Radiology for Dental Auxiliaries
Test Preparation
Course Introduction
This course introduces dental auxiliaries to the fundamental principles and practices of dental radiology. Emphasis is placed on radiation physics, biology, and safety, including infection control and patient management. Students will learn to operate radiographic equipment, process digital and film images, and apply techniques for accurate intraoral and extraoral radiographic procedures. The curriculum also covers the identification of normal and abnormal radiographic anatomy, interpretation skills, and legal considerations. Practical hands-on sessions are included to ensure proficiency in producing diagnostic-quality radiographs while maintaining optimal patient care and minimizing radiation exposure.
Recommended Textbook
Essentials of Dental Radiography for Dental Assistants and Hygienists 10th Edition by Evelyn Thomson
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Chapter 1: Dental Radiography: Historical Perspective and Future Trends
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Sample Questions
Q1) Which radiograph displays the entire dentition and surrounding structures?
Answer: A panoramic radiograph displays a broad area of the mandible and maxilla on a single image receptor.
Q2) What are the two techniques for exposing intraoral dental radiographs?
Answer: The bisecting technique, the first and earliest technique, and the par</KT> technique, the </KT>technique of choice that is taught in all dental assisting, dental hygiene, and dental schools.
Q3) The most significant advancement in the early days of radiography came in 1913 when W. D. Coolidge:
A) became the first to alert the profession of the dangers of radiation exposure and advocated for the science of radiation protection.
B) exposed a prototype of a dental radiograph, setting the stage for preventive oral health care.
C) developed a variable, high kilovoltage x-ray machine compatible with the paralleling technique.
D) introduced an x-ray tube that allowed for an x-ray output that could be predetermined and accurately controlled.
Answer: D
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Chapter 2: Characteristics and Measurement of Radiation
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Q1) 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
Q2) What is the name of the process in which unstable elements undergo spontaneous decay in order to become stable?
Answer: Radioactivity. Unstable, radioactive isotopes try to regain nuclear stability through the release of energy.
Q3) When radiation has great penetrating power it is called what?
Answer: Hard radiation. Useful wavelengths in diagnostic dental radiography range from 0.1 to 0.5 Angstrom and are called "hard radiation" because they have sufficient penetrating power to expose dental radiographs.
Q4) The photoelectric effect is an all-or-nothing energy loss.
A)True
B)False
Answer: True
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4
Chapter 3: The Dental X-Ray Machine: Components and Function
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Sample Questions
Q1) A 1/10-second exposure equals how many impulses?
A) 4
B) 6
C) 10
D) 60
Answer: B
Q2) Which of these statements is FALSE?
A) The positive anode and negative cathode are sealed within the x-ray tube.
B) The control panel may be integrated with the x-ray machine tube head support.
C) The exposure button should be on the end of a 3-foot timer cord.
D) The x-ray tube contains a target capable of stopping the electrons.
Answer: C
Q3) An x-ray beam composed of many different wavelengths is called "polychromatic."
A)True
B)False
Answer: True
Q4) The intensity of the beam refers to the quantity and quality of the x-rays. A)True
B)False
Answer: True
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Chapter 4: Factors Affecting Radiographic Quality
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Q1) The target-image receptor distance should be short to create radiographs with the best definition.
A)True
B)False
Q2) Image magnification can be decreased by:
A) increasing the target-object distance.
B) increasing the object-image receptor distance.
C) decreasing the target-surface distance.
D) increasing the focal spot size.
Q3) Sharpness/definition refers to the detail and clarity of the structures on a radiograph.
A)True
B)False
Q4) The term "short-scale contrast" describes a radiograph in which density differences between adjacent areas are small.
A)True
B)False
Q5) Thicker intensifying screens increase the sharpness of extraoral radiographs.
A)True
B)False
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Chapter 5: Effects of Radiation Exposure
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Q1) At what dose of whole-body radiation would an observable short-term effect of acute radiation syndrome result?
A) 0.01 Gy
B) 0.25 Gy
C) 0.50 Gy
D) 1.0 Gy
Q2) The latent period refers to the time between exposure to radiation and the ionization of molecules.
A)True
B)False
Q3) All humans have the same sensitivity to radiation.
A)True
B)False
Q4) The lethal dose (LD 50/30) of radiation for humans is estimated to be:
A) 4,500 grays.
B) 450 grays.
C) 45 grays.
D) 4.5 grays.
Q5) What is the difference between the effects of irradiation to somatic cells compared to reproductive cells?
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Chapter 6: Radiation Protection
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Q1) The best way to reduce patient risk from radiation exposure is to keep exposures ALARA.
A)True
B)False
Q2) 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
Q3) Some dental x-ray machines appear to have a short PID when in fact the target surface distance is long. Why?
Q4) A rectangular PID requires a larger dose of radiation to produce a diagnostic-quality radiograph than a circular PID.
A)True
B)False
Q5) Absorption of the long wavelength, less penetrating x-rays of the polychromatic beam occurs by passage of the beam through a sheet of aluminum called a .
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Chapter 7: Dental X-Ray Film and Processing Methods
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Q1) What number is given to occlusal film to indicate its size?
Q2) What type of film is needed to copy a dental radiograph?
Q3) Which of the following indicates the correct placement of an intraoral film?
A) The back side faces the buccal surfaces of the teeth and away from the source of radiation.
B) The back side faces the lingual surfaces of the teeth and is facing the source of radiation.
C) The tube side faces the buccal surfaces of the teeth and faces the source of radiation.
D) The tube side faces the lingual surfaces of the teeth and faces the source of radiation.
Q4) Which of these is NOT a component of the dental x-ray film packet?
A) Black paper wrapping
B) One or two films
C) Moisture-resistant outer wrapping
D) Aluminum foil
Q5) Pedodontic films are usually size #2 films.
A)True
B)False
Q6) For what is the embossed dot in one corner of intraoral dental x-ray film used?
Page 9
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Chapter 8: Digital Radiography and Image Acquisition
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Q1) The optimum developing temperature for manual time-temperature film processing is:
A) 58 degrees F.
B) 68 degrees F.
C) 78 degrees F.
D) 88 degrees F.
Q2) Which of these is NOT part of the developer solution?
A) Reducing agent
B) Clearing agent
C) Activator
D) Restrainer
Q3) What is replenisher?
Q4) A thermometer is mandatory for archival manual processing.
A)True
B)False
Q5) The life of processing solutions can be extended by replenishment.
A)True
B)False
Q6) A wet reading can safely take place after which step of processing?
Q7) What is a safelight?
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Chapter 9: Infection Control
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Q1) How many gray levels can a computer monitor display?
A) 8
B) 32
C) 256
D) 65,500
Q2) What is the digital equivalent of film fog?
Q3) What is digital subtraction?
Q4) x and y coordinates are used by the computer to reconstruct digital data obtained by the sensor into an image that can be viewed on the computer monitor.
A)True
B)False
Q5) Most digital imaging systems cannot be used with conventional x-ray machines.
A)True
B)False
Q6) Which of these is NOT a limitation of digital imaging?
A) The need for plastic infection control barriers may hinder placement intraorally.
B) Smaller overall dimensions limit recording area.
C) The initial costs to convert from film-based imaging can be expensive.
D) Images can be manipulated.
Page 11
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Chapter 10: Legal and Ethical Responsibilities
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Q1) Barrier materials should be placed over surfaces likely to be contaminated during radiographic procedures such as the PID and tube head, control panel, exposure switch, and countertops.
A)True
B)False
Q2) Prior to film placement, preprocedural mouthrinses are considered:
A) antiseptics.
B) disinfectants.
C) sterilants.
D) sanitizers.
Q3) How can the chain of infection be broken?
Q4) What is asepsis?
Q5) Protective clothing, mask, and eyewear should be in place prior to putting on patient treatment gloves.
A)True
B)False
Q6) The lead apron should be sterilized after use.
A)True
B)False
Q7) What are infectious diseases?
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Chapter 11: Patient Relations and Education
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Q1) Each of the following statements regarding dental radiographic equipment regulations is correct EXCEPT one. Which one is the EXCEPTION?
A) Most states require registration of dental x-ray machines.
B) Inspection of dental x-ray machines is usually conducted every 2-4 years.
C) Fees are usually collected for inspection of x-ray machines.
D) The dentist can perform inspections of dental x-ray machines.
Q2) Who owns a patient's dental radiographs?
Q3) Which of the following statements is correct?
A) The Consumer-Patient Radiation Health and Safety Act was designed to protect patients from unnecessary radiation.
B) The Federal Performance Act of 1974 was designed to protect patients from unnecessary radiation.
C) The Consumer-Patient Radiation Health and Safety Act requires that all x-ray equipment manufactured or sold in the United States meet federal performance standards.
D) There are no federal laws regarding use of dental x-ray equipment.
Q4) What is the term for the legal right all patients have regarding choices about the health care they will receive?
Q5) Generally, how frequently must x-ray machines be inspected?
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Chapter 12: Introduction to Radiographic Examinations
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Q1) A patient can refuse dental radiographs and still be treated.
A)True
B)False
Q2) Which of the following best responds to this patient question: "Why do you use a lead apron when exposing my radiographs?"
A) "In case you are pregnant."
B) "To protect you from possible scatter radiation."
C) "To assist with holding you still in the chair."
D) "Because it's required by law."
Q3) Show-tell-do is a method of communication reserved for the child patient.
A)True
B)False
Q4) What is the term used to describe the conduct of the radiographer while taking radiographs on the patient?
Q5) Which of the following statements regarding dental radiography during pregnancy is correct?
A) It causes premature delivery.
B) It overexposes the area of the developing fetus.
C) It has been linked to full-term, low birth-weight infants.
D) It creates birth defects.
Page 14
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Chapter 13: The Periapical Examinationparalleling Technique
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Q1) Which of the following statements is correct?
A) Vertical angulation is usually described in millimeters.
B) Vertical angulation of the tube head and PID begins at 90 degrees.
C) To change vertical angulation, the tube head is swiveled from side to side.
D) When the open end of the PID is tilted toward the floor, the vertical angle is positive.
Q2) The correct horizontal and vertical angulations are critical to producing quality periapical radiographs.
A)True
B)False
Q3) Where should the open end of the PID be placed relative to the patient for radiographic exposures?
Q4) The word "periapical" is derived from the Greek word peri (meaning around) and the Latin word apex (meaning highest point).
A)True
B)False
Q5) What is the spot on the surface of the patient's face toward which the central ray is directed called?
Page 15
Q6) Have film holders always been used in dental radiography?
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Chapter 14: The Periapical Examinationbisecting Technique
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Q1) What is the ideal design of a paralleling image receptor holder?
A) A short bite block and an L-shaped backing
B) A long bite block and an L-shaped backing
C) A short bite block and a 105-degree backing
D) A long bite block and a 105-degree backing
Q2) When using the paralleling technique, the patient must bite down on the image receptor holder bite block as far away from the teeth as possible with the exception of which area?
A) Maxillary anteriors
B) Mandibular canines
C) Maxillary premolars
D) Mandibular molars
Q3) What is the ideal target-image receptor distance used with the paralleling technique?
A) 8 inches (20.5 cm)
B) 12 inches (30 cm)
C) 16 inches (41 cm)
Q4) What are three image receptor holders designed for use with the paralleling technique?
Q5) Incorrectly aligning the point of entry will result in what type of error?
Page 16
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Chapter 15: The Bitewing Examination
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Q1) Careful attention to the steps of the bisecting technique can produce acceptable radiographs.
A)True
B)False
Q2) A longer 12-inch or 16-inch PID is better suited to the bisecting technique.
A)True
B)False
Q3) Name an image receptor holder that may be used with both the paralleling and the bisecting techniques.
Q4) Which of the following will correct a foreshortened image?
A) Increasing the vertical angulation
B) Decreasing the vertical angulation
C) Directing the central ray perpendicular to the plane of the image receptor
D) Directing the central ray perpendicular to the long axis of the tooth
Q5) Which of the following will correct an elongated image?
A) Increasing the vertical angulation
B) Decreasing the vertical angulation
C) Directing the central ray perpendicular to the plane of the image receptor
D) Directing the central ray perpendicular to the long axis of the tooth
Q6) Explain how the bisecting technique relates to the rule of isometry.
Page 17
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Chapter 16: The Occlusal Examination
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Q1) Each of the following statements regarding horizontal angulation is correct EXCEPT one. Which one is the EXCEPTION?
A) Contact points should appear open or separate from each other on the radiograph.
B) The central ray should be directed parallel to the curvature of the arch.
C) Overlapped contact points result when incorrect horizontal angulation is used.
D) Horizontal angulation is the positioning of the central ray in a side-to-side plane.
Q2) Traditionally, the image receptor for a bitewing radiograph has been placed with the longer dimension vertically in the posterior region.
A)True
B)False
Q3) Bitewing radiographs are especially useful in detecting caries on which of the following tooth surfaces?
A) Mesial
B) Occlusal
C) Facial
D) Lingual
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18
Chapter 17: The Panoramic Examination
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Q1) The occlusal examination may be made alone or to supplement periapical or bitewing radiographs.
A)True
B)False
Q2) Topographical occlusal radiographs of the mandible may be taken with the head positioned the same as for maxillary topographical occlusal radiographs.
A)True
B)False
Q3) Which of the following statements is correct?
A) Topographical occlusal radiographs yield a greater amount of information in the alveolar crest and apical areas than periapical radiographs.
B) Topographical occlusal radiographs may be exposed only on the maxillary arch.
C) Cross-sectional occlusal radiographs work best to image the maxilla.
D) Topographical occlusal radiographs cannot be used on children.
Q4) Topographical radiographs of the mandible are ideal at detecting the presence of salivary stones (sialoliths) in the ducts of the sublingual and submandibular glands.
A)True
B)False
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Page 19
Chapter 18: Identifying and Correcting Undiagnostic
Radiographs
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Q1) A distomesial projection of the x-ray beam results in more severe overlapping in the posterior region of the radiograph.
A)True
B)False
Q2) Can fluorescent watch faces and dials fog film?
Q3) A scratched safelight filter or incorrect bulb wattage can result in film fog.
A)True
B)False
Q4) 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
Q5) Electronic noise is the digital equivalent of film fog.
A)True
B)False
Q6) Dark spots on the film are caused by premature contact with the developer.
A)True
B)False
Q7) Does radiographic film have an expiration date? Page 20
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Page 21
Chapter 19: Quality Control and Environmental Safety in Dental Radiography
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Q1) Extraoral film cassettes do not require quality control tests.
A)True
B)False
Q2) The darkroom should be evaluated to be sure it is free from chemical fumes.
A)True
B)False
Q3) What is quality assurance in dental radiography?
Q4) Dental x-ray machine output analysis should be performed annually.
A)True
B)False
Q5) Which of the following statements regarding dental x-ray machine output consistency testing is correct?
A) It should be performed by a qualified expert only.
B) Multiple images that are identical in density and contrast indicate a failed test.
C) Each test film should be processed immediately after exposure.
D) It uses a step wedge.
Q6) Which processing solution is most critical and demands careful attention?
Q7) What is a reference film?
Q8) In the coin test, how long is a coin placed on top of the unwrapped film? Page 22
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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) A manufacturer of a developer chemical may not have to disclose a trade secret ingredient, except in an emergency.
A)True
B)False
Q3) The radiographer should not handle the lead foils from film packets unless the hands are protected with gloves.
A)True
B)False
Q4) 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) With the labial 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
Q2) Radiographs may be best interpreted by holding the film up to the overhead room light.
A)True
B)False
Q3) 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
Q4) What part of an intraoral film distinguishes the patient's right and left sides?
Q5) Who is responsible for interpreting a patient's radiographs?
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Chapter 22: Recognizing Normal Radiographic Anatomy
Panoramic Radiographs
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Q1) Structures that are dense and absorb or resist the passage of x-rays will appear dark or black on the radiograph.
A)True
B)False
Q2) 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.
Q3) The nasal septum appears as a radiopaque "V"-shaped projection from the floor of the nasal fossa in the midline.
A)True
B)False
Q4) 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
Q5) How does the lateral fossa appear on a dental radiograph?
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Chapter 3: Radiographic Appearance of Dental Materials and Foreign Objects
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Q1) Which of the following restorative crown types appears the least radiopaque?
A) Porcelain fused to metal
B) Full metal
C) Stainless steel
D) Porcelain
Q2) 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
Q3) A taurodont tooth is a single tooth bud that divides and forms two teeth.
A)True
B)False
Q4) What is the term used for a region of abnormally dense bone, which, as a result of infection, has not developed?
Q5) What is the name of the process characterized by root-end resorption in which the roots of the teeth appear shorter than normal?
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Q6) What is the most commonly encountered form of benign tumor in the arches?
Chapter 24: The Use of Radiographs in the Detection of Dental Caries
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Q1) The caries process demineralizes tooth structures, allowing _____ x-rays to pass through the tooth and _______ the image receptor.
A) more, lighten
B) more, darken
C) less, lighten
D) less, darken
Q2) Root caries develops between the enamel border and free gingival margin on the cemental surface of the tooth.
A)True
B)False
Q3) The high contrast between normal enamel and overlapped enamel can produce an optical illusion called "cervical burnout."
A)True
B)False
Q4) What is the name of the optical illusion that describes the increased darkness near the neck of the teeth proximally on radiographs?
Q5) According to the grading system suggested by Haugejorden and Slack (1977), what is the most extensive class of proximal decay?
Page 28
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Chapter 25: The Use of Radiographs in the Evaluation of
Periodontal Diseases
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Q1) Radiographs can distinguish treated versus untreated disease.
A)True
B)False
Q2) Each of the following is a use of radiographs in the assessment of periodontal disease prognosis EXCEPT one. Which one is the EXCEPTION?
A) Evaluating root-to-crown ratio
B) Detecting furcation involvement
C) Determining active versus inactive disease
D) Revealing root shape and length
Q3) Widening of the periodontal ligament space at the crest of the interproximal bone is called:
A) triangulation.
B) furcation involvement.
C) horizontal bone loss.
D) a local contributing factor.
Q4) Radiographs may assist in making the diagnosis of gingivitis.
A)True
B)False
Page 29
Q5) Can radiographs reveal the effects of traumatic occlusion on the periodontium?
Q6) 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) 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
Q2) Children have the same basic needs for oral health care as do adults.
A)True
B)False
Q3) The radiographer must be able to communicate and explain the procedure so that the child understands what is expected.
A)True
B)False
Q4) The full mouth survey recommended for the child patient between the ages of 12 and 14 is the same as for adult patients.
A)True
B)False
Q5) How many radiographs should be included in a full mouth survey of a child with transitional dentition?
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Chapter 27: Pediatric Radiographic Techniques
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Q1) 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
Q2) The radiographer may better assist the patient with a disability by asking personal questions regarding the nature and cause of the impairment.
A)True
B)False
Q3) 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.
Q4) Should the radiographer allow the patient to help decide the correct position of the image receptor intraorally?
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Chapter 28: Radiographic Techniques for Patients With Special Needs
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Sample Questions
Q1) Bony outgrowths on the palate and lingual surfaces of the mandible are called "nodules."
A)True
B)False
Q2) 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
Q3) Periapical radiographs of an edentulous ridge should be exposed with the bisecting technique.
A)True
B)False
Q4) For a mandibular molar disto-oblique radiograph, the horizontal angulation is shifted so that the x-ray beam intersects the image receptor obliquely:
A) 5 degrees from the mesial.
B) 10 degrees from the mesial.
C) 5 degrees from the distal.
D) 10 degrees from the distal.
33
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Chapter 29: Radiographic Techniques for Specific Oral Conditions
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Sample Questions
Q1) Of what is a grid used in extraoral radiographic techniques composed?
Q2) Which of the following determines the exposure factors for extraoral techniques?
A) Intensifying screen-film combination
B) The patient's size and tissue density
C) Target-film distance
D) All of the above
Q3) Which of these extraoral radiographs is most often used to examine the sinuses?
A) Waters
B) Reverse Towne
C) Submentovertex
D) Lateral cephalometric
Q4) Extraoral film should be loaded in the cassette just prior to use.
A)True
B)False
Q5) Which of the following is the device that transfers x?ray energy into visible light?
A) The grid
B) The cassette
C) The cephalostat
D) The intensifying screen
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Chapter 30: Radiographic Techniques
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Sample Questions
Q1) 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?
Q2) Careful loading of a flexible plastic sleeve cassette must ensure that the film is completely seated within the intensifying screens.
A)True
B)False
Q3) The nasopharyngeal air space is located between the tongue and the palate.
A)True
B)False
Q4) Which of the following facial landmark planes must be positioned slightly (5) down toward the floor when positioning the arches within the focal trough?
A) Frankfort
B) Ala-tragus
C) Midsagittal
D) Occlusal
Q5) What happens to the radiographic image if intensifying screens and film are not in tight contact?
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