What is the passing score for the ADEX DSE OSCE?

Candidates must earn 75% or higher of the 150 available score points. Items are worth 1-3 points each with partial credit possible, and scores are scaled and equated from year to year.

Who administers the ADEX dental exam and where is the DSE OSCE taken?

The American Board of Dental Examiners (ADEX), formed from the merger of CDCA-WREB-CITA, develops the exam. The computer-based DSE OSCE is delivered at Prometric test centers.

How much does the ADEX DSE OSCE cost in 2026?

The 2026 individual DSE OSCE fee is $990 (retake $400). The full ADEX Dental Examination series fee is $2,795 plus a facility fee that varies by clinical location.

How long is the DSE OSCE and how is it structured?

The DSE OSCE provides 192 minutes of test time within an approximately 4-hour seat time and is divided into two sections, with content weighted toward comprehensive treatment planning (60%).

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100+ Free WREB ADEX Dental Exam Practice Questions

Western Regional Examining Board (WREB) ADEX Dental Exam practice questions are available now; exam metadata is being verified.

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Question 1

Score: 0/0

A pregnant patient in her second trimester needs treatment for a symptomatic carious lesion. Which statement reflects appropriate care?

Elective care should be scheduled in the first trimester

Necessary dental treatment, including radiographs with shielding, can be safely provided

All dental treatment must be postponed until after delivery

Radiographs are absolutely contraindicated at any stage

to track

Sample WREB ADEX Dental Exam Practice Questions

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

1A 34-year-old patient presents with a 2 cm well-defined unilocular radiolucency at the apex of a non-vital maxillary lateral incisor that does not respond to pulp testing. The lesion is asymptomatic. Which diagnosis is most consistent with these findings?

A.Odontogenic keratocyst

B.Periapical (radicular) cyst

C.Ameloblastoma

D.Central giant cell granuloma

Explanation: A radicular (periapical) cyst is an inflammatory cyst arising from epithelial rests of Malassez stimulated by pulpal necrosis. The hallmark is association with a non-vital tooth and a well-defined unilocular periapical radiolucency. Pulpal necrosis confirmed by lack of response to testing is the key diagnostic link.

2A patient has a painless, dome-shaped fluctuant swelling on the floor of the mouth, lateral to the midline, with a bluish translucent appearance. It enlarges and shrinks intermittently. Which lesion is most likely?

A.Dermoid cyst

B.Torus mandibularis

C.Ranula

D.Lymphoepithelial cyst

Explanation: A ranula is a mucocele of the floor of the mouth arising from the sublingual gland, classically a bluish, fluctuant, translucent swelling lateral to the midline that fluctuates in size with salivary flow. The intermittent enlargement reflects mucus extravasation/retention.

3On a clinical photograph, a 60-year-old smoker has a non-removable white plaque on the lateral border of the tongue that cannot be wiped off and has no identifiable cause. What is the most appropriate next step?

A.Apply topical corticosteroid

B.Prescribe nystatin and reassess in 2 weeks

C.Reassure the patient it is frictional keratosis

D.Incisional biopsy of the lesion

Explanation: Leukoplakia is a clinical diagnosis of exclusion and is a potentially malignant disorder, especially on high-risk sites such as the lateral tongue in a smoker. Because it cannot be wiped off and has no removable cause, incisional biopsy is required to rule out dysplasia or carcinoma.

4A periapical radiograph shows a tooth with a 'floating' appearance and generalized loss of the lamina dura around multiple teeth in a patient with bone pain and elevated serum calcium. Which systemic condition should be suspected?

A.Hyperparathyroidism

B.Hypothyroidism

C.Paget disease

D.Osteopetrosis

Explanation: Generalized loss of the lamina dura, a ground-glass trabecular pattern, and 'floating teeth' with hypercalcemia and bone pain are classic for hyperparathyroidism. Excess parathyroid hormone increases osteoclastic bone resorption, demineralizing the lamina dura.

5Which radiographic feature best distinguishes condensing osteitis from a periapical cyst at the apex of a mandibular first molar?

A.Root resorption of adjacent teeth

B.A multilocular pattern

C.A localized radiopacity rather than a radiolucency

D.A corticated radiolucent border

Explanation: Condensing osteitis (focal sclerosing osteomyelitis) is a localized bony reaction to low-grade pulpal inflammation and appears as a radiopacity at the apex of a non-vital or pulpitic tooth. A periapical cyst, by contrast, is radiolucent.

6A bitewing radiograph shows a radiolucency confined to the outer half of enamel on the proximal surface of a premolar, with no cavitation detectable clinically. What is the most appropriate management?

A.Pulpotomy

B.Immediate Class II composite restoration

C.Stainless steel crown

D.Non-operative remineralization with fluoride and monitoring

Explanation: An incipient proximal lesion limited to the outer enamel (E1/E2) without clinical cavitation is reversible. Evidence-based caries management favors non-operative remineralization with fluoride and risk control rather than cutting tooth structure.

7During physical evaluation a patient's blood pressure reads 182/112 mmHg with no symptoms. According to ACC/AHA categories, how is this reading classified and what is the appropriate dental management?

A.Elevated; proceed with all treatment normally

B.Stage 2 hypertension; defer elective care and refer for medical evaluation

C.Stage 1 hypertension; no precautions needed

D.Hypertensive emergency; call 911 immediately

Explanation: A reading of 182/112 mmHg is Stage 2 hypertension (systolic 140 or higher, or diastolic 90 or higher per ACC/AHA). With pressures this high but no acute symptoms or target-organ signs, elective dental care should be deferred and the patient referred for medical evaluation.

8A panoramic radiograph reveals a well-defined pericoronal radiolucency surrounding the crown of an impacted mandibular third molar, attached at the cementoenamel junction. Which lesion is most likely?

A.Dentigerous cyst

B.Periapical cyst

C.Residual cyst

D.Lateral periodontal cyst

Explanation: A dentigerous cyst forms around the crown of an unerupted tooth and characteristically attaches at the cementoenamel junction, producing a pericoronal radiolucency. The impacted mandibular third molar is the most common site.

9Which anatomical landmark appears as a radiopaque inverted-Y intersection in the anterior maxilla on a periapical radiograph?

A.The coronoid process

B.The mental foramen

C.The genial tubercles

D.The junction of the lateral wall of the nasal fossa and the maxillary sinus

Explanation: The 'inverted Y of Ennis' is formed by the superimposition of the floor of the nasal fossa and the anterior border of the maxillary sinus, seen over the canine region. Recognizing this normal landmark prevents misdiagnosis as pathology.

10Which nerve provides sensory innervation to the pulps of the maxillary molars (except the mesiobuccal root of the first molar in many patients)?

A.Greater palatine nerve

B.Posterior superior alveolar nerve

C.Nasopalatine nerve

D.Inferior alveolar nerve

Explanation: The posterior superior alveolar nerve, a branch of the maxillary division of the trigeminal nerve, supplies the pulps of the maxillary molars. The mesiobuccal root of the first molar is often additionally supplied by the middle superior alveolar nerve.

About the WREB ADEX Dental Exam Practice Questions

Verified exam format metadata for Western Regional Examining Board (WREB) ADEX Dental Exam is pending. The practice questions above remain available while official exam length, timing, passing score, fee, and administrator details are reviewed.