AAPD Oral Board Exam Questions With Complete Solutions
AAPD
CASE 1: EARLY CHILDHOOD CARIES (ECC)
Question
A 3-year-old presents with severe caries on maxillary anterior teeth. The child uses a bottle at
night with milk. How do you manage this patient?
Complete Answer
This patient has Early Childhood Caries (ECC). Management includes:
1. Caries risk assessment – patient is high risk
2. Parent education:
o Discontinue nighttime bottle use
o Avoid sugary liquids in bottles
o Brush twice daily with fluoridated toothpaste
3. Preventive care:
o Fluoride varnish application
o Establish a dental home
4. Restorative treatment:
o Depending on severity: composite crowns, strip crowns, or extractions
5. Behavior management:
o Likely need advanced behavior guidance (sedation or GA)
6. Recall schedule:
o Every 3 months
Follow-Up
Why are maxillary incisors most affected?
👉 They erupt first and are exposed to pooling liquids while mandibular incisors are protected
by the tongue and saliva.
, Examiner Pearl
Use the term “ECC”, not “baby bottle caries” (AAPD preferred terminology).
CASE 2: BEHAVIOR MANAGEMENT
Question
A 4-year-old is extremely anxious and uncooperative for dental treatment. What behavior
guidance techniques would you consider?
Complete Answer
Management should follow a continuum of care:
1. Basic techniques:
o Tell-Show-Do
o Positive reinforcement
o Voice control
2. Advanced techniques (if needed):
o Nitrous oxide sedation
o Oral conscious sedation
o General anesthesia (if extensive treatment)
The chosen method depends on:
Age
Emotional maturity
Medical status
Treatment complexity
Follow-Up
When is general anesthesia indicated?
👉 GA is indicated when:
Patient is unable to cooperate due to age or disability
AAPD
CASE 1: EARLY CHILDHOOD CARIES (ECC)
Question
A 3-year-old presents with severe caries on maxillary anterior teeth. The child uses a bottle at
night with milk. How do you manage this patient?
Complete Answer
This patient has Early Childhood Caries (ECC). Management includes:
1. Caries risk assessment – patient is high risk
2. Parent education:
o Discontinue nighttime bottle use
o Avoid sugary liquids in bottles
o Brush twice daily with fluoridated toothpaste
3. Preventive care:
o Fluoride varnish application
o Establish a dental home
4. Restorative treatment:
o Depending on severity: composite crowns, strip crowns, or extractions
5. Behavior management:
o Likely need advanced behavior guidance (sedation or GA)
6. Recall schedule:
o Every 3 months
Follow-Up
Why are maxillary incisors most affected?
👉 They erupt first and are exposed to pooling liquids while mandibular incisors are protected
by the tongue and saliva.
, Examiner Pearl
Use the term “ECC”, not “baby bottle caries” (AAPD preferred terminology).
CASE 2: BEHAVIOR MANAGEMENT
Question
A 4-year-old is extremely anxious and uncooperative for dental treatment. What behavior
guidance techniques would you consider?
Complete Answer
Management should follow a continuum of care:
1. Basic techniques:
o Tell-Show-Do
o Positive reinforcement
o Voice control
2. Advanced techniques (if needed):
o Nitrous oxide sedation
o Oral conscious sedation
o General anesthesia (if extensive treatment)
The chosen method depends on:
Age
Emotional maturity
Medical status
Treatment complexity
Follow-Up
When is general anesthesia indicated?
👉 GA is indicated when:
Patient is unable to cooperate due to age or disability
