2025/2026
Which of the following dental procedures does NOT requires antibiotic prophylaxis for individuals
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at high risk of bacterial endocarditis?
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Il` Routine fillings Il`
Il` Post-operative suture removal Il` Il`
Il` Dental cleaning Il`
Il` Fluoride treatments Il`
Il` Orthodontic appliance adjustment - Answer Fluoride treatments Il` Il` Il` Il` Il` Il`
Il` Which clinical finding distinguishes periodontitis from gingivitis?
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Il` Inflammation of the gums Il` Il` Il`
Il` White discoloration of the permanent teeth
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Il` Enlarged pockets at the gum base Il` Il` Il` Il` Il`
Il` Gingival hypertrophy - Answer Enlarged pockets at the gum base
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Il` Which of the following is the least common site for the development of oral cancer?
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Il` The tongue
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Il` Floor of mouth Il` Il`
Il` Hard palate Il`
Il` Lower lip - Answer Hard palate
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,Il` Which of the following factors reduces the risk for caries in adults?
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Il` Low socioeconomic status
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Il` Existing tooth restoration
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Il` A vegetarian diet
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Il` Decreased salivary flow Il` Il`
Il` Low sugar diet - Answer Low sugar diet
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Il` Which of the following patients require bacterial endocarditis antibiotic prophylaxis?
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A 26-year-old woman with mitral valve prolapse undergoing routine teeth cleaning with no
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anticipated bleeding.
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Il` A 64-year-old man with a prosthetic mitral valve who is undergoing a tooth extraction.
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A 16-year-old boy with a ventricular septal defect completely repaired in infancy who requires
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extraction of an impacted wisdom tooth.
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A 32-year-old man who had bacterial endocarditis 5 years ago who is undergoing orthodontic
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appliance adjustment. - Answer A 64-year-old man with a prosthetic mitral valve who is
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undergoing a tooth extraction.
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Il` Which of the following is an abnormal tooth change not explained by aging alone?
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Il` Gingival recession Il`
Il` Root caries Il`
Il` Yellowing of teeth Il` Il`
Il` Wearing away of teeth with exposed dentin - Answer Root caries
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,Il` Which of the following statements concerning xerostomia, or dry mouth, is NOT true?
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Il` Xerostomia is caused by a decrease in the production of saliva. Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`
Il` Xerostomia can cause a burning sensation, change in taste, and difficulty swallowing.
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Il` Medications can contribute to the development of xerostomia. Il` Il` Il` Il` Il` Il` Il`
Il` Xerostomia increases risk for the development of caries. Il` Il` Il` Il` Il` Il` Il`
Xerostomia is rarely a problem for patients wearing complete dentures. - Answer Xerostomia is
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rarely a problem for patients wearing complete dentures.
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Il` Which of the following has been implicated in the development of recurrent aphthous ulcers?
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Il` Trauma
Il` Vitamin C deficiency Il` Il`
Il` Sickle Cell Anemia Il` Il`
Il` Herpes simplex virus infection - Answer Trauma
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Mrs. Pederson is a 74 year old who presents for a routine blood pressure follow up visit. Her blood
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pressure is well controlled, but on review of systems she reports dry mouth of several years
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duration that has acutely worsened over the past 2 months. She quit smoking after she developed
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thyroid cancer that required surgery and neck radiation for cure. She has been drinking more
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water than usual, but it only improves her symptoms for a few minutes. She drinks wine with
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dinner and sometimes before bed for insomnia.
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All of the following are likely contributing to Mrs. Pederson's xerostomia (the sensation of dry
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mouth) except:
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Il` The aging process
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Il` Antihypertensive medications Il`
Il` Alcohol use Il`
, Il` Head and neck radiation Il` Il` Il`
Il` Sedative medications - Answer The aging process Il` Il` Il` Il` Il` Il`
Mrs. Pederson's active medical problems include Hypertension, Type 2 Diabetes Mellitus, and
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Glaucoma. Her past history is remarkable for treated thyroid cancer, seasonal allergies, and
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intermittent insomnia. She smoked when she was younger, but quit 30 years ago. She is widowed
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and a retired administrative assistant. She enjoys a glass of wine about five times a week with
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dinner and walks daily for exercise.
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Her medications include:
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- lisinopril/HCTZ 10/25 mg orally once daily
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- metformin 1000 mg orally twice daily
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- aspirin 81 mg orally once daily
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- zolpidem 10 mg orally at bedtime approximately twice per week
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- diphenhydramine 25 mg orally as needed for allergy symptoms in the spring and fall
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- latanoprost ophthalmic drops daily (topical prostaglandin analog for closed angle glaucoma
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treatment)
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Based on the information provided above, which of the following scenarios would most likely
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contribute to Mrs. Pederson's - Answer 2. She has been taking zolpidem nightly for worsening
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insomnia following the recent death of her favorite cousin.
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Mrs. Pederson reduces her alcohol intake and stops taking diphenhydramine and zolpidem. She
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understands the need for her antihypertensive and diabetic medications and will continue to take
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those as directed. After these changes her dry mouth improves to some degree, but is still
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symptomatic. She inquires what else she can do to improve her symptoms.
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Which of the following interventions would be contraindicated for Mrs. Pederson?
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Il` Use of an over-the-counter saliva substitute
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Il` Sucking sugarless candy during the day to promote saliva production
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Il` Starting cevimeline in an effort to increase saliva production
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