GENERAL AND ORAL PATHOLOGY FOR
DENTAL HYGIENE PRACTICE
AUTHOR(S)MYERS, SANDRA; CURRAN,
ALICE
TEST BANK
Reference — Ch. 1 — Differential Diagnosis
Question Stem
A 58-year-old smoker presents with a solitary, non-painful white
patch on the lateral tongue present for 6 weeks that does not
rub off. Which next step is the most appropriate to distinguish a
benign hyperkeratosis from early squamous cell carcinoma?
Options
A. Prescribe a 2-week antifungal rinse and reassess
B. Perform toluidine blue staining and observe if it lightens over
time
C. Obtain an incisional (or excisional) biopsy for histopathologic
examination
D. Document as a variant of normal and reevaluate in 6 months
,Correct Answer
C
Rationales
Correct: Biopsy provides definitive histopathologic diagnosis
and is the standard to rule out dysplasia or carcinoma when a
persistent white lesion cannot be clinically explained.
A: Antifungal therapy is appropriate only if candidiasis is
suspected; a lesion that does not wipe off and persists in a
smoker requires tissue diagnosis.
B: Toluidine blue can highlight dysplastic areas but is an
adjunctive test with false positives/negatives and cannot
replace biopsy.
D: Labeling as a variant of normal without tissue diagnosis risks
delayed cancer detection.
Teaching Point
Persistent, unexplained white lesions require biopsy to exclude
dysplasia or carcinoma.
Citation
Myers, S., & Curran, A. (2023). General and Oral Pathology for
Dental Hygiene Practice (3rd Ed.). Ch. 1.
2.
Reference — Ch. 1 — Patient Assessment and History
Question Stem
During medical history review, a patient reports long-term use
,of an anticholinergic medication and now has extensive dry
mouth and burning tongue. Which management action best
addresses this patient’s oral pathology risk?
Options
A. Recommend postponing dental care until medication is
stopped
B. Provide fluoride therapy, saliva substitutes, and discuss
antimicrobial surveillance
C. Prescribe topical corticosteroids for immediate relief
D. Advise routine toothbrushing only and recheck in one year
Correct Answer
B
Rationales
Correct: Anticholinergic-induced xerostomia increases caries
and candidiasis risk; fluoride, saliva substitutes, and microbial
monitoring are evidence-based preventive measures.
A: Stopping systemic medication is a medical decision and often
not feasible; dental management should proceed.
C: Topical steroids treat inflammatory mucosal disease, not
xerostomia or its sequelae.
D: Routine brushing alone is insufficient to mitigate the elevated
caries and infection risk from chronic dry mouth.
Teaching Point
Xerostomia requires active prevention: fluoride, salivary aids,
and monitoring for candidiasis/caries.
, Citation
Myers, S., & Curran, A. (2023). General and Oral Pathology for
Dental Hygiene Practice (3rd Ed.). Ch. 1.
3.
Reference — Ch. 1 — Head, Neck, and Intraoral Neck
Examinations
Question Stem
On extraoral exam, a 45-year-old patient has a firm, nonmobile
submandibular node palpable for 2 months with no drainage or
acute infection signs. Which interpretation best guides next
steps?
Options
A. Reactive node from a minor oral infection — reassure and
observe for 6 months
B. Likely malignant or metastatic node — expedited referral for
imaging and biopsy
C. Benign lipoma — no further action required
D. Salivary gland obstruction — irrigate and schedule routine
follow-up
Correct Answer
B
Rationales
Correct: A firm, nonmobile lymph node persisting beyond
several weeks without infection raises concern for
DENTAL HYGIENE PRACTICE
AUTHOR(S)MYERS, SANDRA; CURRAN,
ALICE
TEST BANK
Reference — Ch. 1 — Differential Diagnosis
Question Stem
A 58-year-old smoker presents with a solitary, non-painful white
patch on the lateral tongue present for 6 weeks that does not
rub off. Which next step is the most appropriate to distinguish a
benign hyperkeratosis from early squamous cell carcinoma?
Options
A. Prescribe a 2-week antifungal rinse and reassess
B. Perform toluidine blue staining and observe if it lightens over
time
C. Obtain an incisional (or excisional) biopsy for histopathologic
examination
D. Document as a variant of normal and reevaluate in 6 months
,Correct Answer
C
Rationales
Correct: Biopsy provides definitive histopathologic diagnosis
and is the standard to rule out dysplasia or carcinoma when a
persistent white lesion cannot be clinically explained.
A: Antifungal therapy is appropriate only if candidiasis is
suspected; a lesion that does not wipe off and persists in a
smoker requires tissue diagnosis.
B: Toluidine blue can highlight dysplastic areas but is an
adjunctive test with false positives/negatives and cannot
replace biopsy.
D: Labeling as a variant of normal without tissue diagnosis risks
delayed cancer detection.
Teaching Point
Persistent, unexplained white lesions require biopsy to exclude
dysplasia or carcinoma.
Citation
Myers, S., & Curran, A. (2023). General and Oral Pathology for
Dental Hygiene Practice (3rd Ed.). Ch. 1.
2.
Reference — Ch. 1 — Patient Assessment and History
Question Stem
During medical history review, a patient reports long-term use
,of an anticholinergic medication and now has extensive dry
mouth and burning tongue. Which management action best
addresses this patient’s oral pathology risk?
Options
A. Recommend postponing dental care until medication is
stopped
B. Provide fluoride therapy, saliva substitutes, and discuss
antimicrobial surveillance
C. Prescribe topical corticosteroids for immediate relief
D. Advise routine toothbrushing only and recheck in one year
Correct Answer
B
Rationales
Correct: Anticholinergic-induced xerostomia increases caries
and candidiasis risk; fluoride, saliva substitutes, and microbial
monitoring are evidence-based preventive measures.
A: Stopping systemic medication is a medical decision and often
not feasible; dental management should proceed.
C: Topical steroids treat inflammatory mucosal disease, not
xerostomia or its sequelae.
D: Routine brushing alone is insufficient to mitigate the elevated
caries and infection risk from chronic dry mouth.
Teaching Point
Xerostomia requires active prevention: fluoride, salivary aids,
and monitoring for candidiasis/caries.
, Citation
Myers, S., & Curran, A. (2023). General and Oral Pathology for
Dental Hygiene Practice (3rd Ed.). Ch. 1.
3.
Reference — Ch. 1 — Head, Neck, and Intraoral Neck
Examinations
Question Stem
On extraoral exam, a 45-year-old patient has a firm, nonmobile
submandibular node palpable for 2 months with no drainage or
acute infection signs. Which interpretation best guides next
steps?
Options
A. Reactive node from a minor oral infection — reassure and
observe for 6 months
B. Likely malignant or metastatic node — expedited referral for
imaging and biopsy
C. Benign lipoma — no further action required
D. Salivary gland obstruction — irrigate and schedule routine
follow-up
Correct Answer
B
Rationales
Correct: A firm, nonmobile lymph node persisting beyond
several weeks without infection raises concern for
