Oral Radiology Exam Materials
Course Introduction
Oral Radiology is a specialized course that explores the principles, techniques, and clinical applications of radiographic imaging in dentistry. Students will gain an understanding of the physics behind X-rays, radiation safety protocols, and the interpretation of various types of dental radiographs, including intraoral and extraoral images. The course emphasizes hands-on practice with digital and conventional radiographic equipment, identification of normal anatomy and pathological conditions, and the integration of radiology into diagnostic and treatment planning processes in dental practice. Ethical and legal considerations, as well as advances in imaging technology, are also discussed to prepare students for comprehensive radiologic assessment in patient care.
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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1488 Flashcards
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Chapter 1: Dental Radiography: Historical Perspective and Future Trends
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Sample Questions
Q1) The first dental radiograph was produced using an exposure time of:
A) 0.5 second.
B) 1 minute.
C) 5 minutes.
D) 25 minutes.
E) 1 hour.
Answer: D
Q2) The development of radiation protection as a science is credited to:
A) A. Cieszy ski.
B) W. D. Coolidge.
C) W. H. Rollins.
D) F. Mouyen.
Answer: C
Q3) Who developed the hot cathode ray tube?
A) W. D. Coolidge
B) W. A. Price
C) H. R. Raper
D) W. H. Rollins
Answer: A
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Chapter 2: Characteristics and Measurement of Radiation
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Sample Questions
Q1) The wavelength determines the energy and penetrating power of the radiation. The longer the wavelength, the higher the energy of the radiation.
A) The first statement is true. The second statement is false.
B) The first statement is false. The second statement is true.
C) Both statements are true.
D) Both statements are false.
Answer: A
Q2) The units used to measure the dose equivalent of radiation is the:
A) Gray (Gy).
B) Sieverts (Sv).
C) Coulombs per kilogram (C/kg).
D) Roentgens (R).
Answer: B
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) What are the positively charged particles in the nucleus of an atom called?
Answer: Protons. Positively charged protons and neutral neutrons make up the nucleus of atoms.
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Chapter 3: The Dental X-Ray Machine: Components and Function
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Sample Questions
Q1) The intensity of the beam refers to the quantity and quality of the x-rays.
A)True
B)False
Answer: True
Q2) What is the name of the device that allows the amount of current passing through the wires of the circuit to be changed?
Answer: The milliamperage (mA) selector determines the available number of free electrons at the cathode filament. This allows for variation in the amount of x-rays which are produced
Q3) Sixty (60) impulses is equivalent to:
A) 1/6 second.
B) 1/10 second.
C) ½ second.
D) 1 second.
Answer: D
Q4) Primary beam refers to a high-energy, short wavelength x-ray beam. A)True
B)False
Answer: False
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Chapter 4: Factors Affecting Radiographic Quality
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Sample Questions
Q1) What is the relationship between kVp and contrast?
Q2) The degree of overall blackness of a radiographic image is termed:
A) sharpness.
B) density.
C) resolution.
D) contrast.
Q3) Each of the following is a term used to describe visual image characteristics EXCEPT one. Which one is the EXCEPTION?
A) Sharpness
B) Contrast
C) Milliamperage
D) Density
Q4) Each of the following results in image unsharpness EXCEPT one. Which one is the EXCEPTION?
A) Patient movement during exposure
B) Image receptor positioned close to the teeth
C) A short PID
D) The use of intensifying screens
Q5) What is radiographic density?
Q6) What is penumbra?
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Chapter 5: Effects of Radiation Exposure
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Q1) Which of the following statements regarding the biological effect mechanisms of the direct theory is FALSE?
A) Most dental x-ray photons pass through the cell, causing no damage.
B) X-ray photons may collide with important cell chemicals and break them apart.
C) Ionization can cause critical damage to large molecules.
D) Irradiated cells cannot be repaired.
Q2) Which of these is NOT a symptom of acute radiation syndrome.
A) Constipation
B) Nausea
C) Hemorrhage
D) Hair loss
Q3) Which of the following is NOT a component of the Law of Bergonié and Tribondeau?
A) Actively dividing cells are less sensitive.
B) Immature cells are more sensitive.
C) More specialized cells are more radioresistant.
D) Cells are most susceptible to injury during cell division.
Q4) A stochastic effect is when a biological response is based on the probability of occurrence rather than the severity of the change..
A)True
B)False
Page 7
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Chapter 6: Radiation Protection
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Q1) Which intraoral technique should be the radiographer's first choice when exposing periapical radiographs?
Q2) The ALARA concept implies that:
A) any radiation dose that can be reduced without major difficulty, great expense, or inconvenience, should be reduced or eliminated.
B) if a radiation dose cannot be reduced without major difficulty, great expense, or inconvenience, then no radiographs should be exposed.
C) radiation dosages slightly above the acceptable level of risk are acceptable only in emergency treatment situations.
D) fewer radiographs should be taken only if a radiation dose cannot be reduced due to major difficulty, inconvenience, and great expense.
Q3) The United States Nuclear Regulatory Commission has developed dose limits for radiographers and patients.
A)True
B)False
Q4) What are the three categories of methods for protecting oral health care personnel from radiation exposure?
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Chapter 7: Dental X-Ray Film and Processing Methods
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Sample Questions
Q1) Which structure is most likely to absorb or stop more of the x-rays from reaching the film?
A) The enamel
B) The bone
C) The pulp
D) The soft tissue (cheek)
Q2) Duplicating film gets lighter the longer the exposure to light.
A)True
B)False
Q3) Dental film emulsion is about 90 to 99 percent silver bromide and 1 to 10 percent silver iodide.
A)True
B)False
Q4) Extraoral radiographs require the use of a cassette and what else?
Q5) The purpose of the lead foil in the film packet is to absorb back-scattered x-rays to reduce film fog.
A)True
B)False
Q6) Which side of the film packet faces the source of radiation?
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Q7) For what is the embossed dot in one corner of intraoral dental x-ray film used?
Chapter 8: Digital Radiography and Image Acquisition
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Q1) Processing chemistry can be used indefinitely.
A)True
B)False
Q2) The purpose of the washing step in film processing is to:
A) shrink and harden the emulsion.
B) remove any residual chemistry remaining on the emulsion.
C) neutralize alkaline and/or acidic chemistry.
D) reduce the exposed silver halide to metallic silver.
Q3) The ideal time-temperature for manual processing archival radiographs is 85 degrees F.
A)True
B)False
Q4) Of what material are manual processing tanks fabricated?
Q5) The preservative sodium sulfite</KT> is found in both the developer and fixer solutions.
A)True
B)False
Q6) How frequently should processing solutions be changed?
Q7) What is the purpose of rinsing the film after it has been in the developer during manual processing?
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Chapter 9: Infection Control
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Q1) Each of the following statements regarding digital radiography is correct EXCEPT one. Which one is the EXCEPTION?
A) In film-based radiography, the radiographer "takes a radiograph," while in digital imaging, the radiographer "acquires an image."
B) A digital image has no physical form.
C) Digital radiography systems are limited to intraoral systems.
D) Indirect digital imaging replaces film with a photostimulable plate.
Q2) Which of these statements is FALSE?
A) The digital image is composed of structurally ordered pixels.
B) Each pixel is a single dot in a digital image.
C) Pixel is short for "pixel element."
D) Each pixel has a number from 1 to 10.
Q3) The discernable separation of closely adjacent image details is referred to as contrast.
A)True
B)False
Q4) The lower the line pairs per millimeter, the better the spatial resolution.
A)True
B)False
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Chapter 10: Legal and Ethical Responsibilities
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Q1) Which of these statements regarding classification of objects used in radiographic procedures is FALSE?
A) Critical objects must be sterilized after each use.
B) Most quality-made image receptor holders are sterilizable or disposable.
C) Semicritical objects are those used to penetrate soft tissue or bone.
D) No critical instruments are used in dental radiography.
Q2) Each of the following types of protective eyewear is acceptable for use by the dental radiographer EXCEPT one. Which one is the EXCEPTION?
A) Glasses with side shields
B) Goggles
C) Contact lenses
D) Full face shields
Q3) Semicritical objects must be sterilized after use.
A)True
B)False
Q4) Universal precautions have replaced standard precautions.
A)True
B)False
Q5) How should films secured in barrier envelopes be handled?
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Chapter 11: Patient Relations and Education
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Q1) As prudent risk management, radiographs should be retained as part of a client's record for 7 years.
A)True
B)False
Q2) Patients have the right to reasonable access to their radiographs.
A)True
B)False
Q3) Who has a legal right to request copies of a patient's radiographs?
A) Another dentist
B) The patient
C) An insurance company
D) All of the above
Q4) Which of these statements regarding risk management is FALSE?
A) Obtain a duplicate copy of a new patient's radiographs if possible.
B) Use the best equipment currently available for exposing radiographs.
C) Take radiographs only if the dentist is present.
D) Establish a written quality assurance system for radiographic equipment.
Q5) Policies and procedures to be followed by the radiographer to reduce the likelihood that a patient will file legal action against the oral health care team are collectively called what?
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Chapter 12: Introduction to Radiographic Examinations
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Q1) Respectfulness and courtesy are examples of interpersonal skills.
A)True
B)False
Q2) Show-tell-do is a method of communication reserved for the child patient.
A)True
B)False
Q3) Apathy is the ability to share in another's emotions or feelings.
A)True
B)False
Q4) An educated patient is more inclined to understand and accept dental treatment plans and embrace suggestions for oral health promotion and disease prevention.
A)True
B)False
Q5) Should patients who have had radiation therapy for cancer of the head or neck avoid dental x-rays?
Q6) When placing the image receptor intraorally, the radiographer should ask the patient, "Does that feel okay?"
A)True
B)False
Page 14
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Chapter 13: The Periapical Examinationparalleling Technique
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Q1) Conditions that would indicate the need for a periapical radiograph include each of the following EXCEPT one. Which one is the EXEPTION?
A) Abscess
B) Cleft palate
C) Large caries
D) Root fracture
Q2) A minimum of how many periapical radiographs should make up a full mouth survey for most adult patients?
A) 10
B) 12
C) 14
D) 16
Q3) Which of these statements is FALSE?
A) Incorrect vertical angulation results in overlapped contact points.
B) Negative angulation is generally used for exposure of the mandibular arch.
C) Positive angulation is generally used for exposure of the maxillary arch.
D) An image receptor will aid the radiographer in determining the correct angulations.
Q4) Aligning the PID in the vertical and horizontal dimensions is called what?
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Chapter 14: The Periapical Examinationbisecting Technique
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Q1) The paralleling technique does not meet the shadow-casting principle that requires placement of the image receptor close to the teeth of interest.
A)True
B)False
Q2) The paralleling technique is preferred over the bisecting technique.
A)True
B)False
Q3) An image receptor holder with an external aiming device can make radiographic errors less likely.
A)True
B)False
Q4) Because of the supporting structures on the maxillary arch, to accomplish a parallel relationship between the image receptor and the long axes of teeth, the image receptor must be placed closer to the teeth.
A)True
B)False
Q5) What are two image receptor holders that with slight modifications can be used for either the paralleling or the bisecting technique?
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Chapter 15: The Bitewing Examination
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Q1) 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.
Q2) Which of the two techniques for obtaining intraoral radiographs may be easier to use for children or adults with shallow palates?
Q3) The two planes that can be visualized by the radiographer are the estimated long axis of the tooth and the plane of the image receptor.
A)True
B)False
Q4) An isometric triangle is a triangle with sides that are inversely related to the base. A)True B)False
Q5) Careful attention to the steps of the bisecting technique can produce acceptable radiographs.
A)True
B)False
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Chapter 16: The Occlusal Examination
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Q1) Bitewings are limited in their ability to image the entire tooth.
A)True
B)False
Q2) For bitewing radiographs, the image receptor is placed near and almost parallel to the teeth of both arches while the patient holds the mouth in an open position.
A)True
B)False
Q3) Each of the following statements regarding preparations for bitewing exams is correct EXCEPT one. Which one is the EXCEPTION?
A) The dental x-ray machine should be turned on and the exposure setting selected prior to placing the image receptor intraorally.
B) The radiographic procedure should be explained to the patient prior to beginning the exposures.
C) The patient's head should be positioned with the mean tangent parallel to the floor.
D) The patient should be asked to remove eyeglasses and all intraoral appliances prior to placement of the image receptor.
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Chapter 17: The Panoramic Examination
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Q1) When imaging the mandibular arch, the printed side of the occlusal film packet will face the mandible.
A)True
B)False
Q2) Each of the following statements regarding occlusal radiographs is correct EXCEPT one. Which one is the EXCEPTION?
A) They do not require the use of an image receptor holder.
B) They images both of the arches on a single film.
C) They may be either topographical or cross-sectional.
D) They are placed in the mouth between the occlusal surfaces of the maxillary and mandibular teeth.
Q3) An occlusal radiograph must be taken with the size #4 image receptor.
A)True
B)False
Q4) Can a thyroid collar be used during the occlusal radiographic exam?
Q5) How is the image receptor positioned to expose an occlusal radiograph?
Q6) Do occlusal radiographs display dimensional distortion?
Q7) List reasons for assessing a patient for occlusal radiographs.
Q9) What is the purpose of the occlusal radiographic exam? Page 19
Q8) What are the recommended exposure settings for occlusal radiographs?
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Chapter 18: Identifying and Correcting Undiagnostic Radiographs
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Q1) Can fluorescent watch faces and dials fog film?
Q2) Each of the following statements regarding retake radiographs is correct EXCEPT one. Which one is the EXCEPTION?
A) All errors create a need to re-expose the patient.
B) If one radiograph in a set of bitewings is overlapped, it should be determined whether adjacent radiographs image the area adequately.
C) Determining when a retake is necessary will keep radiation exposure to a minimum.
D) All errors reduce the quality of the radiograph.
Q3) What causes discrete black lines to appear on the radiograph?
Q4) What is film fog?
Q5) A scratched safelight filter or incorrect bulb wattage can result in film fog.
A)True
B)False
Q6) If the darkroom door is accidentally opened during unwrapping of the film packets, the resultant image will appear clear, or blank of any image.
A)True
B)False
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Q7) What produces thin black lines or smudges often in a pattern on the radiograph?
Chapter 19: Quality Control and Environmental Safety in Dental Radiography
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Q1) The dental x-ray machine should be tested for tube head stability periodically.
A)True
B)False
Q2) In the coin test, how long is a coin placed on top of the unwrapped film?
Q3) In automatic processing, the most likely cause of damp films is that:
A) the water level too high.
B) the dryer was not operating correctly.
C) distilled water was not used.
D) the rinse spray was too forceful.
Q4) Dental x-ray machine tube head stability should be tested annually.
A)True
B)False
Q5) What is a reference film?
Q6) Which of these statements regarding the competency operators is FALSE?
A) They must be able to carry out an effective quality assurance program.
B) They must be competent in exposing, processing, and mounting dental radiographs.
C) They must know when to prescribe dental radiographs.
Page 22
D) They must be able to identify errors that occur on dental radiographs.
Q7) What is quality assurance in dental radiography?
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Chapter 20: Image Orientation and Introduction to Interpretation
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Q1) Sodium thiosulphate found in used fixer of dental radiographic processors is actually a very stable compound.
A)True
B)False
Q2) Fixer is caustic.
A)True
B)False
Q3) If splashed into the eyes, developer would be more easily washed away in the emergency eyewash station than fixer.
A)True
B)False
Q4) Which of these is NOT considered PPE?
A) Mask
B) Gloves
C) Eyewear
D) Radiation monitoring device
Q5) List the requirements of an emergency eyewash station.
Q6) Developer and fixer should be stored in their original containers.
A)True
B)False Page 23
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Chapter 21: Recognizing Normal Radiographic Anatomy
Intraoral Radiographs
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Q1) What pieces of equipment are necessary for optimum film viewing?
Q2) How long should dental radiographs be retained?
Q3) A practice may contact a manufacturer of film mounts to order a custom-designed mount for that practice.
A)True
B)False
Q4) Each of the following statements regarding film mounting is correct EXCEPT one. Which one is the EXCEPTION?
A) Mounted films are easy to store.
B) Mounting decreases the chance of error caused by confusing the patient's right and left sides.
C) Lingually mounted radiographs allow for easy transfer of findings to the patient's record.
D) Patient communication is enhanced when films are mounted.
Q5) Patient radiographs should be retained indefinitely.
A)True
B)False
Q6) What part of an intraoral film distinguishes the patient's right and left sides?
Q7) What type of film mount is preferable?
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Chapter 22: Recognizing Normal Radiographic Anatomy
Panoramic Radiographs
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Q1) What is the thin radiolucent line that delineates the midline of the palate and the junction of the right and left maxilla called?
Q2) Which of these statements is FALSE?
A) The incisive foramen appears as a round or pear-shaped radiolucency between the apices of the maxillary central incisors.
B) The nasal fossa appears as two paired radiolucencies separated by the radiopaque nasal septum.
C) The lateral fossa appears as a radiolucency between the maxillary canine and first premolar.
D) The median palatine suture appears as a thin radiolucent line between the maxillary central incisors.
Q3) The oblique ridge is 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.
Q4) What is a bony growth extending out from the lingual surface of the mandible called?
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Chapter 3: Radiographic Appearance of Dental Materials and Foreign Objects
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Q1) Which of these restorative materials will appear the most radiopaque on a dental radiograph?
A) Cement
B) A temporary filling
C) Gold
D) Base material
Q2) Which of the following restorative materials may appear radiopaque or radiolucent?
A) Amalgam
B) Sealants
C) Composite
D) Gold
Q3) What is the most common odontogenic tumor?
Q4) A torus is a bony growth projecting outward from the surface of a bone.
A)True
B)False
Q5) A cyst is an epithelium-lined sac containing fluid or other fibrous or solid material that appears radiolucent.
A)True
B)False
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Chapter 24: The Use of Radiographs in the Detection of Dental Caries
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Q1) The depth of buccal or lingual caries can be determined by observing the radiographs.
A)True
B)False
Q2) Caries is a disease of the calcified tissues of the teeth.
A)True
B)False
Q3) A caries grading system establishes a baseline from which to track the progression and/or remineralization of the carious lesions at future appointments.
A)True
B)False
Q4) Incipient caries is seen radiographically as a radiolucency that has:
A) penetrated less than halfway through the enamel.
B) penetrated over halfway through the enamel but did not reach the DEJ.
C) penetrated at or through the DEJ but less than halfway through the dentin toward the pulp.
D) penetrated over halfway through the dentin toward the pulp.
Q5) According to the grading system suggested by Haugejorden and Slack (1977), what is the most extensive class of proximal decay?
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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) 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
Q3) Name three local contributing factors for the development of periodontal diseases.
Q4) To image periodontal conditions, horizontal bitewing radiographs are preferred over vertical bitewing radiographs.
A)True
B)False
Q5) Can gingivitis be detected radiographically?
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Q1) Which size image receptor would best image a bitewing radiodgraph on a 4-year-old?
A) 0 or 1
B) 1
C) 1 or 2
D) 3
Q2) By how much should adult exposure times be reduced for a 12-year-old child patient?
A) One-half the exposure time used for the adult patient
B) One-third the exposure time used for the adult patient
C) One-fourth the exposure time used for the adult patient
D) One-fifth the exposure time used for the adult patient
Q3) Which of the following extraoral radiographs is commonly assessed for in conjunction with intraoral radiographs for the child patient?
A) Transcranial
B) Panoramic
C) Waters
D) Reverse Towne
Q4) Are methods for exposing radiographs on children essentially the same as for adults?
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Chapter 27: Pediatric Radiographic Techniques
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Q1) What are two stimuli that must be diminished or eliminated to reduce gagging?
Q2) Using a distraction technique would produce the best results of suppressing a gag reflex that originates from psychogenic stimuli.
A)True
B)False
Q3) Before starting the procedure, the radiographer should ask the patient, "Are you a gagger?"
A)True
B)False
Q4) To suppress a gag reflex, the patient must continue breathing during the exposure of the radiograph and must be told not to hold the breath.
A)True
B)False
Q5) Is receipt of large amounts of therapeutic radiation to the head and neck area a contraindication to future dental radiographs?
Q6) A disability is defined as a physical limitation.
A)True
B)False
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Chapter 28: Radiographic Techniques for Patients With Special Needs
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Sample Questions
Q1) To clearly image the proximal surfaces of malaligned or crowded teeth, which of the following may be necessary?
A) A smaller image receptor positioned lower in the oral cavity
B) A smaller image receptor positioned higher in the oral cavity
C) Additional radiographs varying the horizontal angulation
D) Additional radiographs varying the vertical angulation
Q2) Looking at a full mouth series of radiographs you note that an impacted retained primary root tip can be observed between the right mandibular second premolar and the first molar in the premolar periapical radiograph. You note that the root tip appears to have "moved" mesially in the molar periapical radiograph. Which of the following is true regarding the impacted retained primary root tip?
A) It is located on the buccal.
B) It is located on the lingual.
C) An additional radiograph would be required to determine the buccal or lingual location of the impacted retained primary root tip.
Q3) What is the name of bony protuberances that may arise on the palate and lingual surfaces of the mandible of some patients?
Q4) What are three methods of localization?
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Chapter 29: Radiographic Techniques for Specific Oral Conditions
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Q1) The radiographic technique that uses simultaneous movement of the x-ray source and the image receptor to record images of structures located within a selected plane of tissue while blurring structures outside the selected plane is called "tomography."
A)True
B)False
Q2) Which of these dental practitioners would most likely use a lateral cephalometric radiograph to assess growth and development?
A) A general practitioner
B) An orthodontist
C) A periodontist
D) An endodontist
Q3) Why should cassettes and intensifying screens be examined prior to use?
Q4) A grid is a device used in extraoral radiography to prevent scatter radiation from fogging the image receptor.
A)True
B)False
Q5) What is a lateral cephalometric radiograph?
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Q6) Of what is a grid used in extraoral radiographic techniques composed?
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Chapter 30: Radiographic Techniques
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Q1) All panoramic images have between 10 and 30 percent image magnification.
A)True
B)False
Q2) What is the name of the anatomic landmark that appears on a panoramic image as a radiopaque, wing-like bony projection of the sphenoid bone located posterior to the maxillary tuberosity?
Q3) The bite block is used to position the arches correctly in the forward-backward dimension of the focal trough.
A)True
B)False
Q4) Positioning the arches too far back in the focal trough, toward the tube head, will result in:
A) the anterior teeth appearing blurred and diminished in width.
B) the anterior teeth appearing blurred and magnified.
C) an image that appears as an exaggerated smile.
D) wide radiopacities superimposed over the anterior teeth.
Q5) What is the name of the anatomic landmark that appears on a panoramic image as a pea-shaped, radiolucent opening in the bone located between the roots of the maxillary central incisors?
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