INBDE Pediatric Dentistry Practice Exam
2026 | 100 Advanced Questions &
Answers with Detailed Rationales |
Integrated National Board Dental
Examination Prep & Study Guide
1. A 5-year-old child presents with a deep carious lesion on the primary
mandibular second molar. The tooth has no spontaneous pain, no percussion
sensitivity, and the radiograph shows caries approaching the pulp without
furcation radiolucency. Which treatment is most appropriate if the pulp is
judged vital?
A. Extraction
B. Indirect pulp treatment
C. Pulpectomy
D. Direct pulp cap
Answer: Indirect pulp treatment
Rationale: Indirect pulp treatment is indicated for a vital primary tooth with
deep caries near the pulp when there are no clinical or radiographic signs of
,irreversible pulpitis or necrosis. Selective caries removal preserves the affected
dentin near the pulp and reduces the risk of pulp exposure.
2. A 4-year-old has a primary mandibular second molar with spontaneous
nocturnal pain and a furcation radiolucency. What is the most appropriate
treatment?
A. Indirect pulp treatment
B. Pulpotomy
C. Pulpectomy
D. Fluoride varnish
Answer: Pulpectomy
Rationale: Spontaneous pain and furcation pathology indicate irreversible
pulpal inflammation or necrosis. In a restorable primary tooth, pulpectomy is
generally indicated to remove infected necrotic pulp tissue and preserve the
tooth until normal exfoliation.
3. During a pulpotomy of a primary molar, bleeding from the canal orifices
cannot be controlled after appropriate coronal pulp removal. What does this
finding most strongly suggest?
A. Normal radicular pulp
B. Reversible pulpitis
C. Irreversible pulpal inflammation
D. Hypercalcification
Answer: Irreversible pulpal inflammation
Rationale: Persistent hemorrhage that cannot be controlled after coronal pulp
removal suggests inflammation extending into the radicular pulp. This makes
pulpotomy inappropriate and favors pulpectomy or extraction depending on
restorability and prognosis.
,4. Which material has traditionally been used as a medicament in primary-tooth
pulpotomy but is associated with concerns regarding formaldehyde exposure?
A. Calcium hydroxide
B. Ferric sulfate
C. Formocresol
D. MTA
Answer: Formocresol
Rationale: Formocresol contains formaldehyde and has historically been widely
used for primary pulpotomy. Contemporary pediatric dentistry increasingly
favors calcium-silicate materials such as MTA or Biodentine because of their
favorable biologic profiles.
5. A 7-year-old has a traumatized permanent maxillary central incisor with an
open apex. The tooth is nonresponsive to sensibility testing, but there is no
swelling or periapical lesion. What is the most important initial consideration?
A. Immediate extraction
B. Apexification in every case
C. Possibility of transient neural damage after trauma
D. Immediate complete root canal treatment
Answer: Possibility of transient neural damage after trauma
Rationale: A recently traumatized immature permanent tooth may temporarily
fail sensibility testing despite having viable pulp tissue. Treatment should not be
based solely on a negative sensibility test; clinical signs, radiographic findings,
follow-up, and developmental status must be considered.
, 6. Which traumatic injury most commonly causes displacement of a primary
tooth into the alveolar socket?
A. Concussion
B. Intrusion
C. Subluxation
D. Enamel fracture
Answer: Intrusion
Rationale: Intrusion is displacement of the tooth apically into the alveolar bone.
In primary teeth, management is strongly influenced by the direction and
degree of intrusion and the potential relationship to the developing permanent
successor.
7. A primary maxillary incisor is avulsed in a 3-year-old child. What is the
preferred management?
A. Immediate replantation
B. Replantation after splinting
C. Do not replant the primary tooth
D. Store in milk and replant later
Answer: Do not replant the primary tooth
Rationale: Avulsed primary teeth generally should not be replanted because
replantation can damage the developing permanent successor and may increase
the risk of ankylosis or infection. The priority is management of the child and
monitoring eruption of the permanent tooth.
8. A 9-year-old presents shortly after avulsion of a permanent maxillary central
incisor. The tooth has been stored in milk. What is the preferred management?
2026 | 100 Advanced Questions &
Answers with Detailed Rationales |
Integrated National Board Dental
Examination Prep & Study Guide
1. A 5-year-old child presents with a deep carious lesion on the primary
mandibular second molar. The tooth has no spontaneous pain, no percussion
sensitivity, and the radiograph shows caries approaching the pulp without
furcation radiolucency. Which treatment is most appropriate if the pulp is
judged vital?
A. Extraction
B. Indirect pulp treatment
C. Pulpectomy
D. Direct pulp cap
Answer: Indirect pulp treatment
Rationale: Indirect pulp treatment is indicated for a vital primary tooth with
deep caries near the pulp when there are no clinical or radiographic signs of
,irreversible pulpitis or necrosis. Selective caries removal preserves the affected
dentin near the pulp and reduces the risk of pulp exposure.
2. A 4-year-old has a primary mandibular second molar with spontaneous
nocturnal pain and a furcation radiolucency. What is the most appropriate
treatment?
A. Indirect pulp treatment
B. Pulpotomy
C. Pulpectomy
D. Fluoride varnish
Answer: Pulpectomy
Rationale: Spontaneous pain and furcation pathology indicate irreversible
pulpal inflammation or necrosis. In a restorable primary tooth, pulpectomy is
generally indicated to remove infected necrotic pulp tissue and preserve the
tooth until normal exfoliation.
3. During a pulpotomy of a primary molar, bleeding from the canal orifices
cannot be controlled after appropriate coronal pulp removal. What does this
finding most strongly suggest?
A. Normal radicular pulp
B. Reversible pulpitis
C. Irreversible pulpal inflammation
D. Hypercalcification
Answer: Irreversible pulpal inflammation
Rationale: Persistent hemorrhage that cannot be controlled after coronal pulp
removal suggests inflammation extending into the radicular pulp. This makes
pulpotomy inappropriate and favors pulpectomy or extraction depending on
restorability and prognosis.
,4. Which material has traditionally been used as a medicament in primary-tooth
pulpotomy but is associated with concerns regarding formaldehyde exposure?
A. Calcium hydroxide
B. Ferric sulfate
C. Formocresol
D. MTA
Answer: Formocresol
Rationale: Formocresol contains formaldehyde and has historically been widely
used for primary pulpotomy. Contemporary pediatric dentistry increasingly
favors calcium-silicate materials such as MTA or Biodentine because of their
favorable biologic profiles.
5. A 7-year-old has a traumatized permanent maxillary central incisor with an
open apex. The tooth is nonresponsive to sensibility testing, but there is no
swelling or periapical lesion. What is the most important initial consideration?
A. Immediate extraction
B. Apexification in every case
C. Possibility of transient neural damage after trauma
D. Immediate complete root canal treatment
Answer: Possibility of transient neural damage after trauma
Rationale: A recently traumatized immature permanent tooth may temporarily
fail sensibility testing despite having viable pulp tissue. Treatment should not be
based solely on a negative sensibility test; clinical signs, radiographic findings,
follow-up, and developmental status must be considered.
, 6. Which traumatic injury most commonly causes displacement of a primary
tooth into the alveolar socket?
A. Concussion
B. Intrusion
C. Subluxation
D. Enamel fracture
Answer: Intrusion
Rationale: Intrusion is displacement of the tooth apically into the alveolar bone.
In primary teeth, management is strongly influenced by the direction and
degree of intrusion and the potential relationship to the developing permanent
successor.
7. A primary maxillary incisor is avulsed in a 3-year-old child. What is the
preferred management?
A. Immediate replantation
B. Replantation after splinting
C. Do not replant the primary tooth
D. Store in milk and replant later
Answer: Do not replant the primary tooth
Rationale: Avulsed primary teeth generally should not be replanted because
replantation can damage the developing permanent successor and may increase
the risk of ankylosis or infection. The priority is management of the child and
monitoring eruption of the permanent tooth.
8. A 9-year-old presents shortly after avulsion of a permanent maxillary central
incisor. The tooth has been stored in milk. What is the preferred management?
