ABDSM - DENTAL SLEEP MEDICINE FINAL EXAM PREPARATION WITH
ACCURATE QUESTIONS AND ANSWERS UPDATED 2025 GRADED A+
Which of the following statements is true regarding a modified Mallampati
classification of the oral pharynx?
A. Mallampati II allows visualization of only the hard palate
B. Mallampati III allows visualization of only the hard palate
C. Mallampati classifications are taken with the patient sedated and reclined
D. Mallampati classifications of IV have greater odds ratio than Mallampati
classifications of I for severe OSA - correct answer D. Mallampati classifications of IV
have greater odds ratio than Mallampati classifications of I for severe OSA
What 8 item questionnaire was developed to perioperatively screen for risk of OSA?
A. ESS
B. STOP-BANG
C. MSLT
D. Berlin - correct answer B. STOP-BANG
In the pathophysiology of sleep apnea, airway patency and stability is promoted by
which factor?
A. Increased lung volume
B. Shorter mandible
C. Increased parapharyngeal fat deposition
D. Negative inspiratory pressure
E. Reduced pharyngeal muscle dilator activity - correct answer A. Increased lung
volume
Oral appliance therapy commonly provides successful sole therapy for which of the
following sleep-related breathing disorders?
A. Primary central sleep apnea
B. Cheyne-Stoke periodic breathing
C. Obesity hypoventilation
D. Overlap syndrome (OSA and COPD)
E. None of the above - correct answer E. None of the above
Which of the following is true about OSA and HTN?
A. Ambulatory BP is increased in OSA patients primarily due to increased salt intake
associated with elevated ghrelin levels
B. Ambulatory BP normally increases in the early AM before awakening - this
increase is blunted in OSA
,C. Untreated OSA is associated with a similar risk of HTN at all severity levels
D. The risk of HTN in untreated OSA is due to intermittent hypoxia, sympathetic
overactivation, inflammation, and other complex factors - correct answer D. The risk
of HTN in untreated OSA is due to intermittent hypoxia, sympathetic overactivation,
inflammation, and other complex factors
Across a general population, what is the most common sleep disorder?
A. RLS
B. Narcolepsy
C. Delayed sleep phase syndrome
D. Insomnia
E. Obstructive sleep apnea - correct answer D. Insomnia
Measurement has shown that patients with sleep apnea have smaller upper airways
than those without sleep apnea but manage to keep an open airway during
wakefulness by:
A. Mouth Breathing
B. Increased muscle tone on inspiration
C. Increased blood flow to the soft tissue
D. Frequent bruxing - correct answer B. Increased muscle tone on inspiration
Key features of sleep apnea as recorded during an in-lab sleep study include
marked reduction or absence of air flow, arousals from sleep, slowing of heart rate
and:
A. Choking or gasping for air
B. Oxygen desaturation
C. Flattening of the nasal pressure signal
D. Flailing of the arms and legs
E. Sawtooth waves in the EEG - correct answer B. Oxygen Desaturation
Who publishes the CPT codebook?
A. The Centers for Medicare and Medicaid Services
B. The American Medical Association
C. The Office of the Inspector General
D. The Durable Medical Equipment Service
E. The American Academy of Sleep Medicine - correct answer B. The American
Medical Association
A 48 year old man is treated with OAT for his moderate OSA. On repeat sleep
testing, his apnea-hypopnea index (AHI) has decreased to 3 events per hour, and he
reports resolution of snoring and daytime sleepiness. What is the most reasonable
dental-medical sleep medicine follow up regimen for this patient?
A. As needed
B. Every 6 months for the first year, then annually
C. Monthly for the first 6 months, then every 6 months
,D. Every other year - correct answer B. Every 6 months for the first year, then
annually
Which of the following would exclude oral appliance therapy as a first treatment trial
for OSA?
A. Xerostomia
B. Edentulism
C. Micrognathia
D. Steep mandibular plane angle - correct answer B. Edentulism
Reviewing your patient's diagnostic polysomnogram, you note more than a 50%
epoch consists of alpha waves. According to the current PSG scoring guidelines, the
patient is in which stage of sleep?
A. Stage I NREM
B. Stage II NREM
C. Stage III NREM
D. Stage REM - correct answer A. Stage I NREM
A patient presents for an evaluation to determine their candidacy for an oral
appliance to treat their mild OSA. During your examination, you note the presence of
TMD. This might include the following:
A. Pain in the TMJ
B. Pain in the muscles of mastication
C. Anomalies in mandibular movement
D. All of the above - correct answer D. All of the above
The qualified dentist designation (QDD) came about in response to the 2015
practice guidelines paper recommending that physicians refer patients to dentists
"qualified" to treat sleep related breathing disorders. This was based upon
recognition of which of the following?
A. Older dentists have more experience than younger dentists
B. All dentists have the skills they need to deliver knowledgeable care
C. Oral appliance efficacy data collected in studies is obtained by dentist with
extensive clinical experience
D. Training in dental schools on oral appliance therapy has become common place -
correct answer C. Oral appliance efficacy data collected in studies is obtained by
dentist with extensive clinical experience
The 2015 Practice Guidelines created through cooperative effort of the AASM and
AADSM suggest a physician should seek collaboration with a qualified dentist,
described as someone who has at least:
A. Board certification
B. Facility accreditation
C. Completion of a 1 yr residency in dental sleep medicine
, D. Additional training or experience in dental sleep medicine - correct answer D.
Additional training or experience in dental sleep medicine
An understanding of loop gain is important to the clinical practice of dental sleep
medicine because:
A. It excludes the possibility of cheyne stokes breathing in patients with severe OSA
B. It is the basis of the Mallampati classification system
C. It defines the number of sequential obstructive apneas in an epoch
D. rIt rcontributes rto rthe rmultifactorial rnature rof rsleep rrelated rbreathing rdisorders r-
rcorrect ranswer rD. rIt rcontributes rto rthe rmultifactorial rnature rof rsleep rrelated rbreathing
rdisorders
rWith rregards rto rbiomechanical rproperties rof rthe rupper rairway, rwhich rstatement ris
rtrue?
A. rSleep rapnea rpatients rparalyzed rduring rgeneral ranesthesia r(neural rdrive rremoved)
rdemonstrated rairway rcompliance rsimilar rto rhealthy rsubjects
B. rSleep rapnea rpatients rhad rmore rnegative rclosing rpressures
C. rSleep rapnea rpatients rdemonstrate ra rmore rpositive rPcrit
D. rThere ris rno rcorrelation rbetween rcollapsibility rwhen rawake rand rcollapsibility rwhen
rasleep r- rcorrect ranswer rC. rSleep rapnea rpatients rdemonstrate ra rmore rpositive rPcrit
r Tagged rMRI rrecently rshowed r3 rpatterns rof rtissue rformation rduring rmandibular
r advancement. rWhich rof rthese rwas rNOT robserved?
A. rThe rwhole rtongue rmoved rforward r"en rbloc"
B. rOnly rthe rsuperior rposterior rportion rof rthe rtongue rmoved rforward
C. rThe rposterior rtongue rdid rnot rmove, rbut rthe rwhole rtongue relongated
D. rOnly rthe rinferior rposterior rportion rof rthe rtongue rmoved rforward r- rcorrect ranswer rB.
rOnly rthe rsuperior rposterior rportion rof rthe rtongue rmoved rforward
r In rVan rHeasendonck's r2015 rsystematic rreview rof roral rappliance rhealth rbenefits,
r mean rdisease ralleviation rwas rcalculated rusing rthe rfollowing:
A. rAn rembedded rmicrosensor
B. rA rhighly rcompliant rpatient rpopulation
C. rPatient's rdiaries rof rhours rof rnightly rdevice ruse
D. rPatient's rattestations rto rhours rof rnightly rdevice ruse r- rcorrect ranswer rA. rAn
rembedded rmicrosensor
r Caffeine rpromotes rwakefulness rby rsuppressing ror rblocking:
A. rThyroid rstimulating rhormone
B. rGrowth rhormone
C. rOrexin
D. rAdenosine r- rcorrect ranswer rD. rAdenosine
ACCURATE QUESTIONS AND ANSWERS UPDATED 2025 GRADED A+
Which of the following statements is true regarding a modified Mallampati
classification of the oral pharynx?
A. Mallampati II allows visualization of only the hard palate
B. Mallampati III allows visualization of only the hard palate
C. Mallampati classifications are taken with the patient sedated and reclined
D. Mallampati classifications of IV have greater odds ratio than Mallampati
classifications of I for severe OSA - correct answer D. Mallampati classifications of IV
have greater odds ratio than Mallampati classifications of I for severe OSA
What 8 item questionnaire was developed to perioperatively screen for risk of OSA?
A. ESS
B. STOP-BANG
C. MSLT
D. Berlin - correct answer B. STOP-BANG
In the pathophysiology of sleep apnea, airway patency and stability is promoted by
which factor?
A. Increased lung volume
B. Shorter mandible
C. Increased parapharyngeal fat deposition
D. Negative inspiratory pressure
E. Reduced pharyngeal muscle dilator activity - correct answer A. Increased lung
volume
Oral appliance therapy commonly provides successful sole therapy for which of the
following sleep-related breathing disorders?
A. Primary central sleep apnea
B. Cheyne-Stoke periodic breathing
C. Obesity hypoventilation
D. Overlap syndrome (OSA and COPD)
E. None of the above - correct answer E. None of the above
Which of the following is true about OSA and HTN?
A. Ambulatory BP is increased in OSA patients primarily due to increased salt intake
associated with elevated ghrelin levels
B. Ambulatory BP normally increases in the early AM before awakening - this
increase is blunted in OSA
,C. Untreated OSA is associated with a similar risk of HTN at all severity levels
D. The risk of HTN in untreated OSA is due to intermittent hypoxia, sympathetic
overactivation, inflammation, and other complex factors - correct answer D. The risk
of HTN in untreated OSA is due to intermittent hypoxia, sympathetic overactivation,
inflammation, and other complex factors
Across a general population, what is the most common sleep disorder?
A. RLS
B. Narcolepsy
C. Delayed sleep phase syndrome
D. Insomnia
E. Obstructive sleep apnea - correct answer D. Insomnia
Measurement has shown that patients with sleep apnea have smaller upper airways
than those without sleep apnea but manage to keep an open airway during
wakefulness by:
A. Mouth Breathing
B. Increased muscle tone on inspiration
C. Increased blood flow to the soft tissue
D. Frequent bruxing - correct answer B. Increased muscle tone on inspiration
Key features of sleep apnea as recorded during an in-lab sleep study include
marked reduction or absence of air flow, arousals from sleep, slowing of heart rate
and:
A. Choking or gasping for air
B. Oxygen desaturation
C. Flattening of the nasal pressure signal
D. Flailing of the arms and legs
E. Sawtooth waves in the EEG - correct answer B. Oxygen Desaturation
Who publishes the CPT codebook?
A. The Centers for Medicare and Medicaid Services
B. The American Medical Association
C. The Office of the Inspector General
D. The Durable Medical Equipment Service
E. The American Academy of Sleep Medicine - correct answer B. The American
Medical Association
A 48 year old man is treated with OAT for his moderate OSA. On repeat sleep
testing, his apnea-hypopnea index (AHI) has decreased to 3 events per hour, and he
reports resolution of snoring and daytime sleepiness. What is the most reasonable
dental-medical sleep medicine follow up regimen for this patient?
A. As needed
B. Every 6 months for the first year, then annually
C. Monthly for the first 6 months, then every 6 months
,D. Every other year - correct answer B. Every 6 months for the first year, then
annually
Which of the following would exclude oral appliance therapy as a first treatment trial
for OSA?
A. Xerostomia
B. Edentulism
C. Micrognathia
D. Steep mandibular plane angle - correct answer B. Edentulism
Reviewing your patient's diagnostic polysomnogram, you note more than a 50%
epoch consists of alpha waves. According to the current PSG scoring guidelines, the
patient is in which stage of sleep?
A. Stage I NREM
B. Stage II NREM
C. Stage III NREM
D. Stage REM - correct answer A. Stage I NREM
A patient presents for an evaluation to determine their candidacy for an oral
appliance to treat their mild OSA. During your examination, you note the presence of
TMD. This might include the following:
A. Pain in the TMJ
B. Pain in the muscles of mastication
C. Anomalies in mandibular movement
D. All of the above - correct answer D. All of the above
The qualified dentist designation (QDD) came about in response to the 2015
practice guidelines paper recommending that physicians refer patients to dentists
"qualified" to treat sleep related breathing disorders. This was based upon
recognition of which of the following?
A. Older dentists have more experience than younger dentists
B. All dentists have the skills they need to deliver knowledgeable care
C. Oral appliance efficacy data collected in studies is obtained by dentist with
extensive clinical experience
D. Training in dental schools on oral appliance therapy has become common place -
correct answer C. Oral appliance efficacy data collected in studies is obtained by
dentist with extensive clinical experience
The 2015 Practice Guidelines created through cooperative effort of the AASM and
AADSM suggest a physician should seek collaboration with a qualified dentist,
described as someone who has at least:
A. Board certification
B. Facility accreditation
C. Completion of a 1 yr residency in dental sleep medicine
, D. Additional training or experience in dental sleep medicine - correct answer D.
Additional training or experience in dental sleep medicine
An understanding of loop gain is important to the clinical practice of dental sleep
medicine because:
A. It excludes the possibility of cheyne stokes breathing in patients with severe OSA
B. It is the basis of the Mallampati classification system
C. It defines the number of sequential obstructive apneas in an epoch
D. rIt rcontributes rto rthe rmultifactorial rnature rof rsleep rrelated rbreathing rdisorders r-
rcorrect ranswer rD. rIt rcontributes rto rthe rmultifactorial rnature rof rsleep rrelated rbreathing
rdisorders
rWith rregards rto rbiomechanical rproperties rof rthe rupper rairway, rwhich rstatement ris
rtrue?
A. rSleep rapnea rpatients rparalyzed rduring rgeneral ranesthesia r(neural rdrive rremoved)
rdemonstrated rairway rcompliance rsimilar rto rhealthy rsubjects
B. rSleep rapnea rpatients rhad rmore rnegative rclosing rpressures
C. rSleep rapnea rpatients rdemonstrate ra rmore rpositive rPcrit
D. rThere ris rno rcorrelation rbetween rcollapsibility rwhen rawake rand rcollapsibility rwhen
rasleep r- rcorrect ranswer rC. rSleep rapnea rpatients rdemonstrate ra rmore rpositive rPcrit
r Tagged rMRI rrecently rshowed r3 rpatterns rof rtissue rformation rduring rmandibular
r advancement. rWhich rof rthese rwas rNOT robserved?
A. rThe rwhole rtongue rmoved rforward r"en rbloc"
B. rOnly rthe rsuperior rposterior rportion rof rthe rtongue rmoved rforward
C. rThe rposterior rtongue rdid rnot rmove, rbut rthe rwhole rtongue relongated
D. rOnly rthe rinferior rposterior rportion rof rthe rtongue rmoved rforward r- rcorrect ranswer rB.
rOnly rthe rsuperior rposterior rportion rof rthe rtongue rmoved rforward
r In rVan rHeasendonck's r2015 rsystematic rreview rof roral rappliance rhealth rbenefits,
r mean rdisease ralleviation rwas rcalculated rusing rthe rfollowing:
A. rAn rembedded rmicrosensor
B. rA rhighly rcompliant rpatient rpopulation
C. rPatient's rdiaries rof rhours rof rnightly rdevice ruse
D. rPatient's rattestations rto rhours rof rnightly rdevice ruse r- rcorrect ranswer rA. rAn
rembedded rmicrosensor
r Caffeine rpromotes rwakefulness rby rsuppressing ror rblocking:
A. rThyroid rstimulating rhormone
B. rGrowth rhormone
C. rOrexin
D. rAdenosine r- rcorrect ranswer rD. rAdenosine
