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Exam Review

Key Facts: ABOP Diplomate Exam

Orofacial Pain was recognized as the 12th ADA dental specialty on March 31, 2020 by NCRDSCB.

ABOP was recognized as the national certifying board for Orofacial Pain on March 28, 2022.

The ABOP written exam contains 200 multiple-choice questions delivered in a 4-hour Prometric session.

The ABOP oral exam is virtually proctored and must follow successful completion of the written exam.

ABOP eligibility requires enrollment in or completion of a CODA-accredited Orofacial Pain residency.

ABOP certification is valid 5 years; recertification requires 100 hours of orofacial pain CE in the prior cycle.

Current written and oral exam fees are approximately $1,300 each per the ABOP fee schedule.

The 2026 ABOP written exam window runs April 17-27, 2026 with oral exam April 25, 2026.

ABOP is the NCRDSCB-recognized certifying board for the ADA Orofacial Pain specialty. Candidates must be enrolled in or have graduated from a CODA-accredited OFP residency. The 200-item written exam (4 hours, Prometric) must be passed before the virtually proctored oral exam. Recertification requires 100 hours of orofacial pain CE every 5 years plus annual maintenance fees.

Sample ABOP Diplomate Practice Questions

Try these sample questions to review concepts for the ABOP Diplomate exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 38-year-old reports right preauricular pain for 6 months, worse with chewing, with audible reciprocal clicking on opening and closing. Maximum unassisted opening is 44 mm without deviation. Per DC/TMD Axis I criteria, which diagnosis is most likely?
A.Disc displacement with reduction
B.Disc displacement without reduction with limited opening
C.Degenerative joint disease
D.Myalgia of the masseter
Explanation: DC/TMD criteria for disc displacement with reduction require a history of joint noise with movement in the last 30 days plus clinical reproduction of clicking, popping, or snapping during opening and closing (or opening or closing plus laterotrusion/protrusion). Opening greater than 40 mm and absence of locking exclude the without-reduction-with-limited-opening subtype.
2A 26-year-old woman reports 4 lifetime severe headaches lasting 12-36 hours, unilateral pulsating, aggravated by stairs, with nausea and photophobia. Neurologic exam is normal. Which ICHD-3 diagnosis applies?
A.Migraine without aura
B.Probable migraine without aura
C.Tension-type headache
D.New daily persistent headache
Explanation: ICHD-3 migraine without aura requires at least 5 attacks meeting full criteria. With only 4 fulfilling attacks but otherwise typical features (unilateral, pulsating, moderate-severe, aggravated by routine activity, with nausea or photo/phonophobia), the correct diagnosis is probable migraine without aura (1.5.1) until a fifth attack occurs.
3A 62-year-old reports paroxysms of severe right cheek pain triggered by light touch and tooth brushing, each lasting seconds, with refractory periods between. Exam and MRI with FIESTA sequence are pending. What is the first-line pharmacotherapy per AAN/EFNS guidelines?
A.Amitriptyline 25 mg nightly
B.Carbamazepine 100 mg twice daily, titrating to effect
C.Gabapentin 300 mg three times daily
D.Topical capsaicin 0.025% four times daily
Explanation: Classical trigeminal neuralgia is treated first-line with carbamazepine (200-1200 mg/day) per AAN/EFNS evidence-based guidelines, with NNT around 1.7-1.8 for 50% pain relief. Oxcarbazepine is an acceptable alternative with fewer interactions. Initial dose is typically 100 mg twice daily titrated upward as tolerated.
4A 55-year-old postmenopausal woman reports daily bilateral burning of the anterior two-thirds of the tongue, present on waking and worsening through the day, with no visible mucosal lesions. Labs (CBC, ferritin, B12, folate, glucose, TSH) are normal. Which diagnosis is most consistent?
A.Geographic tongue
B.Burning mouth syndrome (primary)
C.Atrophic candidiasis
D.Lichen planus
Explanation: Primary (idiopathic) burning mouth syndrome is defined by ICOP and ICHD-3 as intraoral burning or dysesthesia recurring daily more than 2 hours/day for more than 3 months without clinical lesions or identifiable cause. The characteristic crescendo through the day in a postmenopausal woman with normal mucosa and labs is classic.
5Per the AASM 2015 clinical practice guideline (reaffirmed), which patient is the BEST candidate for mandibular advancement device therapy rather than CPAP as first-line?
A.AHI 42 with severe daytime sleepiness who tolerates CPAP at 10 cm H2O
B.AHI 8 with snoring and mild sleepiness who declines CPAP
C.AHI 65 with cardiac arrhythmias
D.Edentulous patient with AHI 30
Explanation: AASM guidelines recommend oral appliance therapy for adult patients with primary snoring or mild-to-moderate OSA who prefer it to CPAP or are intolerant of CPAP. The patient with AHI 8 (mild OSA) who declines CPAP fits the strongest recommendation tier. Severe OSA should be offered CPAP first.
6A 35-year-old reports waking with bilateral masseter soreness, headache in the temples, and a partner-reported grinding noise. Tooth wear shows flat occlusal facets and shiny enamel. What is the best initial diagnostic step before splint therapy?
A.Polysomnography to confirm sleep bruxism
B.Clinical diagnosis of probable sleep bruxism and trial of stabilization splint
C.EMG biofeedback over 7 nights
D.MRI of the TMJ to rule out internal derangement
Explanation: Per the 2018 international consensus (Lobbezoo et al.), sleep bruxism is graded as possible (self-report), probable (self-report plus clinical signs such as tooth wear, masseter hypertrophy, morning jaw pain), or definite (PSG with audio-video confirmation). For routine dental management, a probable diagnosis is sufficient to initiate a stabilization splint and behavioral counseling without PSG.
7Which feature is REQUIRED by ICHD-3 criteria for cluster headache?
A.Bilateral throbbing pain
B.Severe unilateral orbital, supraorbital, or temporal pain lasting 15-180 minutes
C.Pain duration of 4-72 hours per attack
D.Pain triggered exclusively by alcohol
Explanation: ICHD-3 criteria for cluster headache require severe or very severe strictly unilateral orbital, supraorbital, and/or temporal pain lasting 15-180 minutes (when untreated), occurring from once every other day to 8 times per day, with at least one ipsilateral autonomic feature (lacrimation, conjunctival injection, nasal congestion/rhinorrhea, eyelid edema, miosis/ptosis) or restlessness/agitation.
8Indomethacin produces complete resolution of headache within 24-48 hours. Which trigeminal autonomic cephalalgia is this absolute response diagnostic of?
A.Cluster headache
B.Paroxysmal hemicrania
C.SUNCT
D.Hemicrania continua
Explanation: Paroxysmal hemicrania (and hemicrania continua) demonstrate an absolute response to therapeutic doses of indomethacin (typically 75-225 mg/day), which is a defining ICHD-3 diagnostic criterion. Attacks are shorter (2-30 minutes) and more frequent (>5/day) than cluster headache. However, the question specifies short attacks consistent with PH; if continuous, hemicrania continua applies.
9Which structure on a closed-mouth proton-density-weighted sagittal oblique MRI of the TMJ provides the best assessment of disc position?
A.Articular eminence
B.Posterior band of the disc relative to the 12 o'clock position of the condyle
C.Lateral pterygoid muscle insertion
D.Retrodiscal tissue vascularity
Explanation: On closed-mouth sagittal oblique PD MRI, normal disc position places the posterior band at approximately the 12 o'clock position relative to the superior aspect of the condyle. Anterior displacement of the posterior band beyond 11 o'clock (some authors use >10 degrees from vertical) indicates disc displacement. T2 sequences add information about effusion and inflammation.
10A patient with chronic TMD pain (>6 months) scores 8/10 on the GCPS-revised. According to DC/TMD Axis II framework, what is the next most appropriate step?
A.Refer for psychosocial assessment and consider co-management with a behavioral health provider
B.Increase NSAID dose to maximum
C.Order CBCT to find an occult cause
D.Begin trigger point injections weekly
Explanation: DC/TMD Axis II addresses pain-related disability and psychosocial status. A GCPS grade III-IV (high disability) score signals need for biopsychosocial co-management including screening for depression (PHQ-9), anxiety (GAD-7), and somatization, with referral to behavioral health/CBT or pain psychology when indicated. Escalating biomedical therapy alone without addressing Axis II often fails.

About the ABOP Diplomate Exam

The ABOP Diplomate credential certifies dentists with advanced expertise in orofacial pain, the 12th ADA-recognized dental specialty (recognized March 31, 2020). Candidates complete a CODA-accredited Orofacial Pain residency and pass a 200-question written exam at Prometric (4 hours) plus a virtually proctored oral exam. Content spans DC/TMD diagnosis, ICHD-3 headache, ICOP neuropathic orofacial pain, burning mouth syndrome, sleep-related breathing disorders with oral appliance therapy, bruxism, pharmacology, imaging, and biopsychosocial co-management.

Exam sponsor: American Board of Orofacial Pain (ABOP) - NCRDSCB-recognized national certifying board for the ADA Orofacial Pain specialty (recognized March 28, 2022). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

200 questions

Time Limit

Written: 4 hours; Oral: scheduled separately

Passing Score

Criterion-referenced (set by ABOP)

Exam / Certification Fees

Written $1,300 + Oral $1,300 per current ABOP schedule

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

Major

TMD diagnosis (DC/TMD Axis I + Axis II)

Myalgia subtypes (local, with spreading, with referral), arthralgia, disc displacement with/without reduction, DJD, headache attributed to TMD, subluxation; Axis II GCPS, JFLS, PHQ-9, GAD-7, PHQ-15, OBC; biopsychosocial co-management.

Major

Headache (ICHD-3)

Migraine with/without aura, tension-type, trigeminal autonomic cephalalgias (cluster, paroxysmal hemicrania, SUNCT/SUNA, hemicrania continua), medication-overuse headache, secondary headaches and SNOOP red flags.

Major

Neuropathic orofacial pain (ICOP)

Classical and secondary TN, painful post-traumatic trigeminal neuropathy (PPTTN), PIFP/PIDAP (atypical odontalgia), postherpetic neuralgia; QST, treatment with carbamazepine, oxcarbazepine, gabapentin, pregabalin, TCAs, SNRIs.

Moderate

Burning mouth syndrome

ICOP definition, primary vs secondary diagnosis, workup (CBC, iron, B12, folate, glucose, TSH, candidiasis, salivary flow, medications); topical/systemic clonazepam, alpha-lipoic acid, CBT.

Moderate

Sleep-related breathing disorders

OSA and UARS evaluation, PSG/HSAT, AASM/AADSM oral appliance therapy guidelines, MAD titration, follow-up sleep testing, side-effect monitoring, co-management with sleep physicians.

Moderate

Bruxism

Sleep and awake bruxism (2018 international consensus), possible/probable/definite grading, stabilization splint design, anterior repositioning vs anterior bite plane considerations, behavioral strategies.

Moderate

Pharmacology and pain science

TCAs (amitriptyline, nortriptyline), SNRIs (duloxetine, venlafaxine), gabapentinoids, carbamazepine/oxcarbazepine, NSAIDs, muscle relaxants, triptans, gepants, lasmiditan, PREEMPT onabotulinumtoxinA, capsaicin patch; nociceptive vs neuropathic vs nociplastic mechanisms.

Cross-cutting

Imaging, ethics, evidence-based practice

MRI (disc position, effusion, synovitis), CBCT (osseous DJD, ankylosis, neoplasm), SNOOP red flags, AAOP guidelines, opioid stewardship, inter-professional referral, evidence hierarchy.

Preparing for the ABOP Diplomate Exam

What You Need to Know

  • Passing score: Criterion-referenced (set by ABOP)
  • Exam length: 200 questions
  • Time limit: Written: 4 hours; Oral: scheduled separately
  • Exam / certification fees: Written $1,300 + Oral $1,300 per current ABOP schedule Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

ABOP Diplomate: Suggested Study Strategy

1Master DC/TMD Axis I diagnostic criteria - they appear repeatedly in case-based items and oral exam scenarios
2Memorize ICHD-3 criteria for migraine, tension-type, cluster, paroxysmal hemicrania, SUNCT, and hemicrania continua side-by-side
3Learn the ICOP framework for neuropathic orofacial pain (TN, PPTTN, PIFP/PIDAP, BMS) and how to distinguish them
4Practice with red-flag screening (SNOOP), thunderclap headache, GCA in older patients, and malignancy markers
5Review AASM/AADSM oral appliance therapy guidelines - indications, contraindications, titration, and side-effect monitoring
6Study evidence-based pharmacology: carbamazepine first-line for TN, TCAs/SNRIs/gabapentinoids for chronic neuropathic pain, PREEMPT botulinum toxin protocol
7Practice biopsychosocial Axis II assessment using PHQ-9, GAD-7, GCPS, JFLS, PCS, and OBC
8Use the AAOP textbook and clinical guidelines plus the Journal of Oral and Facial Pain and Headache as core references

Frequently Asked Questions

What is the ABOP Diplomate exam format?

Two parts: a 200-question written multiple-choice exam (4 hours, at Prometric testing centers) and a virtually proctored oral exam delivered live online. Candidates must pass the written exam before challenging the oral exam.

How is the ABOP exam scored?

Criterion-referenced. ABOP sets the passing standard based on the difficulty of each form; there is no fixed published percentage.

What are the eligibility requirements?

Candidate must be a dentist actively enrolled in (or graduated from) a CODA-accredited Orofacial Pain residency. The written exam is a prerequisite for the oral exam.

How much does the ABOP exam cost?

Per the current ABOP fee schedule, the written exam fee is approximately $1,300 and the oral exam fee is approximately $1,300, in addition to annual board fees and maintenance fees once certified.

How long is ABOP certification valid?

Five years. Recertification requires documentation of 100 hours of orofacial pain continuing education completed during the prior 5-year cycle and payment of annual board fees plus the recertification fee.

Is Orofacial Pain an ADA-recognized dental specialty?

Yes. On March 31, 2020 the National Commission on Recognition of Dental Specialties and Certifying Boards (NCRDSCB) recognized Orofacial Pain as the 12th ADA-recognized dental specialty. On March 28, 2022 NCRDSCB further recognized ABOP as the national certifying board for the specialty.

When are the 2026 ABOP exams scheduled?

The 2026 written exam window is April 17-27, 2026 at Prometric centers worldwide. The oral exam is scheduled for April 25, 2026 on a virtual platform. Registration opens October 1, 2025 with an application deadline of January 31, 2026.