NEBDN Diploma (Dental Nursing) Exam Flashcards

Q: What is the format of the NEBDN written exam?

The written exam is taken online (MaxExam software) and has 100 questions combining 1-from-5 single best answer MCQs and Extended Matching Questions (EMQs), completed in 2 hours.

Q: Do I need to pass the written exam before the OSCE?

Yes. Candidates must pass the written exam first. The OSCE then follows as a 12-station assessment split into a 7-station workbook part (1 hour) and 5 live stations.

Q: What topics carry the most weight on the NEBDN written exam?

Health, Safety and Infection Control (14%) and Restorative Dentistry and Dental Materials (13%) carry the highest weighting, followed by Professionalism, Law and Ethics (11%) and Medical Emergencies (11%).

Q: Does passing the NEBDN Diploma let me work as a dental nurse?

Yes. Successful completion makes you eligible to apply to the General Dental Council (GDC) for registration as a dental nurse in the UK, which is required to practise.

Question 1

What is GDC Standards for the Dental Team Principle One?

Accepted Answer

'Put patients' interests first' - this is the foundational principle underpinning all nine GDC Standards for the Dental Team.

Question 2

Which statutory body registers all dental professionals in the UK?

Accepted Answer

The General Dental Council (GDC). NEBDN awards the qualification, but the GDC maintains the professional register that a nurse must join to legally practise.

Question 3

What is 'Gillick competence'?

Accepted Answer

The principle that a child under 16 can give valid consent to their own treatment if a clinician judges they have sufficient understanding and intelligence to fully appreciate what is involved.

Question 4

What three conditions must be met for consent to dental treatment to be valid?

Accepted Answer

It must be given voluntarily, by a patient with capacity, and the patient must be adequately informed about the treatment, risks, benefits and alternatives (including no treatment).

Question 5

How many hours of verifiable CPD must a registered dental nurse complete over a 5-year GDC cycle?

Accepted Answer

50 hours minimum (with at least 10 hours in any 2-year period), plus an annual CPD statement to the GDC. Dental therapists/hygienists need 75 hours; dentists need 100 hours.

Question 6

Under UK GDPR and the Data Protection Act 2018, what right does a patient have over their dental records?

Accepted Answer

The right of access (subject access request) - the practice must normally respond within one month and generally cannot charge a fee to provide copies of records or radiographs.

Question 7

Which HTM document sets UK primary care dental decontamination standards, and what does it cover?

Accepted Answer

HTM 01-05 'Decontamination in primary care dental practices' - it sets the standards for cleaning, disinfection and sterilisation of reusable dental instruments in England.

Question 8

What is the correct order of the instrument decontamination cycle?

Accepted Answer

Clean, then inspect, then sterilise, then store. Cleaning must always precede sterilisation because residual debris shields micro-organisms from the sterilising process.

Question 9

What temperature and holding time does a vacuum (type B) autoclave use to sterilise dental instruments?

Accepted Answer

134-137 degrees Celsius with a minimum holding (plateau) time of 3 minutes.

Question 10

What is the principle of 'standard (universal) precautions' in infection control?

Accepted Answer

All blood and body fluids from every patient are treated as potentially infectious, because infection status is often unknown - this protects staff and patients consistently on every procedure.

Question 11

What is the single most effective routine measure for preventing cross-infection in a dental practice?

Accepted Answer

Effective hand hygiene (handwashing or alcohol hand rub at the correct moments) - recognised as more important than any single item of PPE.

Question 12

What is the correct immediate first-aid response to a sharps injury?

Accepted Answer

Encourage the wound to bleed gently, wash thoroughly under running water without scrubbing or sucking, dry and cover with a waterproof dressing, then report the incident for an occupational health risk assessment.

Question 13

What feature do amalgam waste containers include, and why?

Accepted Answer

A mercury suppressant, to limit release of mercury vapour. Amalgam waste and amalgam-containing extracted teeth are collected by a licensed contractor for mercury recovery, kept separate from clinical waste streams.

Question 14

What is the adult basic life support compression-to-ventilation ratio, and the correct compression rate and depth?

Accepted Answer

30 compressions to 2 breaths, delivered at 100-120 compressions per minute to a depth of 5-6 cm (Resuscitation Council UK guidance).

Question 15

What is the first-line drug and dose for anaphylaxis in the dental surgery?

Accepted Answer

Intramuscular adrenaline 1:1000 (1 mg/mL); adult dose is 500 micrograms (0.5 mL), repeated after 5 minutes if there is no improvement, alongside calling 999.

Question 16

What is the first-line emergency treatment for an acute asthma attack in the dental chair?

Accepted Answer

A salbutamol (beta-2 agonist) inhaler delivering 100 micrograms per actuation, ideally via a spacer, to relieve bronchospasm.

Question 17

A conscious diabetic patient becomes shaky, sweaty and confused mid-treatment. What is the immediate management?

Accepted Answer

This suggests hypoglycaemia - give fast-acting oral glucose (sugary drink, glucose tablets or gel) if the patient is conscious and able to swallow; if unconscious, give intramuscular glucagon 1 mg.

Question 18

What medication is given for a suspected myocardial infarction (heart attack) in the dental surgery, and why?

Accepted Answer

300 mg aspirin, chewed (if not allergic), because it inhibits platelet aggregation. Oxygen and reassurance are also given while awaiting the ambulance.

Question 19

What is the correct management of a patient having a generalised tonic-clonic seizure?

Accepted Answer

Protect the patient from injury, do not restrain them, do not place anything in the mouth, and time the seizure. If convulsions last over 5 minutes, buccal midazolam is indicated and 999 should be called.

Question 20

In FDI two-digit tooth notation, what does the tooth number 16 refer to?

Accepted Answer

The upper right first permanent molar. The first digit gives the quadrant (1 = upper right permanent) and the second digit gives the tooth position from the midline (6 = first molar).

Question 21

How many teeth are in a complete primary (deciduous) dentition, and a complete permanent dentition?

Accepted Answer

20 teeth in the primary dentition (2 incisors, 1 canine, 2 molars per quadrant, no premolars); 32 teeth in the permanent dentition.

Question 22

Which cranial nerve provides sensory innervation to the teeth and most of the face, and what are its three divisions?

Accepted Answer

The trigeminal nerve (cranial nerve V), with ophthalmic (V1), maxillary (V2) and mandibular (V3) divisions; local anaesthetic blocks target branches of V2 and V3.

Question 23

What structure attaches the root of a tooth (cementum) to the alveolar bone?

Accepted Answer

The periodontal ligament - a band of fibrous connective tissue that suspends the tooth in its socket, allows slight physiological movement and provides proprioception.

Question 24

What is the critical pH below which enamel begins to demineralise during an acid attack?

Accepted Answer

Approximately pH 5.5. After sugar intake, plaque pH can fall below this level for 20-30 minutes before saliva buffers it back up (the Stephan curve).

Question 25

What is the key difference between gingivitis and periodontitis?

Accepted Answer

Gingivitis is reversible plaque-induced inflammation of the gingiva with no loss of attachment. Periodontitis involves irreversible destruction of the periodontal ligament and alveolar bone.

Question 26

What red-flag features of a mouth ulcer should prompt urgent referral to exclude oral cancer?

Accepted Answer

A non-healing ulcer with raised, rolled margins persisting more than 3 weeks warrants urgent referral (suspected cancer pathway) for specialist assessment and biopsy.

Question 27

What are the two most significant modifiable risk factors for oral cancer?

Accepted Answer

Tobacco use and alcohol - their effects are synergistic when combined. HPV and areca/betel nut use are also recognised risk factors.

Question 28

What is the difference between dental plaque and calculus?

Accepted Answer

Plaque is a soft bacterial biofilm that is the primary cause of caries and periodontal disease; calculus is plaque that has mineralised (hardened) with calcium and phosphate salts and must be removed by professional scaling.

Question 29

What fluoride concentration toothpaste does Delivering Better Oral Health recommend for most adults and children?

Accepted Answer

1350-1500 ppm fluoride. Higher-strength pastes (2800 or 5000 ppm) are prescription-only for higher-caries-risk patients.

Question 30

Why should patients 'spit, don't rinse' after brushing?

Accepted Answer

Rinsing with water washes away residual fluoride from the toothpaste; spitting without rinsing leaves a higher concentration of fluoride in contact with the teeth, maximising the protective effect.

Question 31

For caries risk, what matters more: total daily sugar amount or frequency of intake?

Accepted Answer

Frequency of free-sugar intake matters more than total amount, because each exposure produces a separate acid attack on the enamel.

Question 32

What is the purpose of a fissure sealant, and where is it typically applied?

Accepted Answer

A resin or glass ionomer material placed into the pits and fissures of newly erupted permanent posterior teeth to create a smooth, cleansable surface and reduce occlusal caries risk.

Question 33

What regulations protect the patient (as opposed to staff) during dental radiography, and what roles do they define?

Accepted Answer

IR(ME)R 2017 (Ionising Radiation (Medical Exposure) Regulations) - requiring every exposure to be justified, optimised and authorised, and defining the referrer, practitioner and operator roles. IRR 2017 separately protects staff and the public.

Question 34

Which radiographic view is standard for detecting interproximal caries and assessing crestal bone levels in posterior teeth?

Accepted Answer

The bitewing radiograph - it captures the crowns of upper and lower posterior teeth plus crestal bone on one film.

Question 35

What does a Basic Periodontal Examination (BPE) score of 4 in a sextant indicate?

Accepted Answer

A probing depth of 6 mm or more, indicating advanced periodontal disease requiring detailed assessment and treatment. Scores range 0 (healthy) to 4, with an asterisk denoting furcation involvement.

Question 36

Why is it clinically important to note that a patient takes warfarin before a dental extraction?

Accepted Answer

Warfarin is an anticoagulant that prolongs clotting and increases the risk of prolonged post-operative bleeding; INR is often checked and local haemostatic measures planned.

Question 37

What are the main components of dental amalgam?

Accepted Answer

Liquid mercury mixed with an alloy powder composed mainly of silver, tin and copper.

Question 38

What acid and concentration is used to etch enamel before bonding a composite restoration, and why?

Accepted Answer

Approximately 37% phosphoric acid - it creates a micro-rough surface and removes the smear layer, allowing a strong micromechanical bond with the bonding agent and composite.

Question 39

What key property makes glass ionomer cement useful for high-caries-risk patients and children?

Accepted Answer

It chemically bonds to tooth structure and releases fluoride over time, offering ongoing caries protection - valuable as a restoration, base, liner or luting cement.

Question 40

How is a light-cured composite restoration set (polymerised) chairside?

Accepted Answer

With a blue curing light (typically around 450-470 nm wavelength) that activates the photoinitiator, hardening the material in increments; the light should never be viewed directly.

Question 41

What material is standard for obturating (filling) a cleaned and shaped root canal?

Accepted Answer

Gutta-percha, used with a sealer, fills the canal space three-dimensionally to prevent bacterial reinfection of the root canal system.

Question 42

Why is a rubber dam placed during root canal treatment?

Accepted Answer

To isolate the tooth, improve moisture control and visibility, and crucially protect the airway from inhaling or swallowing small instruments and irrigants during endodontic treatment.

Question 43

How much fluoride toothpaste should be used for children under 3, and for children aged 3-6?

Accepted Answer

A smear of toothpaste containing at least 1000 ppm fluoride for children under 3; a pea-sized amount of at least 1000 ppm fluoride for children aged 3-6, brushed by/with an adult twice daily from first tooth eruption.

Question 44

What is the most common cause of early childhood (nursing bottle) caries?

Accepted Answer

Frequent or prolonged exposure to sugary drinks in a feeding bottle, especially at night, which pools sugar around the upper anterior teeth and drives rapid decay.

Question 45

What is dry socket (alveolar osteitis) and when does it typically present?

Accepted Answer

Loss or failure of the blood clot in an extraction socket, presenting 2-3 days after extraction with severe throbbing pain, a bad taste and an empty-looking socket.

Question 46

What post-extraction advice should a dental nurse give to encourage clot formation and prevent complications?

Accepted Answer

Bite firmly on gauze for about 20-30 minutes; avoid rinsing, hot food/drinks, alcohol, smoking and vigorous exercise for 24 hours; and avoid disturbing the socket (e.g. with the tongue or a straw).

Question 47

What is a periapical (dental) abscess?

Accepted Answer

A collection of pus at the apex of a non-vital (dead) tooth, caused by bacterial infection of the pulp, which may cause swelling and can point and discharge.

Question 48

What is the most commonly used local anaesthetic in UK dental practice, and what is it typically combined with?

Accepted Answer

Lidocaine (lignocaine) 2%, typically combined with adrenaline (epinephrine) 1:80,000 as a vasoconstrictor to prolong anaesthesia and reduce bleeding at the injection site.

Question 49

What gas mixture is delivered during inhalation sedation in dentistry?

Accepted Answer

A titrated mixture of nitrous oxide and oxygen, adjusted to the individual patient to produce relaxation while the patient remains conscious and cooperative.

Question 50

What defines 'conscious sedation' in dentistry, and what is the reversal agent for midazolam?

Accepted Answer

Conscious sedation must maintain a level at which the patient remains responsive to verbal command throughout. Flumazenil is the specific benzodiazepine reversal agent for midazolam and must be available during IV sedation.

Free NEBDN Diploma (Dental Nursing) Exam Flashcards

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