WREB Dental Examination Practice
Exam 2026 | 100 Advanced Questions &
Answers with Detailed Rationales |
WREB Dental Licensing Exam Prep &
Study Guide
1. A patient presents with a deep carious lesion on the mandibular first molar.
The tooth is asymptomatic, responds normally to cold testing, and there is
no percussion sensitivity. Radiographically, the lesion approaches the pulp
but there is no periapical pathology. Which treatment is most appropriate if
the pulp remains protected by a thin layer of dentin?
A. Immediate pulpectomy
B. Extraction
C. Indirect pulp treatment with a definitive restoration
D. Surgical endodontic treatment
Answer: Indirect pulp treatment with a definitive restoration
Rationale: When a deep carious lesion is close to the pulp but the tooth has a
normal pulpal response and no signs of apical disease, selective caries
,removal/indirect pulp treatment can preserve vitality while minimizing
unnecessary pulp exposure.
2. During preparation for a mandibular posterior composite, the clinician
notices that the gingival margin extends subgingivally and is contaminated
repeatedly by crevicular fluid. Which factor most directly threatens the
restoration's prognosis?
A. Occlusal anatomy
B. Polymerization shrinkage alone
C. Inability to achieve reliable isolation and adhesive bonding
D. Excessive enamel etching
Answer: Inability to achieve reliable isolation and adhesive bonding
Rationale: Moisture contamination compromises resin adhesion, particularly at
a deep gingival margin. Rubber dam isolation, appropriate matrix adaptation,
and control of the operative field are essential for predictable bonding.
3. A patient has generalized probing depths of 5–6 mm, bleeding on probing,
clinical attachment loss, and radiographic horizontal bone loss. Which
diagnosis best describes this condition?
A. Gingivitis
B. Periodontitis
C. Periapical periodontitis
D. Occlusal trauma without periodontal disease
Answer: Periodontitis
Rationale: Clinical attachment loss accompanied by periodontal pocketing and
radiographic alveolar bone loss establishes periodontitis rather than plaque-
induced gingivitis.
4. A maxillary central incisor has a nonresponsive pulp, a periapical
radiolucency, and tenderness to percussion. Which diagnosis is most
appropriate?
,A. Symptomatic irreversible pulpitis
B. Pulpal necrosis with symptomatic apical periodontitis
C. Reversible pulpitis with normal apical tissues
D. Normal pulp with chronic apical abscess
Answer: Pulpal necrosis with symptomatic apical periodontitis
Rationale: A nonresponsive pulp indicates necrosis, while percussion sensitivity
indicates symptomatic inflammation of the apical periodontal tissues.
5. A patient taking warfarin requires an uncomplicated extraction. What is the
most appropriate general approach?
A. Automatically discontinue warfarin for one week
B. Proceed without reviewing anticoagulation status
C. Assess anticoagulation status and use appropriate local hemostatic measures
D. Substitute aspirin immediately before extraction
Answer: Assess anticoagulation status and use appropriate local hemostatic
measures
Rationale: Routine dental procedures can often be performed without
interruption of anticoagulation, but the patient's current anticoagulation status
and medical risk must be assessed. Local measures such as pressure, suturing,
and hemostatic agents are important.
6. Which local anesthetic characteristic generally increases duration of pulpal
anesthesia?
A. Lower lipid solubility
B. Greater protein binding
C. Lower tissue penetration
D. Faster systemic absorption
Answer: Greater protein binding
, Rationale: Protein binding is associated with longer duration of action because
the anesthetic remains associated with neural membrane proteins for a longer
period.
7. A patient develops facial swelling, fever, malaise, and trismus associated
with a mandibular molar infection. What is the most important initial
concern?
A. Tooth discoloration
B. Potential spread of infection into fascial spaces and airway compromise
C. Development of fluorosis
D. Chronic gingivitis
Answer: Potential spread of infection into fascial spaces and airway compromise
Rationale: Systemic symptoms, progressive swelling, and trismus may indicate a
spreading odontogenic infection. Airway assessment and urgent management
take priority over definitive restorative treatment.
8. Which radiographic finding is most characteristic of a dentigerous cyst?
A. Radiolucency attached at the cemento-enamel junction of an unerupted tooth
B. Diffuse mixed radiopacity around multiple teeth
C. Radiopaque mass fused to a tooth root
D. Generalized loss of lamina dura
Answer: Radiolucency attached at the cemento-enamel junction of an
unerupted tooth
Rationale: A dentigerous cyst characteristically surrounds the crown of an
unerupted tooth and attaches near the cemento-enamel junction.
9. A patient has severe spontaneous lingering pain after exposure to cold. The
pain persists for several minutes after the stimulus is removed. Which
pulpal diagnosis is most likely?
A. Normal pulp
B. Reversible pulpitis
Exam 2026 | 100 Advanced Questions &
Answers with Detailed Rationales |
WREB Dental Licensing Exam Prep &
Study Guide
1. A patient presents with a deep carious lesion on the mandibular first molar.
The tooth is asymptomatic, responds normally to cold testing, and there is
no percussion sensitivity. Radiographically, the lesion approaches the pulp
but there is no periapical pathology. Which treatment is most appropriate if
the pulp remains protected by a thin layer of dentin?
A. Immediate pulpectomy
B. Extraction
C. Indirect pulp treatment with a definitive restoration
D. Surgical endodontic treatment
Answer: Indirect pulp treatment with a definitive restoration
Rationale: When a deep carious lesion is close to the pulp but the tooth has a
normal pulpal response and no signs of apical disease, selective caries
,removal/indirect pulp treatment can preserve vitality while minimizing
unnecessary pulp exposure.
2. During preparation for a mandibular posterior composite, the clinician
notices that the gingival margin extends subgingivally and is contaminated
repeatedly by crevicular fluid. Which factor most directly threatens the
restoration's prognosis?
A. Occlusal anatomy
B. Polymerization shrinkage alone
C. Inability to achieve reliable isolation and adhesive bonding
D. Excessive enamel etching
Answer: Inability to achieve reliable isolation and adhesive bonding
Rationale: Moisture contamination compromises resin adhesion, particularly at
a deep gingival margin. Rubber dam isolation, appropriate matrix adaptation,
and control of the operative field are essential for predictable bonding.
3. A patient has generalized probing depths of 5–6 mm, bleeding on probing,
clinical attachment loss, and radiographic horizontal bone loss. Which
diagnosis best describes this condition?
A. Gingivitis
B. Periodontitis
C. Periapical periodontitis
D. Occlusal trauma without periodontal disease
Answer: Periodontitis
Rationale: Clinical attachment loss accompanied by periodontal pocketing and
radiographic alveolar bone loss establishes periodontitis rather than plaque-
induced gingivitis.
4. A maxillary central incisor has a nonresponsive pulp, a periapical
radiolucency, and tenderness to percussion. Which diagnosis is most
appropriate?
,A. Symptomatic irreversible pulpitis
B. Pulpal necrosis with symptomatic apical periodontitis
C. Reversible pulpitis with normal apical tissues
D. Normal pulp with chronic apical abscess
Answer: Pulpal necrosis with symptomatic apical periodontitis
Rationale: A nonresponsive pulp indicates necrosis, while percussion sensitivity
indicates symptomatic inflammation of the apical periodontal tissues.
5. A patient taking warfarin requires an uncomplicated extraction. What is the
most appropriate general approach?
A. Automatically discontinue warfarin for one week
B. Proceed without reviewing anticoagulation status
C. Assess anticoagulation status and use appropriate local hemostatic measures
D. Substitute aspirin immediately before extraction
Answer: Assess anticoagulation status and use appropriate local hemostatic
measures
Rationale: Routine dental procedures can often be performed without
interruption of anticoagulation, but the patient's current anticoagulation status
and medical risk must be assessed. Local measures such as pressure, suturing,
and hemostatic agents are important.
6. Which local anesthetic characteristic generally increases duration of pulpal
anesthesia?
A. Lower lipid solubility
B. Greater protein binding
C. Lower tissue penetration
D. Faster systemic absorption
Answer: Greater protein binding
, Rationale: Protein binding is associated with longer duration of action because
the anesthetic remains associated with neural membrane proteins for a longer
period.
7. A patient develops facial swelling, fever, malaise, and trismus associated
with a mandibular molar infection. What is the most important initial
concern?
A. Tooth discoloration
B. Potential spread of infection into fascial spaces and airway compromise
C. Development of fluorosis
D. Chronic gingivitis
Answer: Potential spread of infection into fascial spaces and airway compromise
Rationale: Systemic symptoms, progressive swelling, and trismus may indicate a
spreading odontogenic infection. Airway assessment and urgent management
take priority over definitive restorative treatment.
8. Which radiographic finding is most characteristic of a dentigerous cyst?
A. Radiolucency attached at the cemento-enamel junction of an unerupted tooth
B. Diffuse mixed radiopacity around multiple teeth
C. Radiopaque mass fused to a tooth root
D. Generalized loss of lamina dura
Answer: Radiolucency attached at the cemento-enamel junction of an
unerupted tooth
Rationale: A dentigerous cyst characteristically surrounds the crown of an
unerupted tooth and attaches near the cemento-enamel junction.
9. A patient has severe spontaneous lingering pain after exposure to cold. The
pain persists for several minutes after the stimulus is removed. Which
pulpal diagnosis is most likely?
A. Normal pulp
B. Reversible pulpitis
