100+ Free ABPD Pediatric Dentistry Practice Questions

Restorative Pediatric Dentistry

Primary tooth morphology, rubber dam isolation, Class I/II amalgam and composite, resin-modified glass ionomer, strip crowns for anterior primary incisors, stainless steel crowns (Hall technique — no caries removal, preformed SSC cemented with GIC, evidence supports for primary molars), zirconia pediatric esthetic crowns, indirect/direct pulp cap, atraumatic restorative treatment (ART).

Growth & Development

Prenatal and postnatal craniofacial growth, primary dentition eruption (mandibular central incisor first ~6-10 mo; all primary teeth erupt by 30 mo), mixed dentition (1st permanent molar and mandibular central incisor ~6 yr), leeway space (~2.5 mm/side mandibular, ~1.5 mm/side maxillary — E space), Baume's Type I spacing vs Type II closed, primate space, Hellman's stages (IIA-IVA), cervical vertebral maturation (CVM), hand-wrist radiograph.

Behavior Guidance

AAPD 2020 Best Practices — basic behavior guidance: tell-show-do, positive reinforcement, distraction, voice control, nonverbal communication, parental presence/absence, desensitization, memory restructuring; advanced: protective stabilization (informed consent required, documented indications), nitrous oxide/oxygen minimal sedation, moderate sedation, deep sedation, general anesthesia. Frankl behavior rating scale (1 definitely negative to 4 definitely positive). Informed consent documentation.

Caries Risk Assessment & Prevention

Caries risk assessment tool (CAT/CAMBRA — low/moderate/high risk), Streptococcus mutans vertical transmission (window of infectivity), xylitol, community water fluoridation (HHS 2015 optimal 0.7 ppm F — lowered from 0.7-1.2 range), professionally applied 5% NaF fluoride varnish (22,600 ppm F), silver diamine fluoride 38% (SDF — arrests caries, black staining requires parental consent), pit-and-fissure sealants, ICDAS, anticipatory guidance, age-based toothpaste (smear/rice <3 yr, pea-size 3-6 yr).

Anesthesia & Sedation

AAPD/AAP 2019 pediatric sedation guideline — pre-sedation ASA status, NPO (2 hr clear liquids, 4 hr breast milk, 6 hr formula/light meal, 8 hr solid food), monitoring (continuous pulse oximetry; capnography required for moderate/deep sedation), nitrous oxide/oxygen (max 50%, nasal hood, scavenging), oral sedation pharmacology (midazolam 0.25-0.5 mg/kg PO; hydroxyzine, meperidine), reversal (flumazenil for benzodiazepines, naloxone for opioids), local anesthesia max doses (lidocaine 4.4 mg/kg, articaine 7 mg/kg — avoid articaine in mandibular blocks <4 yr due to paresthesia).

Pulp Therapy

Diagnosis (normal, reversible pulpitis, symptomatic/asymptomatic irreversible pulpitis, pulp necrosis), indirect pulp cap (IPC — leave affected dentin, restore), direct pulp cap for small mechanical exposure in primary teeth, vital pulpotomy — formocresol (historically standard but carcinogen concerns), ferric sulfate 15.5%, sodium hypochlorite, MTA (mineral trioxide aggregate — now preferred by AAPD), Biodentine; pulpectomy for non-vital primary teeth (ZOE or Vitapex — Ca(OH)2/iodoform paste that resorbs), apexogenesis vs apexification with MTA/Biodentine apical plug, regenerative endodontics (REP).

Dental Trauma

IADT 2020 guidelines — primary dentition: no replantation of avulsed primary teeth (risk to permanent successor; concussion/subluxation monitor; lateral luxation/intrusion typically monitor, extract if impinging on permanent bud). Permanent dentition avulsion: replant ASAP; storage HBSS > milk > saliva; socket rinse; flexible splint 2 wk; systemic antibiotic — doxycycline >8 yr (amoxicillin <8 yr due to tetracycline staining); tetanus status; RCT after splint removal for closed apex. Ellis/fracture classification, complicated crown fracture with pulp exposure (Cvek partial pulpotomy with MTA). Root fracture splinting (4 wk cervical, 4 mo apical).

Special Healthcare Needs

Autism spectrum disorder (desensitization visits, visual schedules, sensory accommodations), Down syndrome (periodontal disease, hypodontia, macroglossia, CHD, atlantoaxial instability — caution with neck extension), cerebral palsy, cleft lip/palate (timed care with cleft team — lip repair ~3 mo, palate ~9-18 mo), congenital heart disease — AHA 2007/2021 endocarditis prophylaxis ONLY for prosthetic valve, prior IE, unrepaired cyanotic CHD, repaired CHD with residual defect, post-transplant cardiac valvulopathy (amoxicillin 50 mg/kg PO 30-60 min pre-op; clindamycin no longer recommended — cephalexin or azithromycin for PCN allergy), bleeding disorders, hematologic malignancy (dental clearance before chemotherapy), hypophosphatasia, amelogenesis/dentinogenesis imperfecta.

Space Management

Band-and-loop (unilateral premature loss of primary 1st or 2nd molar when permanent 1st molar has erupted), crown-and-loop, lingual arch/LLHA (bilateral mandibular loss), Nance appliance (bilateral maxillary loss — acrylic button on rugae), distal shoe (premature loss of 2nd primary molar BEFORE 1st permanent molar erupts — intragingival extension guides 6-yr molar eruption; contraindicated in CHD requiring IE prophylaxis), transpalatal arch. Mixed dentition analysis — Moyers probability tables (75th percentile), Tanaka-Johnston prediction equation.

Oral Exam & Radiography

Age-based radiographic selection criteria (AAPD/ADA), bitewings when proximal contacts close (~age 3-4 for high risk), posterior PA as indicated, panoramic radiograph for mixed dentition assessment/trauma/development, CBCT judicious use (ALARA, As Low As Reasonably Achievable), lead apron and thyroid collar, rectangular collimation, E/F-speed film or digital sensor to minimize dose, patient of record comprehensive exam every 6 months (high-risk), plaque and calculus assessment, gingival assessment, orthodontic screening.

Malocclusion & Interceptive Orthodontics

Angle classification (Class I, II div 1/2, III molar relationship), primary terminal plane (flush/mesial step/distal step — predictive of permanent molar relationship), anterior crossbite (pseudo vs true), posterior crossbite with functional shift (treat early with expansion), open bite (thumb/finger/pacifier habits — counseling, habit reminder, habit appliance), deep bite, lower lingual holding arch (LLHA), 2x4 appliance for anterior alignment, serial extraction, palatal expansion (RPE — hyrax/haas) typically ages 6-12.

Infant Oral Health

First dental visit by age 1 (AAPD recommendation), anticipatory guidance, breastfeeding/bottle caries (ECC — early childhood caries; S-ECC severe ECC), non-nutritive sucking (thumb, pacifier), teething (no topical benzocaine <2 yr — FDA warning for methemoglobinemia; cold teething ring), natal/neonatal teeth (Riga-Fede ulcer, extract if very mobile), ankyloglossia/tongue-tie (frenectomy indications), fluoride supplementation schedule based on age and primary water source F concentration (<0.3 ppm).

Medical/Oral Interface

Child abuse recognition (TEN-4 FACES bruising, oral injuries in ~50% of physical abuse cases, frenulum tears suspicious, mandatory reporting), HPV, HSV-1 primary herpetic gingivostomatitis, hand-foot-mouth disease (coxsackie A), Kawasaki disease (strawberry tongue, lip fissuring), leukemia oral manifestations (gingival hyperplasia, petechiae), eating disorders (perimolysis — palatal erosion), vaping/tobacco prevention, pediatric pharmacology dosing and antibiotic stewardship (amoxicillin 50 mg/kg/day divided), pregnancy considerations.