Applied Biomedical Sciences
15-25%of exam
Restorative, Prosthodontics, Implants
11-21%of exam
Oral Medicine, Pathology, Radiology
10-20%of exam
Pharmacology, Anesthesia, Emergencies
9-19%of exam
Orthodontics and Lifespan Care
3-13%of exam
Periodontics
3-13%of exam
Surgery, Trauma, Pain, Emergencies
3-13%of exam
Oral SurgeryDental TraumaOrofacial PainDental Emergencies
Endodontics
1-11%of exam
Evidence, Prevention, Infection, Ethics
0-10%of exam
Quick Facts
- Questions
- 200 single-answer MCQs
- Parts
- Two in one day
- Time per part
- Two hours
- Total testing
- Four hours
- Scheduled breaks
- One
- Question value
- One point each
- Wrong-answer penalty
- None
- Passing score
- Equated scaled 75
- Attempt limit
- Three
- Delivery
- Prometric or select booklet
- Tooth notation
- FDI two-digit
- Results
- Normally within eight weeks
- Failed-score verification
- Request within 30 days
FDI Numbering
Quadrant first, tooth second
Permanent quadrants one through fourPrimary quadrants five through eight
Anatomy and Physiology
- CN V
- Facial sensation; mastication motor
- CN VII
- Facial expression; taste pathway
- Coronoid notch
- IAN block height landmark
- Below mylohyoid
- Submandibular spread
- Above mylohyoid
- Sublingual spread
- PTH
- Raises serum calcium
- Hyperventilation
- Respiratory alkalosis
- Supine pregnancy
- Caval compression lowers return
Microbiology and Cariology
- Caries driver
- Frequent fermentable carbohydrate exposure
- Acidogenic biofilm
- Produces repeated pH drops
- Topical fluoride
- Promotes remineralization
- Secretory antibody
- IgA
- Primary response
- IgM appears first
- Type I allergy
- IgE mast-cell degranulation
- Neutrophil chemotaxis
- C5a, LTB4, IL-8
- Oral candidiasis
- Candida albicans commonly
Biomaterials
- Yield strength
- Begins permanent deformation
- Elastic modulus
- Resistance to elastic bending
- Polymerization shrinkage
- Can open marginal gaps
- Composite filler
- Strengthens; reduces shrinkage
- Glass ionomer
- Chemical bond; fluoride release
- High-copper amalgam
- Eliminates gamma-two phase
- PVS
- Highly dimensionally stable
- Polyether
- Hydrophilic and stiff
Mucositis vs Peri-Implantitis
Mucositis
- Soft-tissue inflammation
- No progressive bone loss
Peri-implantitis
- Inflammation plus bone loss
- Often needs escalation
Compare current and baseline bone
Restorative Choice
- Lesion is noncavitated→Prioritize prevention(Monitor lesion activity)
- Isolation is excellent→Consider bonded composite(Control shrinkage stress)
- Moisture control is limited→Consider glass ionomer(Match load demands)
- Deep caries stays vital→Use selective excavation(Avoid unnecessary exposure)
- Cusp is structurally weakened→Consider cuspal coverage(Assess remaining tissue)
- Ferrule is inadequate→Reassess restorability(Do not crown blindly)
- Tooth replacement is planned→Compare all options(Patient values matter)
- Risk remains uncontrolled→Stabilize before definitive care(Restoration alone will fail)
Direct Restorative
- Noncavitated active lesion
- Control risk; remineralize
- Cavitated cleansable lesion
- Consider nonoperative control
- Cavitated uncleansable lesion
- Restore conservatively
- Selective excavation
- Protects deep vital pulp
- Enamel etch
- Creates micromechanical retention
- C-factor
- Bonded-to-free surface ratio
- Deep preparation
- Preserve remaining dentin
- Definitive seal
- Controls bacterial leakage
Direct vs Indirect Pulp Therapy
Direct cap
- Material touches exposed pulp
- Strict case selection
Indirect treatment
- Leaves deepest affected dentin
- Avoids pulp exposure
Vital diagnosis controls selection
Prosthodontics
- Ferrule
- Encircles sound tooth structure
- Crown retention
- Resists pathwise removal
- Crown resistance
- Resists tipping forces
- Denture support
- Resists tissueward movement
- Denture retention
- Resists dislodgement
- Denture stability
- Resists lateral movement
- Kennedy classification
- Based on edentulous areas
- RPI assembly
- Rest, plate, I-bar
Screw vs Cement Retention
Screw retained
- Retrievable restoration
- Access channel required
Cement retained
- No occlusal access hole
- Residual cement risk
Position and retrievability decide
Implants
- Primary stability
- Mechanical at placement
- Secondary stability
- Biological after healing
- Osseointegration
- Direct functional bone contact
- Three-dimensional planning
- Restoration guides implant position
- Excess cement
- Raises peri-implant inflammation risk
- Overloading
- Threatens components and bone
- Mucositis
- Inflammation without bone loss
- Peri-implantitis
- Inflammation with bone loss
Radiographic Scan
Site, Contour, Appearance, Neighbour effects
Describe before diagnosingAdd vitality and history
Pemphigus vs Pemphigoid
Pemphigus
- Intraepithelial acantholysis
- Fragile flaccid bullae
Pemphigoid
- Subepithelial split
- Scarring risk exists
Biopsy confirms separation plane
White Lesion Picker
- Plaque wipes away→Consider candidiasis(Check predisposing factors)
- Bilateral lace-like striae→Consider lichen planus(Assess symptoms and pattern)
- Along occlusal trauma→Remove local irritant(Confirm resolution)
- Lateral tongue corrugation→Consider hairy leukoplakia(Assess immune status)
- Persistent unexplained plaque→Use leukoplakia pathway(Risk-assess and biopsy)
- Red component appears→Escalate biopsy urgency(Higher dysplasia concern)
- Induration or ulceration→Urgent specialist assessment(Exclude malignancy)
- Diagnosis remains uncertain→Biopsy or refer(Do not observe indefinitely)
Mucosal Differentials
- Candidiasis
- White plaques wipe away
- Leukoplakia
- Nonwipeable diagnosis of exclusion
- Lichen planus
- Bilateral Wickham striae
- Minor aphthae
- Nonkeratinized mucosa; heal unscarred
- Recurrent herpes
- Keratinized mucosa commonly
- Erythroplakia
- High dysplasia risk
- Suspicious ulcer
- Persistent, indurated, rolled border
- Actinic cheilitis
- Chronic lower-lip ultraviolet injury
Jaw Lesions and Radiology
- Radicular cyst
- Apex of nonvital tooth
- Dentigerous cyst
- Crown; attaches at CEJ
- Lateral periodontal cyst
- Root side; tooth vital
- OKC
- Anteroposterior growth; recurrence risk
- Ameloblastoma
- Posterior mandible; expansile multilocular
- Cemento-osseous dysplasia
- Vital teeth; maturation pattern
- Aggressive border
- Ill-defined or destructive
- Image interpretation
- Site, border, density, effects
Emergency Start
Stop, Airway, Function, Escalate
Stop dental treatmentSupport breathing and circulation
Syncope vs Anaphylaxis
Syncope
- Pale, slow pulse
- Improves supine
Anaphylaxis
- Airway or circulation compromise
- Needs IM epinephrine
Airway signs demand epinephrine
Emergency First Response
- Patient loses consciousness→Assess airway and breathing(Activate help when needed)
- Pale with brief faint→Supine; elevate legs(Likely syncope)
- Wheeze after allergen→Give IM epinephrine(Treat as anaphylaxis)
- Known asthma wheeze→Give inhaled salbutamol(Escalate if unresponsive)
- Conscious and hypoglycemic→Give oral glucose(Recheck clinical response)
- Seizure remains active→Protect from injury(Do not restrain)
- Chest pain persists→Activate emergency services(Suspect acute coronary syndrome)
- Diagnosis is uncertain→Support ABCs(Seek emergency assistance)
Dental Pharmacology
- Amide anesthetics
- Mainly hepatic metabolism
- Ester anesthetics
- Plasma esterase hydrolysis
- Epinephrine
- Slows anesthetic absorption
- NSAIDs
- First-line inflammatory dental pain
- Odontogenic infection
- Source control comes first
- Antibiotics
- Use when clinically indicated
- IE prophylaxis allergy
- Clindamycin no longer recommended
- Warfarin
- Usually continue; use local hemostasis
Medical Emergencies
- Syncope
- Supine; legs elevated
- Anaphylaxis
- IM epinephrine promptly
- Acute asthma
- Inhaled salbutamol
- Conscious hypoglycemia
- Oral fast-acting glucose
- Unconscious hypoglycemia
- Glucagon or IV glucose
- Seizure
- Protect; never restrain
- Suspected myocardial infarction
- Activate emergency services
- Hyperventilation
- Reassure; coach slow breathing
Orthodontics and Pediatrics
- Angle Class I
- Normal molar relationship
- Angle Class II
- Mandibular molar distal
- Angle Class III
- Mandibular molar mesial
- Primary enamel
- Thinner than permanent
- Primary pulp
- Proportionally larger
- Avulsed primary tooth
- Do not replant
- Tell-Show-Do
- Explain, demonstrate, perform
- Retention
- Limits orthodontic relapse
Geriatric and Special Needs
- Polypharmacy
- Common xerostomia driver
- Root caries
- Control risk and moisture
- Capacity
- Decision-specific and time-specific
- Substitute decision-maker
- Follows jurisdictional law
- Autism support
- Visual aids; sensory accommodation
- Caregiver role
- Support, not automatic consent
- Wheelchair care
- Plan access and transfer
- Referral
- When office safety is insufficient
Periodontitis Labels
Stage severity; Grade speed
Stage includes complexityGrade includes risk modifiers
Gingivitis vs Periodontitis
Gingivitis
- Inflammation only
- No attachment loss
Periodontitis
- Attachment loss present
- Stage and grade required
CAL separates the diagnoses
Periodontal Classifier
- Inflammation without CAL→Diagnose gingivitis(Use extent descriptor)
- Interdental CAL exists→Assess periodontitis(Exclude nonperiodontal causes)
- Periodontitis is confirmed→Assign stage(Severity plus complexity)
- Stage is assigned→Assign grade(Progression plus modifiers)
- Few teeth affected→Label localized extent(Apply current threshold)
- Many teeth affected→Label generalized extent(Map affected dentition)
- Implant bleeds without loss→Peri-implant mucositis(Compare baseline imaging)
- Implant bone loss progresses→Peri-implantitis(Control local risks)
Periodontal Diagnosis
- Probing depth
- Margin to pocket base
- Clinical attachment loss
- CEJ to pocket base
- Bleeding on probing
- Inflammation indicator
- Gingivitis
- Inflammation without attachment loss
- Periodontitis
- Attachment and bone loss
- Stage
- Severity and complexity
- Grade
- Progression and risk
- Extent
- Localized or generalized
Periodontal Therapy
- Initial therapy
- Biofilm and risk control
- Instrumentation
- Disrupts subgingival deposits
- Re-evaluation
- Measures treatment response
- Residual deep sites
- Consider further therapy
- Regeneration
- Restores lost attachment apparatus
- Resection
- Reshapes diseased tissues
- Maintenance
- Risk-based supportive care
- Smoking
- Major modifiable risk factor
Primary vs Permanent Avulsion
Primary tooth
- Never replant
- Protect permanent successor
Permanent tooth
- Replant promptly when appropriate
- Handle crown only
Identify dentition before acting
Surgery, Trauma, and Pain
- Spreading infection
- Airway risk comes first
- Fluctuant abscess
- Drain and treat source
- Dry socket
- Severe delayed postextraction pain
- Oroantral communication
- Protect clot; sinus precautions
- Avulsed permanent tooth
- Replant promptly when appropriate
- Incisional biopsy
- Large or suspicious lesion
- Excisional biopsy
- Small apparently benign lesion
- Trigeminal neuralgia
- Brief electric triggerable pain
Reversible vs Irreversible Pulpitis
Reversible
- Brief provoked response
- Pulp can recover
Irreversible
- Lingering or spontaneous pain
- Pulp cannot recover
Test against control teeth
Pulpal Diagnosis Picker
- Brief provoked response→Reversible pulpitis(Remove cause; seal)
- Lingering thermal response→Irreversible pulpitis(Pulpal treatment indicated)
- Spontaneous severe pain→Suspect irreversible pulpitis(Correlate every test)
- No sensibility response→Suspect pulp necrosis(Rule out false negative)
- Percussion is tender→Add apical diagnosis(Pulpal diagnosis remains separate)
- Swelling or purulence→Acute apical abscess(Drain and control source)
- Sinus tract present→Chronic apical abscess(Trace to origin)
- Tests conflict→Repeat and compare controls(Never diagnose one test)
Pulpal Diagnosis
- Sensibility test
- Measures neural response
- Vitality test
- Measures pulpal blood flow
- Reversible pulpitis
- Brief provoked pain
- Irreversible pulpitis
- Lingering or spontaneous pain
- Pulp necrosis
- Usually no sensibility response
- Apical periodontitis
- Percussion or biting tenderness
- Acute apical abscess
- Purulence and swelling
- Diagnostic rule
- Correlate history and tests
Canal Treatment
- Working length
- Electronic plus radiographic confirmation
- Sodium hypochlorite
- Dissolves tissue; antimicrobial
- EDTA
- Removes inorganic smear layer
- Chlorhexidine
- Antimicrobial; no tissue dissolution
- NaOCl plus CHX
- Never mix directly
- Obturation
- Dense fill with apical control
- Coronal seal
- Prevents reinfection
- Persistent disease
- Reassess before retreatment
Clinical Question
Patient, Intervention, Comparison, Outcome
Build searchable questionsMatch evidence to outcome
Scaled Score vs Raw Percent
Scaled 75
- Official passing standard
- Reflects test equating
Raw 75%
- Not the published rule
- Cannot infer from score
Do not convert scaled scores
Evidence Method Picker
- Testing treatment efficacy→Randomized controlled trial(Randomization reduces confounding)
- Studying rare disease→Case-control study(Look backward for exposure)
- Following exposed groups→Cohort study(Can estimate incidence)
- Measuring one-time burden→Cross-sectional study(Estimates prevalence)
- Screening must miss few→Prioritize sensitivity(Few false negatives)
- Confirmation must exclude healthy→Prioritize specificity(Few false positives)
- Prevalence changes→Reassess predictive values(Sensitivity may stay stable)
- Evidence conflicts→Appraise bias and precision(Do not count papers)
Prevention and Evidence
- Water fluoridation
- Approximately 0.7mg/L
- Sealants
- Protect susceptible pits
- DMFT
- Decayed, missing, filled teeth
- Prevalence
- Existing cases proportion
- Incidence
- New cases over time
- Sensitivity
- Detects disease present
- Specificity
- Excludes disease absent
- Predictive values
- Change with prevalence
Four Ethics Principles
Autonomy, Benefit, No harm, Justice
Respect informed patient choiceBalance welfare and fairness
Sensitivity vs Specificity
Sensitivity
- Finds true disease
- Few false negatives
Specificity
- Finds true health
- Few false positives
Sensitive negative helps rule out
Infection Control and Ethics
- Critical instrument
- Sterilize after use
- Semi-critical instrument
- Sterilize when heat-tolerant
- Biological monitoring
- Spore test verifies sterilization
- Autonomy
- Respect informed choices
- Beneficence
- Promote patient welfare
- Nonmaleficence
- Avoid preventable harm
- Justice
- Treat people fairly
- Consent
- Capacity, disclosure, voluntariness, authorization
Prevalence vs Incidence
Prevalence
- Existing cases
- Measures disease burden
Incidence
- New cases
- Requires time period
Stock differs from flow
Critical vs Semi-Critical Instruments
Critical
- Penetrates tissue or bone
- Must be sterilized
Semi-critical
- Contacts mucosa or non-intact skin
- Single-use or clean, then sterilize
Sterilize critical and semicritical reusable devices
Common Traps
Scaled Is Not Raw
Passing score is equated 75 ≠ It is not raw 75%
Self-Assessment Is Not AFK
Self-assessment has 100 questions ≠ Actual AFK has 200
Always Select One
AFK items are single-answer ≠ Each item equals one point
Never Leave Blanks
Incorrect answers have no penalty ≠ Every unanswered item loses opportunity
FDI Is Mandatory
First digit means quadrant ≠ Second digit means tooth position
Antibiotics Are Not Drainage
Control odontogenic source ≠ Drain when clinically indicated
Primary Avulsion Stays Out
Never replant primary teeth ≠ Protect permanent successor
One Pulp Test Misleads
Sensibility does not equal bloodflow ≠ Compare control teeth
Clindamycin Guidance Changed
Not recommended for IE prophylaxis ≠ Severe adverse reactions occur
Law Varies by Province
Capacity has no universal age ≠ Reporting duties differ
Last Minute
- 1.Know all nine blueprint ranges
- 2.Expect 200 single-answer questions
- 3.Budget two hours each part
- 4.Remember one scheduled break
- 5.Answer every question
- 6.Treat 75 as scaled score
- 7.Use FDI tooth notation
- 8.Read the task verb first
- 9.Separate pulp and apical diagnoses
- 10.Use vitality in jaw differentials
- 11.Match emergency before drug
- 12.Control infection source first
- 13.Never replant primary teeth
- 14.Stage severity; grade progression
- 15.Distinguish sterilization from disinfection
- 16.Check consent capacity and voluntariness
- 17.Prefer current clinical guidance
- 18.Remember maximum three attempts
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