100+ Free NZDREX Practice Questions

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Which suture material is non-resorbable and therefore requires removal after intraoral surgical wound healing?

Plain catgut

Silk

Polyglactin 910 (Vicryl)

Polyglycolic acid

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Sample NZDREX Practice Questions

Try these sample questions to test your NZDREX exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1During an inferior alveolar nerve block, the needle is advanced to deposit solution near the mandibular foramen. Which anatomical landmark on the medial surface of the ramus is the key bony guide overlying the foramen?

A.Lingula

B.Coronoid notch

C.Mylohyoid line

D.External oblique ridge

Explanation: The lingula is the bony spine on the medial ramus that overlies the mandibular foramen, through which the inferior alveolar nerve and vessels enter the mandibular canal. Solution is deposited just superior and posterior to the lingula. Recognising it is central to a successful inferior alveolar nerve block.

2A patient reports loss of taste to the anterior two-thirds of the tongue and reduced salivation after a lesion affecting the chorda tympani. The chorda tympani is a branch of which cranial nerve?

A.Glossopharyngeal nerve (IX)

B.Trigeminal nerve (V)

C.Facial nerve (VII)

D.Hypoglossal nerve (XII)

Explanation: The chorda tympani branches from the facial nerve (VII) and carries special sensory taste fibres from the anterior two-thirds of the tongue and parasympathetic secretomotor fibres to the submandibular and sublingual glands. It joins the lingual nerve to reach the tongue. Damage produces altered taste and reduced salivation.

3Which cells in the dental pulp are primarily responsible for the lifelong deposition of secondary and reparative dentine?

A.Fibroblasts

B.Ameloblasts

C.Cementoblasts

D.Odontoblasts

Explanation: Odontoblasts line the periphery of the pulp and form dentine throughout life; after tooth eruption they continue to lay down secondary dentine and, in response to injury, reparative (tertiary) dentine. Their long cytoplasmic processes occupy the dentinal tubules. This is a core histology concept for the AFK biomedical sciences component.

4A 35-year-old patient develops an itchy, raised wheal and difficulty breathing minutes after a penicillin injection. This immediate reaction is mediated by which immunoglobulin class and hypersensitivity type?

A.IgG, Type II (cytotoxic)

B.IgM, Type III (immune complex)

C.IgE, Type I (immediate)

D.T cells, Type IV (delayed)

Explanation: Anaphylaxis is a Type I (immediate) hypersensitivity reaction mediated by IgE bound to mast cells and basophils. Cross-linking of IgE by allergen triggers degranulation, releasing histamine and other mediators that cause urticaria, bronchospasm and hypotension. First-line management is intramuscular adrenaline (epinephrine).

5Which oral bacterium is most strongly associated with the initiation of dental caries because of its ability to produce glucans from sucrose and to thrive in acidic conditions?

A.Porphyromonas gingivalis

B.Fusobacterium nucleatum

C.Aggregatibacter actinomycetemcomitans

D.Streptococcus mutans

Explanation: Streptococcus mutans is the key cariogenic species: it metabolises sucrose to lactic acid (acidogenic), tolerates low pH (aciduric), and synthesises extracellular glucans that promote biofilm adhesion. These properties drive enamel demineralisation. Lactobacilli are more important in advanced lesion progression.

6A patient on warfarin requires a single tooth extraction. The INR measured on the day is 2.3. According to standard guidance for minor oral surgery, what is the most appropriate management?

A.Stop warfarin 5 days before and proceed

B.Bridge with low-molecular-weight heparin first

C.Postpone until INR is below 1.5

D.Proceed with extraction using local haemostatic measures

Explanation: For patients with a stable INR within the therapeutic range (up to about 4.0), warfarin should NOT be interrupted for simple dental extractions; the thromboembolic risk of stopping outweighs the bleeding risk. Treatment proceeds with local measures such as sutures, oxidised cellulose and tranexamic acid mouthwash. An INR of 2.3 is well within the safe range.

7What is the maximum recommended dose of 2% lidocaine WITH 1:100,000 epinephrine, expressed in mg/kg, that limits the local anaesthetic component in a healthy adult?

A.4.4 mg/kg

B.10 mg/kg

C.7 mg/kg

D.1.3 mg/kg

Explanation: When combined with a vasoconstrictor, the maximum recommended dose of lidocaine is approximately 7 mg/kg (absolute maximum about 500 mg). Without a vasoconstrictor the limit drops to 4.4 mg/kg because absorption is faster. Knowing these limits is essential for safe injection in lighter and paediatric patients.

8A patient taking a non-selective beta-blocker is having dental treatment. Why must epinephrine-containing local anaesthetic be used cautiously in this patient?

A.Unopposed alpha effects can cause hypertension and reflex bradycardia

B.Epinephrine is completely inactivated by beta-blockers

C.Beta-blockers prolong anaesthetic onset excessively

D.There is a risk of severe hypoglycaemia

Explanation: With non-selective beta-blockade, the beta-2 mediated vasodilation of epinephrine is blocked, leaving unopposed alpha-1 vasoconstriction. This can produce an acute rise in blood pressure followed by reflex (baroreceptor-mediated) bradycardia. Aspiration and minimising the epinephrine dose are prudent precautions.

9Which muscle is the primary depressor of the mandible that initiates mouth opening, assisted by gravity and the suprahyoid muscles?

A.Masseter

B.Medial pterygoid

C.Temporalis

D.Lateral pterygoid

Explanation: The inferior head of the lateral pterygoid pulls the condyle and articular disc forward and downward, initiating mandibular depression (opening) and protrusion. The masseter, temporalis and medial pterygoid are all elevators that close the jaw. Understanding muscle function aids diagnosis of temporomandibular disorders.

10Fluoride reduces caries partly by forming fluorapatite. Compared with hydroxyapatite, fluorapatite is more resistant to acid dissolution mainly because it has a:

A.Lower critical pH for dissolution

B.Higher critical pH for dissolution

C.Greater solubility in saliva

D.Larger crystal unit cell

Explanation: Fluorapatite has a lower critical pH (around 4.5) than hydroxyapatite (around 5.5), meaning a more acidic environment is needed before it begins to dissolve. Fluoride incorporation produces a more stable, less soluble crystal. Topical fluoride also enhances remineralisation of early lesions.

About the NZDREX Exam

NZDREX is the registration examination pathway for internationally qualified dentists with non-prescribed qualifications who wish to register in New Zealand. Candidates complete the National Dental Examining Board of Canada (NDEB) equivalency process - the AFK (200-question written exam), the ACJ clinical-judgement assessment, and the NDECC clinical skills assessment. AFK and ACJ may each be attempted up to three times.

Assessment

NZDREX is achieved by completing the NDEB of Canada equivalency process: Assessment of Fundamental Knowledge (AFK, 200 MCQs in two parts), Assessment of Clinical Judgement (ACJ), and Assessment of Clinical Skills (NDECC clinical/OSCE component).

Time Limit

AFK: two 2-hour parts (4 hours total). ACJ and NDECC are separately scheduled timed assessments.

Passing Score

A test-equated, re-scaled score of 75 or greater is required to pass the AFK and the ACJ. Results are reported only as pass or fail with the re-scaled score.

Exam Fee

NDEB fees (as of July 2025): AFK CAD $1,000; ACJ CAD $1,350; NDECC CAD $6,500; one-time equivalency application CAD $900. Fees are set by the NDEB, not the Dental Council of New Zealand. (Dental Council of New Zealand (administered via NDEB of Canada equivalency))

NZDREX Exam Content Outline

20%

Biomedical Sciences

Head and neck anatomy, oral physiology and histology, general and oral pathology, microbiology, immunology, biochemistry and pharmacology relevant to safe dental practice.

60%

Clinical Dental Sciences

Operative and restorative dentistry, fixed and removable prosthodontics and implants, endodontics, periodontics, oral and maxillofacial surgery, orthodontics, paediatric dentistry, and oral medicine and radiology.

20%

Behavioural and Community Dental Sciences

Ethics, jurisprudence and professionalism, consent and confidentiality, patient management and communication, and evidence-based practice, epidemiology and dental public health.

How to Pass the NZDREX Exam

What You Need to Know

Passing score: A test-equated, re-scaled score of 75 or greater is required to pass the AFK and the ACJ. Results are reported only as pass or fail with the re-scaled score.
Assessment: NZDREX is achieved by completing the NDEB of Canada equivalency process: Assessment of Fundamental Knowledge (AFK, 200 MCQs in two parts), Assessment of Clinical Judgement (ACJ), and Assessment of Clinical Skills (NDECC clinical/OSCE component).
Time limit: AFK: two 2-hour parts (4 hours total). ACJ and NDECC are separately scheduled timed assessments.
Exam fee: NDEB fees (as of July 2025): AFK CAD $1,000; ACJ CAD $1,350; NDECC CAD $6,500; one-time equivalency application CAD $900. Fees are set by the NDEB, not the Dental Council of New Zealand.

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

NZDREX Study Tips from Top Performers

1Use the NDEB AFK and ACJ protocols as your blueprint and study Canadian-context dental guidelines and terminology, since the assessments are written and scored by the NDEB.

2Build clinical reasoning, not just recall - the AFK and ACJ link basic biomedical science to applied clinical scenarios, so practise vignette-style questions under timed conditions.

3Cover all clinical disciplines proportionally; clinical dental sciences make up about 60% of the AFK, with biomedical and behavioural/community sciences each around 20%.

Frequently Asked Questions

Is the New Zealand exam called the ORE or NZDREX?

It is the New Zealand Dentist Registration Examination (NZDREX). The ORE is a separate UK exam. In New Zealand, the NZDREX pathway is completed through the NDEB of Canada equivalency process (AFK, ACJ and NDECC).

How many questions are on the AFK and what is the passing score?

The AFK has 200 single-answer multiple-choice questions delivered in two parts of two hours each. A test-equated, re-scaled score of 75 or greater is a pass; you do not need to answer 75% of questions correctly.

How many attempts do I get?

The AFK and ACJ can each be attempted a maximum of three times. The NDECC clinical skills component can be taken an unlimited number of times within a 60-month period. There is no overall time limit to complete the equivalency process.

How much does the NDEB equivalency process cost?

As of July 2025, NDEB fees are CAD $1,000 (AFK), CAD $1,350 (ACJ) and CAD $6,500 (NDECC), plus a one-time CAD $900 application fee. Fees are set by the NDEB and may change.