PA EFDA Board Examination 2026–2027 | Expanded Function Dental Assisting
Pennsylvania State Board of Dentistry
EFDA Board Examination 2026–2027 | Expanded Function Dental Assisting
110 Questions | Multiple Choice | Study Guide with Verified Answers
This study guide contains 110 multiple-choice questions aligned with the Pennsylvania EFDA Board Exam
administered by Pearson VUE. Each question is followed by the correct answer and a clinical rationale. Content
covers dental anatomy, restorative procedures, infection control, and Pennsylvania dental law.
SECTION I. DENTAL ANATOMY (Questions 1–10)
1. In the Universal Numbering System, which tooth is designated as tooth number 3?
A. Maxillary right first molar B. Maxillary left first molar
C. Mandibular right first molar D. Mandibular left first molar
Correct Answer: A. Rationale: In the Universal Numbering System, the maxillary right third molar is #1, the
maxillary right second molar is #2, and the maxillary right first molar is #3. The system starts at the maxillary right
third molar and counts across the maxillary arch to the left, then drops to the mandibular left third molar (#16) and
continues across the mandibular arch.
2. Which permanent tooth has the most prominent cingulum on its lingual surface?
A. Maxillary central incisor B. Maxillary canine
C. Mandibular central incisor D. Mandibular lateral incisor
Correct Answer: A. Rationale: The maxillary central incisor has the most prominent cingulum among permanent
teeth. The cingulum is a bulbous, convex prominence of enamel on the lingual surface near the cervical third. It is a
developmental remnant of the lingual lobe and is most pronounced on maxillary incisors, particularly the central
incisor.
3. A patient presents with a total of 20 primary teeth. According to the Universal Numbering System for primary
dentition, the letter designation for the maxillary right second primary molar is:
A. Letter A B. Letter E
C. Letter I D. Letter T
Correct Answer: A. Rationale: In the Universal Numbering System for primary teeth, the maxillary right second
molar is designated as letter A. The system uses uppercase letters A through T, starting with A for the maxillary right
second molar and progressing across the maxillary arch to T for the mandibular right second molar.
4. Which of the following teeth typically has two roots in the permanent dentition?
A. Maxillary first premolar B. Mandibular first premolar
C. Maxillary canine D. Mandibular lateral incisor
Correct Answer: A. Rationale: The maxillary first premolar is the most commonly bifurcated premolar, typically
having a buccal and a lingual root. The mandibular first premolar usually has a single root, the maxillary canine has
a single root, and the mandibular lateral incisor has a single root. The maxillary second premolar may also have two
roots but is less commonly bifurcated than the first premolar.
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, PA EFDA Board Examination 2026–2027 | Expanded Function Dental Assisting
5. The mesial marginal ridge of which tooth is located most cervically relative to the distal marginal ridge?
A. Maxillary first premolar B. Mandibular first molar
C. Maxillary central incisor D. Mandibular canine
Correct Answer: A. Rationale: The maxillary first premolar has a pronounced cervical curvature, with the mesial
marginal ridge located more cervically (closer to the gumline) than the distal marginal ridge. This is an important
anatomical feature for proper cavity preparation and matrix placement during restorative procedures.
6. Which dental tissue is the hardest substance in the human body?
A. Dentin B. Enamel
C. Cementum D. Bone
Correct Answer: B. Rationale: Enamel is the hardest substance in the human body, consisting of approximately
96% inorganic material (primarily hydroxyapatite crystals). Dentin is about 70% inorganic, cementum is about 65%
inorganic, and bone is about 65% inorganic. Enamel covers the anatomic crown of the tooth and provides the
primary resistance to masticatory forces.
7. The lingual surface of a mandibular incisor can also be correctly referred to as the:
A. Facial surface B. Palatal surface
C. Labial surface D. Proximal surface
Correct Answer: A. Rationale: The lingual surface of mandibular teeth is synonymous with the facial surface when
distinguishing from the labial (lip-facing) surface. For maxillary teeth, the lingual surface is called the palatal
surface. The labial surface refers to the lip-facing surface of anterior teeth. Proximal surfaces refer to the mesial and
distal surfaces.
8. A patient has congenitally missing maxillary lateral incisors. This condition is most commonly known as:
A. Dens invaginatus B. Hypodontia
C. Taurodontism D. Gemination
Correct Answer: B. Rationale: Hypodontia is the congenital absence of one or more teeth (excluding third molars).
The maxillary lateral incisor is one of the most commonly congenitally missing teeth. Dens invaginatus is an
invagination of the enamel into the dentin. Taurodontism refers to teeth with elongated pulp chambers and short
roots. Gemination is the incomplete splitting of a single tooth bud.
9. The apical foramen of a tooth is the opening at the root apex through which the following structures pass:
A. Enamel rods and dentinal tubules B. Blood vessels, nerves, and lymphatics
C. Periodontal ligament fibers only D. Salivary gland ducts
Correct Answer: B. Rationale: The apical foramen is the natural opening at the apex of the root through which the
pulp's neurovascular bundle (arteries, veins, nerves, and lymphatic vessels) enters and exits the tooth. This
communication between the pulp and the periodontal ligament is critical for the vitality of the dental pulp.
10. Which tooth in the permanent dentition is most likely to have a transverse ridge?
A. Maxillary canine B. Mandibular central incisor
C. Maxillary first molar D. Mandibular lateral incisor
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, PA EFDA Board Examination 2026–2027 | Expanded Function Dental Assisting
Correct Answer: C. Rationale: A transverse ridge is formed by the junction of a triangular ridge and a marginal
ridge crossing the occlusal surface transversely. The maxillary first molar has well-developed transverse ridges on its
occlusal surface. Incisors and canines lack occlusal surfaces and therefore do not have transverse ridges.
SECTION II. OCCLUSIONS (Questions 11–19)
11. Centric relation is best defined as the:
A. Maximum intercuspation of the teeth with the B. Most superior and anterior position of the condyle in
condyle in its most superior position the fossa at which lateral movement is possible
C. Most musculoskeletally stable position of the D. Position of the mandible during functional lateral
mandible with the condyles in their most superior and excursive movements
retruded position in the fossa
Correct Answer: C. Rationale: Centric relation (CR) is defined as the most musculoskeletally stable position of the
mandible with the condyles in their most superior and retruded (anatomical) position in the glenoid fossa. It is
independent of tooth contact and is considered a bone-to-bone relationship. Maximum intercuspation (centric
occlusion) may differ from centric relation.
12. In Angle's Classification, a Class II Division 1 malocclusion is characterized by:
A. Normal molar relationship with anterior crossbite B. The mesiobuccal cusp of the maxillary first molar
occluding mesial to the buccal groove of the
mandibular first molar, with proclined maxillary
incisors
C. The mesiobuccal cusp of the maxillary first molar D. Lower incisors positioned anterior to the upper
occluding distal to the buccal groove of the mandibular incisors in an edge-to-edge relationship
first molar
Correct Answer: B. Rationale: Angle's Class II Division 1 malocclusion features the maxillary first molar
positioned mesial to normal (mesiobuccal cusp anterior to the mandibular buccal groove), combined with proclined
(protruding) maxillary incisors and typically an increased overjet. Class II Division 2 has retroclined maxillary
incisors with a deep overbite.
13. During lateral excursive movement, the canine guidance concept dictates that:
A. All posterior teeth on the working side maintain B. The maxillary and mandibular canines on the
simultaneous contact working side provide all the disocclusion of the
posterior teeth
C. The incisors alone separate the posterior teeth during D. The condyle on the balancing side translates forward
lateral movement to achieve disocclusion
Correct Answer: B. Rationale: Canine guidance (also called canine-protected occlusion) means that during lateral
excursive movements, only the canines on the working side make contact, causing all posterior teeth to separate
(disocclude). This protects the posterior teeth from lateral forces. Group function, by contrast, distributes lateral
forces across multiple posterior teeth on the working side.
14. Overjet is defined as the:
A. Vertical overlap of the mandibular incisors by the B. Horizontal distance between the labial surface of the
maxillary incisors mandibular incisors and the lingual surface of the
maxillary incisors
3
Pennsylvania State Board of Dentistry
EFDA Board Examination 2026–2027 | Expanded Function Dental Assisting
110 Questions | Multiple Choice | Study Guide with Verified Answers
This study guide contains 110 multiple-choice questions aligned with the Pennsylvania EFDA Board Exam
administered by Pearson VUE. Each question is followed by the correct answer and a clinical rationale. Content
covers dental anatomy, restorative procedures, infection control, and Pennsylvania dental law.
SECTION I. DENTAL ANATOMY (Questions 1–10)
1. In the Universal Numbering System, which tooth is designated as tooth number 3?
A. Maxillary right first molar B. Maxillary left first molar
C. Mandibular right first molar D. Mandibular left first molar
Correct Answer: A. Rationale: In the Universal Numbering System, the maxillary right third molar is #1, the
maxillary right second molar is #2, and the maxillary right first molar is #3. The system starts at the maxillary right
third molar and counts across the maxillary arch to the left, then drops to the mandibular left third molar (#16) and
continues across the mandibular arch.
2. Which permanent tooth has the most prominent cingulum on its lingual surface?
A. Maxillary central incisor B. Maxillary canine
C. Mandibular central incisor D. Mandibular lateral incisor
Correct Answer: A. Rationale: The maxillary central incisor has the most prominent cingulum among permanent
teeth. The cingulum is a bulbous, convex prominence of enamel on the lingual surface near the cervical third. It is a
developmental remnant of the lingual lobe and is most pronounced on maxillary incisors, particularly the central
incisor.
3. A patient presents with a total of 20 primary teeth. According to the Universal Numbering System for primary
dentition, the letter designation for the maxillary right second primary molar is:
A. Letter A B. Letter E
C. Letter I D. Letter T
Correct Answer: A. Rationale: In the Universal Numbering System for primary teeth, the maxillary right second
molar is designated as letter A. The system uses uppercase letters A through T, starting with A for the maxillary right
second molar and progressing across the maxillary arch to T for the mandibular right second molar.
4. Which of the following teeth typically has two roots in the permanent dentition?
A. Maxillary first premolar B. Mandibular first premolar
C. Maxillary canine D. Mandibular lateral incisor
Correct Answer: A. Rationale: The maxillary first premolar is the most commonly bifurcated premolar, typically
having a buccal and a lingual root. The mandibular first premolar usually has a single root, the maxillary canine has
a single root, and the mandibular lateral incisor has a single root. The maxillary second premolar may also have two
roots but is less commonly bifurcated than the first premolar.
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, PA EFDA Board Examination 2026–2027 | Expanded Function Dental Assisting
5. The mesial marginal ridge of which tooth is located most cervically relative to the distal marginal ridge?
A. Maxillary first premolar B. Mandibular first molar
C. Maxillary central incisor D. Mandibular canine
Correct Answer: A. Rationale: The maxillary first premolar has a pronounced cervical curvature, with the mesial
marginal ridge located more cervically (closer to the gumline) than the distal marginal ridge. This is an important
anatomical feature for proper cavity preparation and matrix placement during restorative procedures.
6. Which dental tissue is the hardest substance in the human body?
A. Dentin B. Enamel
C. Cementum D. Bone
Correct Answer: B. Rationale: Enamel is the hardest substance in the human body, consisting of approximately
96% inorganic material (primarily hydroxyapatite crystals). Dentin is about 70% inorganic, cementum is about 65%
inorganic, and bone is about 65% inorganic. Enamel covers the anatomic crown of the tooth and provides the
primary resistance to masticatory forces.
7. The lingual surface of a mandibular incisor can also be correctly referred to as the:
A. Facial surface B. Palatal surface
C. Labial surface D. Proximal surface
Correct Answer: A. Rationale: The lingual surface of mandibular teeth is synonymous with the facial surface when
distinguishing from the labial (lip-facing) surface. For maxillary teeth, the lingual surface is called the palatal
surface. The labial surface refers to the lip-facing surface of anterior teeth. Proximal surfaces refer to the mesial and
distal surfaces.
8. A patient has congenitally missing maxillary lateral incisors. This condition is most commonly known as:
A. Dens invaginatus B. Hypodontia
C. Taurodontism D. Gemination
Correct Answer: B. Rationale: Hypodontia is the congenital absence of one or more teeth (excluding third molars).
The maxillary lateral incisor is one of the most commonly congenitally missing teeth. Dens invaginatus is an
invagination of the enamel into the dentin. Taurodontism refers to teeth with elongated pulp chambers and short
roots. Gemination is the incomplete splitting of a single tooth bud.
9. The apical foramen of a tooth is the opening at the root apex through which the following structures pass:
A. Enamel rods and dentinal tubules B. Blood vessels, nerves, and lymphatics
C. Periodontal ligament fibers only D. Salivary gland ducts
Correct Answer: B. Rationale: The apical foramen is the natural opening at the apex of the root through which the
pulp's neurovascular bundle (arteries, veins, nerves, and lymphatic vessels) enters and exits the tooth. This
communication between the pulp and the periodontal ligament is critical for the vitality of the dental pulp.
10. Which tooth in the permanent dentition is most likely to have a transverse ridge?
A. Maxillary canine B. Mandibular central incisor
C. Maxillary first molar D. Mandibular lateral incisor
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, PA EFDA Board Examination 2026–2027 | Expanded Function Dental Assisting
Correct Answer: C. Rationale: A transverse ridge is formed by the junction of a triangular ridge and a marginal
ridge crossing the occlusal surface transversely. The maxillary first molar has well-developed transverse ridges on its
occlusal surface. Incisors and canines lack occlusal surfaces and therefore do not have transverse ridges.
SECTION II. OCCLUSIONS (Questions 11–19)
11. Centric relation is best defined as the:
A. Maximum intercuspation of the teeth with the B. Most superior and anterior position of the condyle in
condyle in its most superior position the fossa at which lateral movement is possible
C. Most musculoskeletally stable position of the D. Position of the mandible during functional lateral
mandible with the condyles in their most superior and excursive movements
retruded position in the fossa
Correct Answer: C. Rationale: Centric relation (CR) is defined as the most musculoskeletally stable position of the
mandible with the condyles in their most superior and retruded (anatomical) position in the glenoid fossa. It is
independent of tooth contact and is considered a bone-to-bone relationship. Maximum intercuspation (centric
occlusion) may differ from centric relation.
12. In Angle's Classification, a Class II Division 1 malocclusion is characterized by:
A. Normal molar relationship with anterior crossbite B. The mesiobuccal cusp of the maxillary first molar
occluding mesial to the buccal groove of the
mandibular first molar, with proclined maxillary
incisors
C. The mesiobuccal cusp of the maxillary first molar D. Lower incisors positioned anterior to the upper
occluding distal to the buccal groove of the mandibular incisors in an edge-to-edge relationship
first molar
Correct Answer: B. Rationale: Angle's Class II Division 1 malocclusion features the maxillary first molar
positioned mesial to normal (mesiobuccal cusp anterior to the mandibular buccal groove), combined with proclined
(protruding) maxillary incisors and typically an increased overjet. Class II Division 2 has retroclined maxillary
incisors with a deep overbite.
13. During lateral excursive movement, the canine guidance concept dictates that:
A. All posterior teeth on the working side maintain B. The maxillary and mandibular canines on the
simultaneous contact working side provide all the disocclusion of the
posterior teeth
C. The incisors alone separate the posterior teeth during D. The condyle on the balancing side translates forward
lateral movement to achieve disocclusion
Correct Answer: B. Rationale: Canine guidance (also called canine-protected occlusion) means that during lateral
excursive movements, only the canines on the working side make contact, causing all posterior teeth to separate
(disocclude). This protects the posterior teeth from lateral forces. Group function, by contrast, distributes lateral
forces across multiple posterior teeth on the working side.
14. Overjet is defined as the:
A. Vertical overlap of the mandibular incisors by the B. Horizontal distance between the labial surface of the
maxillary incisors mandibular incisors and the lingual surface of the
maxillary incisors
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