the greater acid resistance.

    Reference: Rr5014 front cover-Cont Ed-web.p65 — MMWR 2001;50(RR-14), mechanism of action discussion preceding Figure 1 (p. 4)

  3. 3A hygienist is presenting to a town council on why community water fluoridation should be continued. According to CDC, which population does this measure reach?

    1. A. Persons in all age groups and of all socioeconomic status, including those hard to reach otherwise
    2. B. Children of school age only, because fluoride acts on teeth that are still developing before eruption
    3. C. Adults over sixty only, because the benefit depends on many years of cumulative exposure to it
    4. D. Families with private dental insurance only, because they attend for regular professional care

    Answer: A

    Explanation: CDC describes the reach of the measure: "Community water fluoridation is a safe, effective, and inexpensive way to prevent dental caries. This modality benefits persons in all age groups and of all SES, including those difficult to reach through other public health programs and private dental care." Because fluoride acts posteruptively and topically, CDC also states that "adults also benefit from fluoride, rather than only children, as was previously assumed."

    Reference: Rr5014 front cover-Cont Ed-web.p65 — MMWR 2001;50(RR-14), RECOMMENDATIONS, Continue and Extend Fluoridation of Community Drinking Water (p. 26)

  4. 4Case: A 58-year-old woman reports dry mouth and dry eyes lasting more than a year, with several new cervical caries lesions and bilateral salivary gland swelling. Her physician suspects an autoimmune disorder. According to the American Dental Association, which oral manifestations are associated with Sjogren disease?

    1. A. Increased risk of caries, gingivitis, oral candidiasis and enlarged salivary glands
    2. B. Increased risk of enamel fluorosis, pitting of the enamel and delayed tooth eruption
    3. C. Increased risk of tooth mobility, pulpal calcification and root resorption of incisors
    4. D. Increased risk of tongue fissuring, cleft of the soft palate and gingival overgrowth

    Answer: A

    Explanation: The ADA describes the disease and its oral picture, beginning with the nature of the condition: "Sjögren disease is an autoimmune disease that can result in the destruction of exocrine glandular epithelium." It reports that the most common symptoms are dry mouth and dry eyes, and that the specific oral manifestations associated with the disease may include increased risk of caries, gingivitis, oral candidiasis and enlarged salivary glands. The caries and gland enlargement in this case fit that pattern.

    Reference: Sjögren Disease | American Dental Association — ADA Oral Health Topics, Sjogren Disease, Key Points section

  5. 5A hygienist detects an ulcerated lesion at the base of the tongue during an examination and must name the anatomic region of the site in the referral note. Under the National Cancer Institute's division of head and neck anatomy, which region contains the base of the tongue?

    1. A. Oropharynx
    2. B. Nasopharynx
    3. C. Hypopharynx
    4. D. Oral cavity

    Answer: A

    Explanation: The National Cancer Institute places the base of the tongue in the middle division of the pharynx: the pharynx "has three parts: the nasopharynx (the upper part of the pharynx, behind the nose); the oropharynx (the middle part of the pharynx, including the soft palate [the back of the mouth], the base of the tongue, and the tonsils); the hypopharynx (the lower part of the pharynx)." Because only "the front two-thirds of the tongue" belongs to the oral cavity, the base of the tongue is recorded as an oropharyngeal site rather than an oral cavity site.

    Reference: Head and Neck Cancers - NCI — Head and Neck Cancers fact sheet, 'Cancers of the head and neck can form in the:' list, Throat (pharynx) and Oral cavity entries

  6. 6A hygienist is deciding where a professionally applied topical fluoride will have the greatest uptake on a patient with early white-spot lesions adjacent to intact enamel. According to CDC, how does fluoride uptake by demineralized enamel compare with uptake by sound enamel?

    1. A. Demineralized enamel takes up fluoride more readily than sound enamel
    2. B. Demineralized enamel takes up fluoride less readily than sound enamel
    3. C. Demineralized and sound enamel take up fluoride at identical rates
    4. D. Neither demineralized nor sound enamel takes up fluoride after eruption

    Answer: A

    Explanation: CDC states the comparison directly: "Fluoride is more readily taken up by demineralized enamel than by sound enamel." The same passage explains that cycles of "demineralization and remineralization continue throughout the lifetime of the tooth," so uptake is not confined to the preeruptive period, and the early lesion rather than the adjacent intact surface is where the applied fluoride is preferentially incorporated.

    Reference: Rr5014 front cover-Cont Ed-web.p65 — MMWR 2001;50(RR-14), mechanism of action discussion preceding Figure 1 (p. 4)

  7. 7A hygienist is asked whether fluoridation narrows or widens the gap in decay experience between poorer and better-off children. According to CDC, what effect does water fluoridation have on those disparities?

    1. A. It reduces the disparities in caries experience between poor and nonpoor children
    2. B. It widens the disparities in caries experience between poor and nonpoor children
    3. C. It leaves the disparities in caries experience between the two groups unchanged
    4. D. It reduces caries only among nonpoor children who also attend regularly for care

    Answer: A

    Explanation: CDC reports the effect on the gap and the likely reason: "Water fluoridation also reduces the disparities in caries experience among poor and nonpoor children. Caries experience is considerably higher among persons in low SES strata than among those in high SES strata... Thus, these persons might receive more benefit from fluoridated community water than persons from high SES strata. Regardless of SES, water fluoridation is the most effective and efficient strategy to reduce dental caries."

    Reference: Rr5014 front cover-Cont Ed-web.p65 — MMWR 2001;50(RR-14), disparities discussion (p. 12)

  8. 8Case: A patient's health history notes a reaction to natural rubber latex. The operatory must be prepared with gloves that do not carry the allergenic protein. According to the American Dental Association, which glove materials are not made with that protein?

    1. A. Nitrile and vinyl synthetic latex products
    2. B. Powdered natural rubber latex products
    3. C. Powder-free natural rubber latex products
    4. D. Natural rubber latex products that are washed

    Answer: A

    Explanation: The ADA distinguishes the materials by protein content: "Natural rubber latex contains protein that can cause allergic reactions. Synthetic latex products, including nitrile and vinyl products, are not made with this protein." Removing or reducing powder does not remove the protein; the ADA notes separately that "Powdered latex gloves have been banned by the U.S. Food and Drug Administration due to the role powder plays in triggering allergic response in susceptible individuals."

    Reference: Latex Allergy | American Dental Association — ADA Oral Health Topics, Latex Allergy, Key Points section

  9. 9While explaining to a student why a small swelling can arise almost anywhere on the lining of the mouth, a hygienist describes the distribution of the minor salivary glands. According to the National Cancer Institute, where is minor salivary gland tissue found?

    1. A. Throughout the mucous membranes of the mouth and throat
    2. B. In the floor of the mouth and alongside the lower jawbone
    3. C. Within the paired glands that lie just in front of each ear
    4. D. Along the lateral borders of the tongue and the soft palate

    Answer: A

    Explanation: The National Cancer Institute distinguishes the two groups of glands by their distribution: "The major salivary glands are in the floor of the mouth and near the jawbone. The salivary glands produce saliva. Minor salivary glands are located throughout the mucous membranes of the mouth and throat." The minor glands are therefore not confined to one site; the locations described in the other options are restricted regions rather than the diffuse mucosal distribution that defines minor salivary gland tissue.

    Reference: Head and Neck Cancers - NCI — Head and Neck Cancers fact sheet, 'Cancers of the head and neck can form in the:' list, Salivary glands entry

  10. 10After a patient brushes with a fluoride toothpaste, the fluoride concentration in the saliva in the mouth rises sharply. According to CDC, how long does that raised salivary fluoride concentration take to return to its previous level?

    1. A. Within 1 to 2 hours after the fluoride exposure
    2. B. Within 5 to 10 minutes after the fluoride exposure
    3. C. Within 8 to 12 hours after the fluoride exposure
    4. D. Within 24 to 48 hours after the fluoride exposure

    Answer: A

    Explanation: CDC reports that drinking fluoridated water, brushing with fluoride toothpaste or using other fluoride dental products raises the salivary fluoride concentration by a hundred to a thousand times, and then states how long that lasts: "The concentration returns to previous levels within 1–2 hours". During that interval, CDC adds, saliva serves as an important source of fluoride for concentration in plaque and for tooth remineralization, which is why CDC emphasises frequent small exposures rather than a single large one.

    Reference: Rr5014 front cover-Cont Ed-web.p65 — MMWR 2001;50(RR-14), mechanism of action discussion, saliva as a carrier of topical fluoride (p. 4)

Topics in this practice bank

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

  • Discipline-Based Component — Scientific Basis for Dental Hygiene Practice (61 items)
    • Anatomic Sciences
    • Anatomic Sciences — Anatomy
    • Anatomic Sciences — Anatomy — Head and neck anatomy
    • Anatomic Sciences — Anatomy — Dental anatomy
    • Anatomic Sciences — Anatomy — Dental anatomy — General anatomy
    • Anatomic Sciences — Anatomy — Dental anatomy — Root anatomy
    • Anatomic Sciences — Anatomy — Histology and Embryology
    • Anatomic Sciences — Physiology
    • Anatomic Sciences — Biochemistry and Nutrition
    • Anatomic Sciences — Microbiology and Immunology
    • Anatomic Sciences — Pathology
    • Anatomic Sciences — Pathology — General
    • Anatomic Sciences — Pathology — Oral
    • Anatomic Sciences — Pharmacology
  • Discipline-Based Component — Provision of Clinical Dental Hygiene Services (115 items)
    • Assessing Patient Characteristics
    • Assessing Patient Characteristics — Medical and dental history
    • Assessing Patient Characteristics — Head and neck examination
    • Assessing Patient Characteristics — Periodontal evaluation
    • Assessing Patient Characteristics — Oral evaluation
    • Assessing Patient Characteristics — General
    • Obtaining and Interpreting Radiographs
    • Obtaining and Interpreting Radiographs — Principles of radiophysics and radiobiology
    • Obtaining and Interpreting Radiographs — Principles of radiologic health
    • Obtaining and Interpreting Radiographs — Technique
    • Obtaining and Interpreting Radiographs — Recognition of normalities and abnormalities
    • Obtaining and Interpreting Radiographs — General
    • Planning and Managing Dental Hygiene Care
    • Planning and Managing Dental Hygiene Care — Infection control (application)
    • Planning and Managing Dental Hygiene Care — Recognition of emergency situations and provision of appropriate care
    • Planning and Managing Dental Hygiene Care — Individualized patient education
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Planning of individualized instruction
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Provision of instruction for prevention and management of oral diseases
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Provision of instruction for prevention and management of oral diseases — Dental caries
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Provision of instruction for prevention and management of oral diseases — Periodontal disease
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Provision of instruction for prevention and management of oral diseases — Oral conditions
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Anxiety and pain control
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Recognition and management of compromised patients
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Dental hygiene treatment strategies
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Dental hygiene treatment strategies — Diagnosis
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Dental hygiene treatment strategies — Treatment plan
    • Planning and Managing Dental Hygiene Care — Individualized patient education — Dental hygiene treatment strategies — Case presentation
    • Planning and Managing Dental Hygiene Care — Individualized patient education — General
    • Performing Periodontal Procedures
    • Performing Periodontal Procedures — Etiology and pathogenesis of periodontal diseases
    • Performing Periodontal Procedures — Prescribed therapy
    • Performing Periodontal Procedures — Prescribed therapy — Periodontal debridement
    • Performing Periodontal Procedures — Prescribed therapy — Surgical support services
    • Performing Periodontal Procedures — Prescribed therapy — Chemotherapeutic agents
    • Performing Periodontal Procedures — Prescribed therapy — General
    • Performing Periodontal Procedures — Reassessment and maintenance (e.g., implant care)
    • Using Preventive Agents
    • Using Preventive Agents — Fluorides - systemic and topical
    • Using Preventive Agents — Fluorides - systemic and topical — Mechanisms of action
    • Using Preventive Agents — Fluorides - systemic and topical — Toxicology
    • Using Preventive Agents — Fluorides - systemic and topical — Methods of administration
    • Using Preventive Agents — Fluorides - systemic and topical — Methods of administration — Water fluoridation
    • Using Preventive Agents — Fluorides - systemic and topical — Methods of administration — Self-administered
    • Using Preventive Agents — Pit and fissure sealants
    • Using Preventive Agents — Other preventive agents
    • Providing Supportive Treatment Services
    • Providing Supportive Treatment Services — Properties and manipulation of materials
    • Providing Supportive Treatment Services — Polishing natural and restored teeth
    • Providing Supportive Treatment Services — Making of impressions and preparation of study casts
    • Providing Supportive Treatment Services — Other supportive services (e.g., tooth desensitization)
    • Providing Supportive Treatment Services — General
    • Professional Responsibility
    • Professional Responsibility — Ethical principles, including informed consent
    • Professional Responsibility — Regulatory compliance
    • Professional Responsibility — Patient and professional communication
    • Professional Responsibility — General
  • Discipline-Based Component — Community Health/Research Principles (24 items)
    • Promoting Health and Preventing Disease Within Groups
    • Participating in Community Programs
    • Participating in Community Programs — Assessing populations and defining objectives
    • Participating in Community Programs — Designing, implementing, and evaluating programs
    • Analyzing Scientific Literature, Understanding Statistical Concepts, and Applying Research Results
  • Case-Based Component (150 items involving 12 to 15 dental hygiene patient cases)
    • Cases present information dealing with adult and child patients and may involve geriatric, adult-periodontal, pediatric, special needs, medically compromised, and other patient types; a medically compromised patient is one whose health status may require modification of standard treatment or special consideration.
    • Patient information is presented by means of patient histories, dental charts, radiographs, and clinical photographs.
    • Assessing patient characteristics
    • Obtaining and interpreting radiographs
    • Planning and managing dental hygiene care
    • Performing periodontal procedures
    • Using preventive agents
    • Providing supportive treatment service
    • Professional responsibility

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