Principles of Dental Radiography Practice Exam
Course Introduction
Principles of Dental Radiography introduces students to the foundational concepts and techniques of dental imaging. The course covers the physics of X-ray generation, properties and biological effects of radiation, radiation safety principles, and the legal aspects of radiographic practice. Emphasis is placed on intraoral and extraoral radiographic techniques, film processing, digital imaging, image interpretation, and quality assurance. Students gain the skills necessary to produce high-quality diagnostic images while minimizing patient exposure, ensuring safety, and adhering to professional standards in dental radiography.
Recommended Textbook
Essentials of Dental Radiography for Dental Assistants and Hygienists 10th Edition by Evelyn Thomson
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2
Chapter 1: Dental Radiography: Historical Perspective and Future Trends
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Q1) The <KT>parpaparalleling technique is taught in all dental assisting, dental hygiene, and dental schools because it is the technique of choice for imaging intraoral radiographs.
A) Both the statement and reason are correct and related.
B) Both the statement and reason are correct but NOT related.
C) The statement is correct, but the reason is NOT.
D) The statement is NOT correct, but the reason is correct.
E) NEITHER the statement NOR the reason is correct.
Answer: A
Q2) Digital imaging replaces the conventional dental x-ray machine.
A)True
B)False
Answer: False
Q3) Producing radiographs of the teeth and/or the oral cavity is called:
A) Radiation producing.
B) Radiology.
C) Roentgenograph.
D) X-raying.
E) Radiography.
Answer: E
Page 3
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Chapter 2: Characteristics and Measurement of Radiation
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Q1) What is the maximum number of electron shells (energy levels) an atom can have?
A) 1
B) 3
C) 5
D) 7
Answer: D
Q2) The Compton effect causes x-rays to be scattered in all directions.
A)True
B)False
Answer: True
Q3) X-rays make the materials they pass through radioactive.
A)True
B)False
Answer: False
Q4) The majority of x-rays produced by dental x-ray machines are formed by general (bremsstrahlung) radiation.
A)True
B)False
Answer: True
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Chapter 3: The Dental X-Ray Machine: Components and Function
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Q1) The duration of an x-ray exposure is determined by which control?
A) The timer
B) The line switch
C) The kVp selector
D) The mA selector
Answer: A
Q2) Which of the following best describes how x-rays are actually produced in the dental x-ray tube?
A) Radioactive particulate matter undergoes controlled disintegration.
B) Electrical current passes through an oil mixture, creating minute explosions.
C) Low milliamperage current is transformed to high kilovoltage current.
D) High-speed electrons collide with target material electrons.
Answer: D
Q3) Increasing which of the following would best increase the number of electrons flowing through the dental x-ray electrical circuit?
A) Impulses
B) Kilovoltage
C) Milliamperage
D) PID length
Answer: C
Page 5
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Chapter 4: Factors Affecting Radiographic Quality
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Q1) What types of tissues or structures appear radiolucent on radiographs?
Q2) The term "short-scale contrast" describes a radiograph in which density differences between adjacent areas are small.
A)True
B)False
Q3) That portion of the radiographic image that appears light is called "radiolucent."
A)True
B)False
Q4) Thicker intensifying screens increase the sharpness of extraoral radiographs.
A)True
B)False
Q5) Some clinicians prefer a radiographic image that is of low contrast, and others prefer a radiographic image that is of high contrast.
A)True
B)False
Q6) What is long-scale contrast?
Q7) The quality of the beam of radiation is determined by which exposure factor?
Q8) Why should the x-ray film be placed parallel to the long axis of the tooth?
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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) Erythema is a stochastic effect of exposure to radiation.
A)True
B)False
Q3) Cancer is a stochastic effect of exposure to radiation.
A)True
B)False
Q4) X-rays have been shown to have carcinogenic effects.
A)True
B)False
Q5) A less specialized cell is more radioresistant.
A)True
B)False
Q6) When is the developing fetus most susceptible to the damaging effects of radiation, and why?
Page 7
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Chapter 6: Radiation Protection
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Q1) Guidance for deciding when, what type, and how many radiographs to expose on a patient have been developed and should be followed.
A)True
B)False
Q2) Based on evidence-based selection criteria for keeping radiation exposure ALARA, a child recall patient with several risk factors for caries would most likely be assessed for bitewing radiographs every 6 to 12 months.
A)True
B)False
Q3) Medical, dental, and therapeutic radiation is included in the MPD.
A)True
B)False
Q4) Each of the following protects the radiographer from radiation EXCEPT one. Which one is the EXCEPTION?
A) Wearing a personnel-monitoring device
B) Increased distance from the source of radiation
C) Standing behind protective shielding during exposure
D) Spending less time near radiation-producing equipment
Q5) Currently, what film speed is recommended to reduce radiation exposure?
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Chapter 7: Dental X-Ray Film and Processing Methods
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Q1) Dental x-ray film is surrounded by a sheet of white paper inside the film packet.
A)True
B)False
Q2) The invisible image present on a dental x-ray film that does not become visible until after processing is called what?
Q3) 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
Q4) Intraoral films are designed for use outside the oral cavity.
A)True
B)False
Q5) 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
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Chapter 8: Digital Radiography and Image Acquisition
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Q1) The ideal time-temperature for manual processing archival radiographs is 85 degrees F.
A)True
B)False
Q2) The dark portion of the radiograph is called "radiolucent."
A)True
B)False
Q3) What is the purpose of rinsing the film after it has been in the developer during manual processing?
Q4) The preservative sodium sulfite</KT> is found in both the developer and fixer solutions.
A)True
B)False
Q5) It is safe to read a radiograph under white-light conditions after only 2 or 3 minutes of developing.
A)True
B)False
Q6) How frequently should processing solutions be changed?
Q7) A wet reading can safely take place after which step of processing?
Q8) Of what material are manual processing tanks fabricated?
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Chapter 9: Infection Control
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Q1) Each pixel is a single dot in a digital image.
A)True
B)False
Q2) Solid-state digital sensors are available wired of wireless.
A)True
B)False
Q3) Using digital radiographic software to detect caries is an example of artificial intelligence.
A)True
B)False
Q4) 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
Q5) What is digital subtraction?
Q6) What are the advantages of digital radiography?
Q7) What is the digital equivalent of film fog?
Q8) By what mechanism are PSP plates reusable?
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Chapter 10: Legal and Ethical Responsibilities
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Q1) Which of these statements is FALSE?
A) Microbial aerosols are pathogens present in blood that cause disease in humans.
B) Asepsis means "freedom from infection."
C) An antiseptic is an agent used on living tissue to kill or reduce numbers of bacteria.
D) Contamination is soiling by contact or mixing.
Q2) How can the chain of infection be broken?
Q3) Protective clothing, mask, and eyewear should be in place prior to putting on patient treatment gloves.
A)True
B)False
Q4) Each of the following statements regarding personal protective equipment is correct EXCEPT one. Which one is the EXCEPTION?
A) Protective clothing should be laundered weekly.
B) Protection from aerosols may be achieved through the use of a mask.
C) Protective eyewear protects the eye area from aerosols and spatter.
D) Hands should be washed before gloving and after removing gloves.
Q5) What is asepsis?
Q6) What are infectious diseases?
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Chapter 11: Patient Relations and Education
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Q1) Some states require additional credentials beyond passing the National Board Dental Hygiene Examination or Dental Assisting National Board Examination to place and expose dental radiographs.
A)True
B)False
Q2) Patients may have reasonable access to their radiographs if:
A) changing dentists.
B) having a consult with a specialist.
C) needed for litigation against the dentist.
D) All of the above.
Q3) Dental radiographs must be retained for 7 years after the: A) date of exposure.
B) patient is deceased.
C) patient ceases to be a patient.
D) completion of treatment.
Q4) What is the type of consent a patient gives after being told of the nature and purpose of treatment procedures, the benefits, and the risks?
Q5) Who owns a patient's dental radiographs?
Q6) Generally, how frequently must x-ray machines be inspected?
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Chapter 12: Introduction to Radiographic Examinations
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Q1) 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.
Q2) What is the name of the process by which information is exchanged between two or more people?
Q3) Should patients who have had radiation therapy for cancer of the head or neck avoid dental x-rays?
Q4) Which of the following statements regarding interpersonal skills is best?
A) The radiographer should praise the patient for their assistance with the procedure.
B) Acknowledge mistakes with an easygoing "Oops," indicating that it is not serious.
C) It is natural to show frustration with a patient who is having difficulty managing the procedure.
D) If a patient is feeling discomfort, tell him or her to hang on and be patient.
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Chapter 13: The Periapical Examinationparalleling Technique
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Q1) The bisecting technique originated from the rule of isometry.
A)True
B)False
Q2) Periapical radiographs can be taken with each of the following image receptor sizes
EXCEPT one. Which one is the EXCEPTION?
A) 0
B) 1
C) 2
D) 3
Q3) Periapical image receptors for exposure of anterior areas are placed with the long dimension vertically.
A)True
B)False
Q4) Radiographs are shadow images on an image receptor.
A)True
B)False
Q5) What will assist the radiographer with directing the x-ray beam at the correct angle?
Q6) What are the units used to describe angulation?
Q7) 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) Which of these image receptor holders is NOT designed for use with the paralleling technique?
A) XCP
B) XCP-DS
C) Snap-A-Ray
D) RAPD
Q2) What are three image receptor holders designed for use with the paralleling technique?
Q3) An image receptor holder with an external aiming device can make radiographic errors less likely.
A)True
B)False
Q4) The Dentsply Rinn Stabe and the Flow Dental SUPA image receptor holders designed for the paralleling technique do not have an external aiming device.
A)True
B)False
Q5) Incorrectly aligning the point of entry will result in what type of error?
Q6) What are two image receptor holders that with slight modifications can be used for either the paralleling or the bisecting technique?
Page 16
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Chapter 15: The Bitewing Examination
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Q1) Which of the following best describes the correct vertical direction of the central ray when using the bisecting technique?
A) 90 degrees to the long axes of the teeth
B) 90 degrees to the plane of the image receptor
C) 90 degrees to the long axes of the teeth and the plane of the image receptor
D) 90 degrees to the imaginary bisector
Q2) Which of these is NOT a disadvantage of the bisecting technique?
A) It produces images with dimension distortion.
B) Image receptor positioning is difficult for patients with small mouths.
C) Adjacent structures are often superimposed.
D) Estimating the location of the imaginary bisecting may be difficult.
Q3) Explain how the bisecting technique relates to the rule of isometry.
Q4) Describe the error that results when excessive vertical angulation is used when taking periapical radiographs using the bisecting technique.
Q5) 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.
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Chapter 16: The Occlusal Examination
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Q1) Sometimes there is a need to expose more than four bitewing radiographs on an individual patient.
A)True B)False
Q2) The term used to describe the contact point between teeth in the same arch is "proximal surface."
A)True B)False
Q3) What is the name of the location the central ray is directed toward on the patient's face?
Q4) 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.
Q5) Anterior bitewings should be exposed using a vertical angulation of +20 degrees. A)True B)False
Page 18
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) List reasons for assessing a patient for occlusal radiographs.
Q2) The vertical angulation used for topographical occlusal radiographs follows the rules of the bisecting technique used for periapical radiographs.
A)True
B)False
Q3) When imaging the mandibular arch, the printed side of the occlusal film packet will face the mandible.
A)True
B)False
Q4) How is the image receptor positioned to expose an occlusal radiograph?
Q5) Determining the vertical angulation for exposure of a cross-sectional occlusal radiograph is assisted by positioning the open end of the PID parallel to the external aiming device of the image receptor holder.
A)True
B)False
Q6) Is a short or a long PID recommended for use in occlusal radiography?
Q7) Can a thyroid collar be used during the occlusal radiographic exam?
Q8) What type of image receptor holder is used for occlusal radiography?
Q9) What is the purpose of the occlusal radiographic exam?
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Chapter 18: Identifying and Correcting Undiagnostic Radiographs
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Q1) 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
Q2) Elongation error results from which of the following?
A) Excessive vertical angulation using the bisecting technique
B) Excessive vertical angulation using the paralleling technique
C) Inadequate vertical angulation using the bisecting technique
D) Inadequate vertical angulation using the paralleling technique
Q3) What produces thin black lines or smudges often in a pattern on the radiograph?
Q4) Misuse of a cotton roll to stabilize the image receptor may result in root tips being cut off from the image.
A)True
B)False
Q5) What causes an iridescent stain on the radiograph?
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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Chapter 19: Quality Control and Environmental Safety in Dental Radiography
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Q1) What does the outline of a coin on the processed film used in the coin test indicate?
Q2) Operator competency can reduce patient radiation exposure. A)True
B)False
Q3) What is the name of the device made of layered metal steps of varying thickness used to determine film density and contrast?
Q4) Each of the following statements regarding quality assurance of the automatic processor is correct EXCEPT one. Which one is the EXCEPTION?
A) Solution levels must be replenished and changed on a regular basis.
B) Maintenance procedures and tests need to be performed annually under normal conditions.
C) A failed test should prompt the operator to check the solutions, the water supply, and the film dryer.
D) The water supply must be turned on and the dryer operating correctly to produce a clear, dry film.
Q5) What is the key to peak performance of an automatic processor?
Q6) What is a reference film?
Page 21
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Chapter 20: Image Orientation and Introduction to Interpretation
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Q1) Which of the following is FALSE?
A) Under normal conditions, fixer should not cause respiratory difficulty.
B) If heated sufficiently, developer releases a gas that may cause respiratory difficulty.
C) Prolonged contact with aerosols from processing chemistry may irritate individuals with asthma.
D) If processing chemical mist or vapors are inhaled, proceed immediately to the eyewash station.
Q2) The EPA sets and enforces regulations that protect the radiographer from infection in the oral health care setting.
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) Fixer is caustic.
A)True
B)False
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Chapter 21: Recognizing Normal Radiographic Anatomy
Intraoral Radiographs
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Q1) All radiographs, whether intraoral or extraoral, should be mounted.
A)True
B)False
Q2) From the following, select the correct generalization that aids in mounting radiographs.
A) Most roots curve toward the mesial.
B) Premolars have the longest roots when compared to adjacent teeth.
C) Maxillary anterior teeth are larger than mandibular anterior teeth.
D) Maxillary molars have two roots.
Q3) After orienting the embossed dots all the same way, the next suggested step when systematically mounting dental radiographs is to:
A) separate anterior periapical radiographs from posterior periapical radiographs.
B) separate maxillary periapical radiographs from mandibular periapical radiographs.
C) separate bitewing radiographs from periapical radiographs.
D) label the film mount with the patient's name and date.
Q4) The placement of radiographs in a film holder is called ________________.
Q5) Which is the preferred method of mounting films?
Page 23
Q6) 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) Examples of anatomic landmarks that may appear on a maxillary anterior radiograph include the nasal septum, anterior nasal spine, and soft tissue shadow of the nose.
A)True
B)False
Q2) What term is applied to a large, irregularly shaped radiolucency below the mylohyoid ridge and roots of the mandibular molars?
Q3) What is the thin radiopaque border that outlines the root of the tooth called?
A) The trabeculae
B) The periodontal ligament space
C) The alveolar process
D) The lamina dura
Q4) 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.
Q5) How does the lateral fossa appear on a dental radiograph?
Q6) How does cortical bone appear on a radiograph?
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Chapter 3: Radiographic Appearance of Dental Materials and Foreign Objects
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Q1) What is the name of the process characterized by root-end resorption in which the roots of the teeth appear shorter than normal?
Q2) What is the term applied to tumors that do little or no harm?
Q3) Which of these sequences of interpreting radiographic images is recommended?
A) Examine the teeth, determine the location of the suspected caries and periodontal disease, check the condition of restorations, and identify landmarks.
B) Identify landmarks, examine the teeth, check the condition of restorations, and determine the location of the suspected caries and periodontal disease.
C) Determine the location of the suspected caries and periodontal disease, examine the teeth, identify landmarks, and check the condition of restorations.
D) Check the condition of restorations, determine the location of the suspected caries and periodontal disease, identify landmarks, and examine the teeth.
Q4) What type of resorption appears as a radiolucent widening of the root canal?
Q5) What is the term used for calcifications that may occur in the dental pulp of some teeth?
Q6) What is the most commonly encountered form of benign tumor in the arches?
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Chapter 24: The Use of Radiographs in the Detection of Dental Caries
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Q1) Which of the following conditions resembles caries on a radiograph?
A) Nonmetallic restorations
B) Cervical burnout
C) Mach band effect
D) All of the above
Q2) Radiographs are often prescribed to detect caries on which surfaces of the teeth?
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) Recurrent caries appears as a radiolucency adjacent to the restoration.
A)True
B)False
Q5) What is the name for severe, unchecked caries that affect multiple teeth?
Q6) Occlusal caries occur on the smooth surfaces of the posterior teeth.
A)True
B)False
Q8) What term is applied to caries that are no longer active? Page 26
Q7) How do caries appear radiographically compared to radiopaque enamel?
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Chapter 25: The Use of Radiographs in the Evaluation of Periodontal Diseases
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Q1) Evidence of bone loss up to 30 percent and crestal bone density that appears as a fuzzy cupping-out of the alveolar crest are radiographic signs of case type II periodontal disease.
A)True
B)False
Q2) Radiographs can distinguish treated versus untreated disease.
A)True
B)False
Q3) Radiographs can serve as a baseline and as a means for determining treatment success or failure.
A)True
B)False
Q4) Changes in soft tissue can be demonstrated radiographically.
A)True
B)False
Q5) What is triangulation?
Q6) Name three local contributing factors for the development of periodontal diseases.
Q8) Can gingivitis be detected radiographically? Page 28
Q7) Can radiographs be used to differentiate treated versus untreated disease?
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Chapter 26: Describing Radiographic Anomalies, Lesions, and Opportunistic Screening
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Q1) Modeling is a technique in which the child is given the opportunity to observe another patient undergoing a procedure.
A)True
B)False
Q2) Giving the child a job to do, such as listening for the beep sound to be sure the x-ray machine worked, will encourage the patient to be a willing participant in the process.
A)True
B)False
Q3) Each of the following should be considered when choosing the number and size of image receptors to expose on a child patient EXCEPT one. Which one is the EXCEPTION?
A) The sensitivity of the mucosa
B) The cooperation level of the child
C) The presence of the parent or caregiver
D) The size of the oral cavity
Q4) How many radiographs should be included in a full mouth survey of a child with transitional dentition?
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 allow the patient to help decide the correct position of the image receptor intraorally?
Q2) Placing table salt on the middle or tip of the patient's tongue has been shown to be effective at reducing the gag reflex.
A)True
B)False
Q3) Using a distraction technique would produce the best results of suppressing a gag reflex that originates from psychogenic stimuli.
A)True
B)False
Q4) Standard radiographic procedures can be altered for the older adult who presents with age-related change complications. Using the salutations "Honey" or "Dear" when addressing an elderly patient will assist the radiographic Process.
A) Both sentences are true.
B) Both sentences are false.
C) The first sentence is true. The second sentence is false.
D) The first sentence is false. The second sentence is true.
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Chapter 28: Radiographic Techniques for Patients With Special Needs
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Sample Questions
Q1) Which of the following results in a fuzzy duplicate radiographic image?
A) Setting the exposure timer too short
B) Setting the exposure timer too long
C) Leaving the viewbox light on when opening the box of duplicating film
D) Leaving the original radiographs in the film mount when duplicating
Q2) Disto-oblique periapical radiographs</KT> are valuable in detecting impacted third molars.
A)True
B)False
Q3) A correctly placed and angled canine periapical radiograph will often demonstrate overlapping where?
Q4) Periapical radiographs of an edentulous ridge should be exposed with the bisecting technique.
A)True B)False
Q5) Duplicating film, like radiographic film, has double-sided emulsion. A)True
B)False
Q6) Can dental radiographs be taken in edentulous areas?
Q7) What is the principle behind the tubeshift method of localization? Page 32
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Chapter 29: Radiographic Techniques for Specific Oral Conditions
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Q1) What is a lateral cephalometric radiograph?
Q2) Each of the following statements regarding extraoral film is correct EXCEPT one. Which one is the EXCEPTION?
A) It is individually packaged in the same manner as intraoral films.
B) It should not be handled with latex or vinyl treatment gloves.
C) It is more sensitive than intraoral film.
D) It is used in conjunction with a pair of intensifying screens.
Q3) 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
Q4) Latex or vinyl treatment gloves should be used to handle extraoral films. A)True
B)False
Q5) A static charge can result in a radiographic <KT>artifact</KT>.
A)True
B)False
Q6) What is the purpose of the lateral jaw radiograph?
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Chapter 30: Radiographic Techniques
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Q1) The nasopharyngeal air space is located between the tongue and the palate.
A)True
B)False
Q2) Each of the following will appear radiopaque on a panoramic radiograph EXCEPT one. Which one is the EXCEPTION?
A) The lateral pterygoid plate
B) The zygomatic process
C) The genial tubercles
D) The infraorbital foramen
Q3) Each of the following is an advantage of panoramic radiographs EXCEPT one. Which one is the EXCEPTION?
A) Panoramic radiographs are a simple procedure.
B) They are less likely to cause patient discomfort.
C) There is decreased image distortion.
D) There is a reduced radiation dose.
Q4) 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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Page 35