ABDSM Final Exam – Dental Sleep Medicine 170
Practice Questions & Answers (2026) DETAILED
SOLUTIONS LATEST UPDATE THIS YEAR-JUST
RELEASED.pdf
1. A 48-year-old man with a BMI of 32 kg/m² has loud snoring, witnessed apneas, and
excessive daytime sleepiness. Home sleep testing shows an AHI of 22 events/hour with
predominantly obstructive events. According to AASM criteria, what is the severity of his
OSA?
Answer: Moderate OSA (AHI 15–29).
2. Which of the following best describes the primary pathophysiologic mechanism of
obstructive sleep apnea in most adult patients?
Answer: Repetitive collapse of the upper airway during sleep due to reduced
neuromuscular tone and anatomic narrowing.
3. A 55-year-old woman with OSA cannot tolerate CPAP due to claustrophobia and nasal
dryness. She has mild to moderate OSA and good dentition. Which therapy is most
,appropriate to offer next?
Answer: Custom, titratable mandibular advancement device (oral appliance therapy).
4. Which of the following patient characteristics is most predictive of successful treatment
with a mandibular advancement device for OSA?
Answer: Mild to moderate OSA, supine-predominant OSA, good dentition, and
retrognathic jaw relationship.
5. A dentist is evaluating a patient for oral appliance therapy. Which of the following is an
absolute contraindication to using a mandibular advancement device?
Answer: Severe, untreated periodontal disease with mobile teeth that cannot support
an appliance.
6. Which of the following best describes the recommended follow-up sleep testing after
initiating oral appliance therapy for OSA?
Answer: Objective sleep testing (home or in-lab) to assess efficacy after titration and
again periodically per guidelines.
7. A 60-year-old man with OSA and hypertension is using a mandibular advancement
device. He reports jaw pain and morning bite changes that resolve by noon. What is the
most appropriate initial management?
,Answer: Reduce advancement slightly, assess fit, and consider a morning repositioning
device; monitor symptoms.
8. Which of the following best describes the difference between a fixed and a titratable
mandibular advancement device?
Answer: A titratable device allows adjustable mandibular advancement in small
increments; a fixed device is set at one position.
9. A patient with OSA has an AHI of 35, severe oxygen desaturations, and significant
comorbidities (heart failure, atrial fibrillation). According to guidelines, which is the first-line
therapy?
Answer: Positive airway pressure (PAP) therapy.
10. Which of the following best describes the primary outcome measure used to define
treatment success for OSA with oral appliance therapy in many studies?
Answer: Reduction of AHI to <10 events/hour and/or ≥50% reduction from baseline
with symptom improvement.
11. A 50-year-old man with OSA is being titrated on a mandibular advancement device.
Which of the following is the most appropriate method to determine optimal advancement?
, Answer: Incremental advancement based on symptom resolution and objective sleep
testing results.
12. Which of the following best describes the role of the dentist in the multidisciplinary
management of OSA?
Answer: Screening, diagnosis support (in collaboration), providing oral appliance
therapy, and coordinating follow-up with the sleep physician.
13. A patient with OSA reports persistent daytime sleepiness despite using a mandibular
advancement device and an AHI of 8 on follow-up testing. What is the most appropriate
next step?
Answer: Evaluate for other causes of sleepiness (e.g., insufficient sleep, medications,
other sleep disorders) and consider PAP or combination therapy.
14. Which of the following best describes the recommended position of the mandible
relative to centric relation when initially fitting a mandibular advancement device?
Answer: Typically 50–70% of the patient’s maximum comfortable protrusive range.
15. A 45-year-old woman with OSA and bruxism is being considered for oral appliance
therapy. Which of the following is most important to address in treatment planning?
Practice Questions & Answers (2026) DETAILED
SOLUTIONS LATEST UPDATE THIS YEAR-JUST
RELEASED.pdf
1. A 48-year-old man with a BMI of 32 kg/m² has loud snoring, witnessed apneas, and
excessive daytime sleepiness. Home sleep testing shows an AHI of 22 events/hour with
predominantly obstructive events. According to AASM criteria, what is the severity of his
OSA?
Answer: Moderate OSA (AHI 15–29).
2. Which of the following best describes the primary pathophysiologic mechanism of
obstructive sleep apnea in most adult patients?
Answer: Repetitive collapse of the upper airway during sleep due to reduced
neuromuscular tone and anatomic narrowing.
3. A 55-year-old woman with OSA cannot tolerate CPAP due to claustrophobia and nasal
dryness. She has mild to moderate OSA and good dentition. Which therapy is most
,appropriate to offer next?
Answer: Custom, titratable mandibular advancement device (oral appliance therapy).
4. Which of the following patient characteristics is most predictive of successful treatment
with a mandibular advancement device for OSA?
Answer: Mild to moderate OSA, supine-predominant OSA, good dentition, and
retrognathic jaw relationship.
5. A dentist is evaluating a patient for oral appliance therapy. Which of the following is an
absolute contraindication to using a mandibular advancement device?
Answer: Severe, untreated periodontal disease with mobile teeth that cannot support
an appliance.
6. Which of the following best describes the recommended follow-up sleep testing after
initiating oral appliance therapy for OSA?
Answer: Objective sleep testing (home or in-lab) to assess efficacy after titration and
again periodically per guidelines.
7. A 60-year-old man with OSA and hypertension is using a mandibular advancement
device. He reports jaw pain and morning bite changes that resolve by noon. What is the
most appropriate initial management?
,Answer: Reduce advancement slightly, assess fit, and consider a morning repositioning
device; monitor symptoms.
8. Which of the following best describes the difference between a fixed and a titratable
mandibular advancement device?
Answer: A titratable device allows adjustable mandibular advancement in small
increments; a fixed device is set at one position.
9. A patient with OSA has an AHI of 35, severe oxygen desaturations, and significant
comorbidities (heart failure, atrial fibrillation). According to guidelines, which is the first-line
therapy?
Answer: Positive airway pressure (PAP) therapy.
10. Which of the following best describes the primary outcome measure used to define
treatment success for OSA with oral appliance therapy in many studies?
Answer: Reduction of AHI to <10 events/hour and/or ≥50% reduction from baseline
with symptom improvement.
11. A 50-year-old man with OSA is being titrated on a mandibular advancement device.
Which of the following is the most appropriate method to determine optimal advancement?
, Answer: Incremental advancement based on symptom resolution and objective sleep
testing results.
12. Which of the following best describes the role of the dentist in the multidisciplinary
management of OSA?
Answer: Screening, diagnosis support (in collaboration), providing oral appliance
therapy, and coordinating follow-up with the sleep physician.
13. A patient with OSA reports persistent daytime sleepiness despite using a mandibular
advancement device and an AHI of 8 on follow-up testing. What is the most appropriate
next step?
Answer: Evaluate for other causes of sleepiness (e.g., insufficient sleep, medications,
other sleep disorders) and consider PAP or combination therapy.
14. Which of the following best describes the recommended position of the mandible
relative to centric relation when initially fitting a mandibular advancement device?
Answer: Typically 50–70% of the patient’s maximum comfortable protrusive range.
15. A 45-year-old woman with OSA and bruxism is being considered for oral appliance
therapy. Which of the following is most important to address in treatment planning?
