Clinical Dental Procedures
Final Test Solutions
Course Introduction
Clinical Dental Procedures is a course designed to provide students with hands-on experience and theoretical knowledge essential for performing fundamental dental treatments in a clinical setting. The curriculum covers patient assessment, infection control protocols, local anesthesia administration, restorative procedures, dental radiography, and minor oral surgery techniques. Emphasis is placed on developing clinical skills, professional communication, ethical practice, and adherence to safety standards. By integrating lectures with practical sessions, this course prepares students to manage diverse patient cases effectively and fosters competence and confidence for future dental practice.
Recommended Textbook
Essentials of Dental Radiography for Dental Assistants and Hygienists 10th Edition by Evelyn Thomson
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30 Chapters
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Chapter 1: Dental Radiography: Historical Perspective and Future Trends
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Sample Questions
Q1) Dental x-ray film available today is coated with emulsion on both sides.
A)True
B)False
Answer: True
Q2) What is the technique of choice for intraoral radiography?
Answer: The paralleling technique is the technique of choice because it is less complicated and more consistently produces better radiographs than the bisecting technique
Q3) William Herbert Rollins was awarded the first Nobel Prize for physics.
A)True
B)False
Answer: False
Q4) What is the purpose of studying the history of radiography and dental radiography?
Answer: Through familiarity with the evolution of concepts and theories, investigators gain knowledge about current practices and appreciate future advancements. Radiography plays an important role in the diagnostic process in the modern oral health care practice
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Chapter 2: Characteristics and Measurement of Radiation
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Q1) What is the speed of a wave called?
Answer: Velocity. "Velocity" is the term for the speed of a wave of electromagnetic energy.
Q2) What is the term for bundles of energy that travel through space at the speed of light?
Answer: Photons. The particle (or quantum) theory assumes that electromagnetic radiations are particles or quanta
Q3) People living on the Colorado plateau receive a higher dose of what type of radiation than people living in Philadelphia?
Answer: back ground
Q4) Each of the following is a form of ionizing radiation EXCEPT one. Which one is the EXCEPTION?
A) Cosmic rays
B) X-rays
C) Radio waves
D) Gamma rays
Answer: C
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Chapter 3: The Dental X-Ray Machine: Components and Function
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Q1) If the tube head is properly sealed, the port is the only place through which x-rays can escape.
A)True
B)False
Answer: True
Q2) A small area on the tungsten target of the anode toward which the electron beam is directed is called the "focal spot."
A)True
B)False
Answer: True
Q3) What is the term for the process by which electrons are created at the filament wire of the cathode?
Answer: Thermionic emission occurs when a wire is heated to incandescence
Q4) In the cathode, the wire filament is recessed into what?
Answer: A focusing cup made of molybdenum, the purpose of which is to direct the electrons toward the target on the anode
Q5) What does kVp measure?
Answer: The speed of the electrons, and therefore the penetrating ability of the x-ray beam.
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Chapter 4: Factors Affecting Radiographic Quality
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Q1) What is radiographic density?
Q2) What is radiographic contrast?
Q3) What is long-scale contrast?
Q4) What types of tissues or structures appear radiolucent on radiographs?
Q5) Which of the following statements about dental radiographic exposure variables is true?
A) Increasing the mA darkens the radiograph.
B) Decreasing exposure time darkens the radiograph.
C) Exposure time is difficult to change on most machines.
D) Milliamperage affects radiographic contrast.
Q6) The target-image receptor distance should be short to create radiographs with the best definition.
A)True
B)False
Q7) Penumbra is a device used in extraoral radiography to prevent scatter radiation from fogging the image receptor.
A)True
B)False
Page 6
Q8) What types of tissues or structures appear radiopaque on radiographs?
Q9) What is short-scale contrast?
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Page 7
Chapter 5: Effects of Radiation Exposure
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Q1) Cancer is a stochastic effect of exposure to radiation.
A)True
B)False
Q2) Which of the following statements regarding the theory established by a threshold dose-response curve is true?
A) There is a dose below which no biological response would be expected.
B) It predicts the effects of very low levels of radiation exposure.
C) It indicates that any amount of radiation has the potential to cause a biological response.
D) It has been adopted by the radiation protection community as the conservative approach to radiation exposure.
Q3) Continued exposure to radiation over prolonged periods may result in each of the following EXCEPT one. Which one is the EXCEPTION?
A) It may alter the ability of genetic cells to reproduce normally.
B) It may affect the ability of genetic cells to repair damage.
C) It may produce offspring with increased resistance to radiation exposure.
D) It may result in cumulative chromosome damage.
Q4) When is the developing fetus most susceptible to the damaging effects of radiation, and why?
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Chapter 6: Radiation Protection
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Q1) Based on evidence-based selection criteria for keeping radiation exposure ALARA, an adult recall patient with no risk factors for caries would most likely be assessed for bitewing radiographs annually.
A)True
B)False
Q2) Regulations governing the use of radiation-producing equipment include federal, state, and some local laws.
A)True
B)False
Q3) High-energy x-rays are the most harmful to the patient because they easily penetrate to the deep tissues of the body.
A)True
B)False
Q4) The National Committee on Radiation Protection principle to keep exposure down, based on the idea that all radiation, no matter how small the dose, may cause adverse biological effects, is called "ALARA."
A)True
B)False
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Chapter 7: Dental X-Ray Film and Processing Methods
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Q1) The tab for opening the film packet is on the tube side of the packet.
A)True
B)False
Q2) For what is the embossed dot in one corner of intraoral dental x-ray film used?
Q3) Which film size is ideal for positioning a periapical radiograph in the narrow canine region on an adult patient?
A) Size #0
B) Size #1
C) Size #2
D) Size #3
Q4) The sensitivity of a given type of dental x-ray film is known as its what?
Q5) During periapical radiograph film packet placement, the embossed dot should be positioned toward the apices of the teeth.
A)True
B)False
Q6) Which of these intraoral dental films is 2.25 inches × 3 inches?
A) Size #1
B) Size #2
C) Size #3
D) Size #4
Page 10
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Chapter 8: Digital Radiography and Image Acquisition
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Q1) Which of the following statements regarding automatic processing is correct?
A) No water is required.
B) Processing is accomplished under normal white-light conditions.
C) The chemistry in automatic processors is heated to 68 degrees F.
D) Unwrapped film is fed into the film feed slot on the outside of the processor.
Q2) With what should powdered and liquid concentrate forms of processing solutions be mixed?
Q3) Which processing solution prevents further film development?
Q4) Which of these is NOT part of the developer solution?
A) Reducing agent
B) Clearing agent
C) Activator
D) Restrainer
Q5) Reduction is the union of developer and oxygen.
A)True
B)False
Q6) Processing chemistry can be used indefinitely.
A)True
B)False
11
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Chapter 9: Infection Control
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Q1) How much less radiation exposure is a digital radiograph purported to be over a fast speed film-based radiograph?
A) 0 to 20 percent
B) 0 to 30 percent
C) 0 to 50 percent
D) 0 to 80 percent
Q2) Are digital radiography systems limited to intraoral images?
Q3) What determines the quality of a digital image?
A) Gray scale
B) Spatial resolution
C) Combination of pixels
D) All of the above
Q4) Which of the following features of digital imaging software currently available provides the best aid to interpreting digital images?
A) Density/contrast manipulation
B) Colorization
C) Embossing
D) Reversing the gray scale
Q5) What are the advantages of digital radiography?
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Chapter 10: Legal and Ethical Responsibilities
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Q1) Each of the following statements regarding the use of daylight loader attachments on automatic processors is correct EXCEPT one. Which one is the EXCEPTION?
A) The operator must remove the light-filter cover when placing and removing items.
B) The advantage of these devices is that time-saving shortcuts are acceptable.
C) Clean, dry hands can be slid through light-tight baffles to access the unit.
D) The key to infection control is to never slide anything through the baffles except clean, dry hands.
Q2) Which of the following statements regarding the use of gloves is FALSE?
A) Sterile gloves should be used for surgical procedures.
B) Use of plastic overgloves is acceptable to protect patient treatment gloves.
C) Punctured, torn, or cut gloves should be changed immediately.
D) Gloves should be washed with soap if treatment must be interrupted.
Q3) Noncritical objects are those that do not come into contact with mucous membranes.
A)True
B)False
Q4) What is an antiseptic?
Q5) What is the definition of "disinfect"?
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Chapter 11: Patient Relations and Education
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Q1) Policies and procedures used to reduce the chances a patient will file legal action against the oral health care team is known as:
A) code of ethics.
B) risk management.
C) standards protocol.
D) radiation health and safety.
Q2) The legal right of the patient to refuse radiographs is a form of:
A) the statute of limitations.
B) liability.
C) self-determination.
D) disclosure.
Q3) Good patient relations can reduce the risk of possible legal action.
A)True
B)False
Q4) As prudent risk management, radiographs should be retained as part of a client's record for 7 years.
A)True
B)False
Q5) Who owns a patient's dental radiographs?
Q6) When does the statute of limitations begin to run for children?
Page 14
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Chapter 12: Introduction to Radiographic Examinations
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Q1) Which of these statements is FALSE?
A) The radiographer must remain in the room during the exposure to be sure the patient does not move.
B) A lead/lead-equivalent apron and thyroid collar can be used to protect the patient from stray radiation.
C) Scientists know that exposure to large doses of radiation is more likely to cause biological harm.
D) The risk of harmful effects from dental x-ray exams is extremely small.
Q2) The best answer to the patient question, "Why do I need x-rays?" is because the dentist requested them.
A)True
B)False
Q3) Each of the following is a precaution that minimizes the amount of radiation a patient receives EXCEPT one. Which one is the EXCEPTION?
A) Take only necessary radiographs.
B) Use the slowest film speed currently available.
C) Use collimating equipment that restricts the beam size and shape.
D) Cover all patients with a lead/lead-equivalent apron and thyroid shield.
Q4) Are large amounts of radiation harmful?
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Chapter 13: The Periapical Examinationparalleling Technique
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Q1) Which of these statements is FALSE?
A) Negative angulation directs the central ray upward toward the ceiling.
B) Accurate vertical angulation is more important to the paralleling than the bisecting technique.
C) 0 vertical angulation directs the PID parallel to the floor.
D) Vertical angulation refers to directing the PID up and down.
Q2) Why is it important to not position the embossed dot on the film near the apices of the teeth?
Q3) What will assist the radiographer with directing the x-ray beam at the correct angle?
Q4) The correct horizontal and vertical angulations are critical to producing quality periapical radiographs.
A)True
B)False
Q5) The word "periapical" is derived from the Greek word peri (meaning around) and the Latin word apex (meaning highest point).
A)True
B)False
Q6) Have film holders always been used in dental radiography?
Page 16
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Chapter 14: The Periapical Examinationbisecting Technique
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Q1) Comparing the paralleling technique with the bisecting technique, which of the following statements is correct?
A) The paralleling technique is easy to achieve on all patients.
B) Proficiency should be achieved in both techniques.
C) The bisecting technique is more likely to be uncomfortable for the patient.
D) Once the full mouth series procedure is started, the radiographer must continue with the bisecting or the paralleling technique and not mix the two.
Q2) What is the most likely reason that overlapping occurs even if the image receptor is correctly positioned parallel to the teeth of interest and the central ray is accurately directed through the appropriate embrasure?
Q3) Which of the following is NOT a disadvantage of the paralleling technique?
A) The best images are obtained with the more difficult to position long 16-inch PID.
B) Image receptor positioning is difficult for patients with small mouths.
C) There is a limited number of image receptor holders that accommodate the paralleling technique.
D) It is more likely to excite an exaggerated gag reflex to achieve parallel position in the posterior region.
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17
Chapter 15: The Bitewing Examination
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Q1) The recommended vertical angulation for exposing a maxillary premolar periapical radiograph using the bisecting technique is:
A) +20 degrees
B) +30 degrees
C) +40 degrees
D) +45 degrees
Q2) Because it satisfies fewer shadow-casting principles, the bisecting technique is less likely to produce superior diagnostic-quality radiographs.
A)True
B)False
Q3) Which of the following is true of the bisecting technique?
A) It is easy to standardize subsequent films.
B) There is increased patient comfort during image receptor placement.
C) There is decreased radiation exposure for the patient.
D) It is less likely to cause image distortion.
Q4) Explain how the bisecting technique relates to the rule of isometry.
Q5) Describe the error that results when excessive vertical angulation is used when taking periapical radiographs using the bisecting technique.
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Page 18
Chapter 16: The Occlusal Examination
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Q1) What is the main purpose of the bitewing radiograph?
Q2) A periodontally involved patient would benefit more from vertical bitewing radiographs than traditionally placed bitewing radiographs.
A)True
B)False
Q3) To avoid overlap error, t</OLINK>he central ray of the x-ray beam should be directed perpendicular to the mean tangent.
A)True
B)False
Q4) For bitewing radiographs, the radiographer should strive to ensure placement of the image receptor so that more of which arch, maxillary or mandibular, will be imaged?
Q5) What is the result if a bitewing radiograph is exposed using a negative 10-degree vertical angulation?
A) More maxillary teeth and alveolar bone will be recorded.
B) More mandibular teeth and alveolar bone will be recorded.
C) The image of the arches will appear tilted across the horizontal plane.
D) The image of the arches will appear tilted across the vertical plane.
Q6) Which two angulations are critical to producing quality bitewing radiographs?
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Chapter 17: The Panoramic Examination
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Q1) If the image receptor is not placed in the mouth with at least 1/4 inch (1/2 cm) protruding outside, the result will be cone cutting.
A)True
B)False
Q2) When placing an occlusal film packet intraorally, where should the embossed identification dot be positioned?
Q3) When imaging the maxillary arch, the white, unprinted side of the occlusal film packet will face the maxilla.
A)True
B)False
Q4) The thyroid collar may be in the path of the primary beam during which occlusal technique?
A) Maxillary posterior topographical
B) Mandibular anterior topographical
C) Mandibular posterior topographical
D) Mandibular cross-sectional
Q5) An occlusal radiograph must be taken with the size #4 image receptor.
A)True
B)False
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Chapter 18: Identifying and Correcting Undiagnostic
Radiographs
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Q1) What causes an iridescent stain on the radiograph?
Q2) Light (thin) images may result from each of the following EXCEPT one. Which one is the EXCEPTION?
A) Placing the image receptor (film) in the mouth backward
B) Not depressing the exposure button for the duration of the cycle
C) Using an mA setting that was too high
D) Developing in weak processing solutions
Q3) Does radiographic film have an expiration date?
Q4) Assembling an image receptor holder with external aiming device incorrectly may lead to conecut error.
A)True
B)False
Q5) To avoid radiographic error while opening a film packet in the darkroom, the film should be removed from the outer packaging rapidly.
A)True
B)False
Q6) What causes discrete black lines to appear on the radiograph?
Q8) What conditions permit white-light film fog? Page 21
Q7) What causes the black paper in the film packet to become stuck to the film?
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Page 22
Chapter 19: Quality Control and Environmental Safety in Dental Radiography
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Q1) Monitoring the strength of the manual processing solutions should be performed: A) daily.
B) weekly.
C) monthly.
D) quarterly.
Q2) Radiographic competencies of the dental assistant and dental hygienist include each of the following EXCEPT one. Which one is the EXCEPTION?
A) The ability to recognize quality radiographs
B) The ability to identify the cause of poor-quality radiographs
C) The ability to complete necessary state documentation of safe operating equipment
D) The ability to apply appropriate corrective actions to failed quality control tests
Q3) Establishing a quality control program for radiographic procedures helps to increase the quality of radiographs produced and decrease the incidence of retake radiographs. A)True
B)False
Q4) In the coin test, how long is a coin placed on top of the unwrapped film?
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23
Chapter 20: Image Orientation and Introduction to Interpretation
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Q1) The radiographer must be able to access an emergency eyewash station within 10 seconds of the area where automatic rollers are cleaned.
A)True
B)False
Q2) Contact lenses should be removed prior to using the emergency eyewash station. A)True
B)False
Q3) What does the OSHA Hazard Communication Standard state is the purpose of a product label?
Q4) Identify those materials and chemicals used for dental radiography that are considered hazardous wastes.
Q5) Procedures for safe handling of developer differ from those recommendations for handling fixer.
A)True
B)False
Q6) What information is listed on a product's MSDS?
Q7) Developer and fixer should be stored in their original containers. A)True B)False
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Chapter 21: Recognizing Normal Radiographic Anatomy
Intraoral Radiographs
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Q1) The incisive foramen, the median palatine suture, and the genial tubercles are all anatomical landmarks that can be found on radiographs of the maxillary anterior region.
A)True
B)False
Q2) Maxillary molars generally have how many roots?
Q3) Each of the following is an advantage of film mounting EXCEPT one. Which one is the EXCEPTION?
A) Aids viewing and interpretion
B) Prevents unnecessary retakes
C) Facilitates storage of radiographs
D) Provides meaningful patient education
Q4) With the lingual method of film mounting, the embossed dot will be ____________, and the viewer will interpret the radiographs as if
A) convex, facing the patient
B) concave, facing the patient
C) convex, standing behind the patient
D) concave, standing behind the patient
Q5) What part of an intraoral film distinguishes the patient's right and left sides?
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Chapter 22: Recognizing Normal Radiographic Anatomy
Panoramic Radiographs
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Q1) What is the round radiolucency often observed near the apices of the mandibular premolars called?
Q2) Which of the following lists the structures in order of decreasing radiopacity?
A) Pulp, dentin, cementum, enamel
B) Enamel, dentin, cementum, pulp
C) Pulp, cementum, dentin, enamel
D) Enamel, cementum, dentin, pulp
Q3) While the maxillary sinus appears radiolucent on a radiograph, the maxillary sinus walls appear radiopaque.
A)True
B)False
Q4) What is the thin radiolucent line that delineates the midline of the palate and the junction of the right and left maxilla called?
Q5) The genial tubercles are most likely to be recorded on an intraoral radiograph of the:
A) maxillary anterior region.
B) maxillary posterior region.
C) mandibular anterior region.
D) mandibular posterior region.
Page 26
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Chapter 3: Radiographic Appearance of Dental Materials and Foreign Objects
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Q1) What is the most commonly encountered form of benign tumor in the arches?
Q2) A taurodont tooth is a single tooth bud that divides and forms two teeth.
A)True
B)False
Q3) Radiographs are helpful in revealing each of the following EXCEPT one. Which one is the EXCEPTION?
A) Amalgam particles in soft tissue
B) Bluish-colored gingiva
C) Base material
D) Overhanging restorations
Q4) Which of the following terms means "the absence of teeth"?
A) Supernumerary
B) Anodontia
C) Anomaly
D) Mesiodens
Q5) Hypercementosis is distinguished from other radiopacities in bone by the absence of the periodontal ligament space.
A)True
B)False
Q6) What is the most common odontogenic tumor? Page 27
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Chapter 24: The Use of Radiographs in the Detection of Dental Caries
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Q1) Root caries develops between the enamel border and free gingival margin on the cemental surface of the tooth.
A)True
B)False
Q2) Which of the following is least likely to be imaged on a radiograph?
A) Incipient occlusal caries
B) Moderate proximal surface caries
C) Advanced proximal surface caries
D) Severe root caries
Q3) Buccal and lingual caries are best detected radiographically.
A)True
B)False
Q4) What is the radiographic appearance of moderate occlusal decay at the DEJ?
Q5) What term is applied to an optical illusion in which radiolucent lines are caused by overlapping images of the teeth?
Q6) The borders of buccal and lingual caries are usually ill-defined radiographically.
A)True
B)False
29
Q7) What is the name for severe, unchecked caries that affect multiple teeth?
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Chapter 25: The Use of Radiographs in the Evaluation of Periodontal Diseases
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Q1) Which of the following statements is correct?
A) Localized bone loss occurs throughout both arches simultaneously.
B) Horizontal bone loss is also known as angular bone loss.
C) Horizontal bone loss occurs in a plane perpendicular to the CEJ of adjacent teeth.
D) Vertical bone loss is also known as angular bone loss.
Q2) Can radiographs be used to differentiate treated versus untreated disease?
Q3) To image periodontal conditions, horizontal bitewing radiographs are preferred over vertical bitewing radiographs.
A)True
B)False
Q4) To accurately record the alveolar crestal bone, which of the following is necessary?
A) Precise parallelism with vertical and horizontal angulations
B) Placement of the image receptor parallel to the long axis of the tooth
C) Central rays of the x-ray beam directed perpendicular to the tooth and image receptor
D) All of the above
Q5) How does the two-dimensional nature of radiographs limit their utility as a diagnostic aid?
Page 30
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Chapter
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Q1) What size intraoral image receptor should be used to image a child with a transitional dentition?
Q2) The American Academy of Pediatric Dentistry recommends that a child's first professional oral examination be:
A) between the ages of 3 and 6 months.
B) between the ages of 2 and 4 years.
C) within 12 months following eruption of the first tooth.
D) soon after the eruption of all primary teeth.
Q3) In which of the following situations would four horizontal posterior bitewing radiographs be recommended?
A) Prior to the eruption of the permanent first molar
B) Following the eruption of the permanent first molar
C) Prior to the eruption of the permanent second molar
D) Following the eruption of the permanent second molar
Q4) A full mouth survey for a 15-year-old should consist of:
A) 12 periapicals and 2 bitewings.
B) 12 periapicals and 4 bitewings.
C) 14 periapicals and 2 bitewings.
D) 14 periapicals and 4 bitewings.
Q5) Should a thyroid collar be used when exposing radiographs on children?
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Chapter 27: Pediatric Radiographic Techniques
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Q1) Should the radiographer tell the gagging patient that the gag reflex is all in the mind?
Q2) What is one possible theory to explain why stimulating the oral mucosa by digital palpation suppresses the gag reflex?
Q3) What are some examples of distraction techniques the radiographer can use to help the patient control the gag reflex?
Q4) Each of the following statements regarding the gag reflex is correct EXCEPT one. Which one is the EXCEPTION?
A) Some patients have a heightened gag reflex due to chronic sinus problems.
B) Mucus and saliva in the nasopharynx minimize the gag reflex.
C) A gag reflex may originate in the mind.
D) A gag reflex may be a response to physical stimuli.
Q5) Is receipt of large amounts of therapeutic radiation to the head and neck area a contraindication to future dental radiographs?
Q6) To minimize a patient's gag reflex, the radiographer can apply distraction techniques.
A)True
B)False
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Page 32
Chapter 28: Radiographic Techniques for Patients With Special Needs
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Sample Questions
Q1) A torus mandibularis</KT> is a benign outgrowth of bone along the midline of the hard palate.
A)True
B)False
Q2) Can dental radiographs be taken in edentulous areas?
Q3) A correctly placed and angled canine periapical radiograph will often demonstrate overlapping where?
Q4) Should exposure settings for edentulous areas be the same as for areas with teeth present?
Q5) Precise positioning of the image receptor and accurate angulation will eliminate overlap between the canine and first premolar on a canine periapical radiograph.
A)True
B)False
Q6) To avoid overlap of contact areas on a molar bitewing radiograph, the image receptor should be positioned perpendicularly to the midpoint of the maxillary first molar.
A)True
B)False
Q7) What is a duplicate radiograph?
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Chapter 29: Radiographic Techniques for Specific Oral Conditions
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Q1) Of what is the back cover of a rigid extraoral film cassette constructed?
Q2) Which of these extraoral radiographs is most often used to aid in diagnosing temporomandibular joint problems?
A) Lateral skull projection
B) Transcranial projection
C) Reverse Towne projection
D) Posteroanterior projection
Q3) What is the purpose of a Waters projection?
Q4) Each of the following statements regarding intensifying screens is correct EXCEPT one. Which one is the EXCEPTION?
A) They work in pairs.
B) They require less radiation to produce an image.
C) They transfer x-ray energy into visible light.
D) They are sensitive to white-light exposure.
Q5) Cone beam computed tomography (CBCT) is computed tomography technology dedicated to dental applications.
A)True
B)False
Q6) Of what is the front cover of a rigid extraoral film cassette constructed?
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Chapter 30: Radiographic Techniques
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Q1) Most panoramic machines have wide focal troughs in the anterior region. A)True
B)False
Q2) The genial tubercles appear on a panoramic radiograph as a radiopaque, donut-shaped circle surrounding the lingual foramen. A)True
B)False
Q3) If the patient's chin is tipped up, the image appears as an exaggerated smile. A)True
B)False
Q4) What is the name of the anatomic landmark that appears on a panoramic image as a thick radiopaque horizontal band superior to the maxillary teeth?
Q5) If the patient's head is rotated to the right in the focal trough, the teeth on the right appear magnified.
A)True
B)False
Q6) The nasopharyngeal air space is located between the tongue and the palate. A)True
B)False
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