AAPD Oral Board Exam Questions
With Complete Solutions
Course
AAPD
1. Caries Risk Assessment in a High-Risk Child
Question:
A 6-year-old presents with multiple interproximal caries and poor oral hygiene. How do you
assess and manage?
Answer:
Start with caries risk assessment (CRA):
Disease indicators: existing caries → already high risk
Risk factors: diet (frequent sugars), poor hygiene, low fluoride exposure
Protective factors: fluoride use, dental visits
Management:
Short recall (3 months)
Fluoride varnish application
Dietary counseling (eliminate frequent sugar exposure)
Sealants on permanent molars
Restore active lesions minimally invasively (e.g., GIC for interim)
If you miss risk-based planning, you fail this case. Treatment alone isn’t enough.
2. Behavior Management – Uncooperative Child
Question:
A 4-year-old refuses treatment and is crying uncontrollably. What is your approach?
Answer:
Stepwise escalation:
1. Tell-Show-Do (basic)
2. Positive reinforcement
3. Voice control (controlled, not aggressive)
, 4. Distraction
If failure persists:
Consider protective stabilization (only if necessary and consented)
Evaluate for pharmacologic management (nitrous oxide or GA)
Key point: You justify escalation, not jump straight to sedation.
3. Pulp Therapy Decision
Question:
A primary molar has deep caries with no swelling but history of spontaneous pain. Treatment?
Answer:
Spontaneous pain = irreversible pulpitis
Management:
Pulpectomy if tooth is restorable
Extraction if non-restorable or near exfoliation
Do NOT do pulpotomy—wrong diagnosis leads to failure.
4. Trauma – Avulsed Permanent Tooth
Question:
An 8-year-old presents with an avulsed permanent incisor after 1 hour dry time. What do you do?
Answer:
Rinse tooth (no scrubbing)
Replant immediately
Flexible splint (2 weeks)
Systemic antibiotics
Check tetanus status
But here’s the reality: 1-hour dry time = poor prognosis → expect ankylosis
You still replant for esthetics and bone preservation.
,5. Space Maintenance
Question:
A 7-year-old loses a primary second molar early. Management?
Answer:
Use band and loop if first permanent molar erupted
If not erupted → distal shoe appliance
Miss timing → you create malocclusion.
6. Fluoride Toxicity
Question:
Child ingests a large amount of toothpaste. What do you do?
Answer:
Estimate fluoride dose (mg/kg)
If mild: give milk (binds fluoride)
If severe: emergency referral
Toxic dose threshold ≈ 5 mg/kg
Do not ignore—fluoride toxicity can be fatal.
7. Early Childhood Caries (ECC)
Question:
How do you manage severe ECC in a 3-year-old?
Answer:
Full-mouth rehab (often under GA)
Stainless steel crowns for posterior teeth
Anterior restorations or extractions
Parental counseling (bottle habits, sugars)
Fluoride varnish + recall
If you don’t address the cause (feeding habits), relapse is guaranteed.
, 8. Sedation Case Selection
Question:
Which patient is NOT a candidate for moderate sedation?
Answer:
Contraindications include:
ASA III or higher without medical consult
Airway obstruction risk (e.g., severe tonsillar hypertrophy)
Very young/uncooperative without proper setup
Sedation is not a shortcut for poor behavior management.
9. Dental Infection Management
Question:
Child presents with facial swelling from a dental abscess. What is your management?
Answer:
Establish drainage (definitive treatment: extraction or pulpectomy)
Antibiotics only if systemic involvement (fever, cellulitis)
Antibiotics alone = wrong. Source control is mandatory.
10. Sealant vs Preventive Resin Restoration (PRR)
Question:
When do you choose PRR over sealant?
Answer:
PRR when there is incipient caries into dentin
Sealant when fissures are deep but non-carious
PRR = minimal caries removal + sealant
If you seal over dentin caries blindly, expect failure.
With Complete Solutions
Course
AAPD
1. Caries Risk Assessment in a High-Risk Child
Question:
A 6-year-old presents with multiple interproximal caries and poor oral hygiene. How do you
assess and manage?
Answer:
Start with caries risk assessment (CRA):
Disease indicators: existing caries → already high risk
Risk factors: diet (frequent sugars), poor hygiene, low fluoride exposure
Protective factors: fluoride use, dental visits
Management:
Short recall (3 months)
Fluoride varnish application
Dietary counseling (eliminate frequent sugar exposure)
Sealants on permanent molars
Restore active lesions minimally invasively (e.g., GIC for interim)
If you miss risk-based planning, you fail this case. Treatment alone isn’t enough.
2. Behavior Management – Uncooperative Child
Question:
A 4-year-old refuses treatment and is crying uncontrollably. What is your approach?
Answer:
Stepwise escalation:
1. Tell-Show-Do (basic)
2. Positive reinforcement
3. Voice control (controlled, not aggressive)
, 4. Distraction
If failure persists:
Consider protective stabilization (only if necessary and consented)
Evaluate for pharmacologic management (nitrous oxide or GA)
Key point: You justify escalation, not jump straight to sedation.
3. Pulp Therapy Decision
Question:
A primary molar has deep caries with no swelling but history of spontaneous pain. Treatment?
Answer:
Spontaneous pain = irreversible pulpitis
Management:
Pulpectomy if tooth is restorable
Extraction if non-restorable or near exfoliation
Do NOT do pulpotomy—wrong diagnosis leads to failure.
4. Trauma – Avulsed Permanent Tooth
Question:
An 8-year-old presents with an avulsed permanent incisor after 1 hour dry time. What do you do?
Answer:
Rinse tooth (no scrubbing)
Replant immediately
Flexible splint (2 weeks)
Systemic antibiotics
Check tetanus status
But here’s the reality: 1-hour dry time = poor prognosis → expect ankylosis
You still replant for esthetics and bone preservation.
,5. Space Maintenance
Question:
A 7-year-old loses a primary second molar early. Management?
Answer:
Use band and loop if first permanent molar erupted
If not erupted → distal shoe appliance
Miss timing → you create malocclusion.
6. Fluoride Toxicity
Question:
Child ingests a large amount of toothpaste. What do you do?
Answer:
Estimate fluoride dose (mg/kg)
If mild: give milk (binds fluoride)
If severe: emergency referral
Toxic dose threshold ≈ 5 mg/kg
Do not ignore—fluoride toxicity can be fatal.
7. Early Childhood Caries (ECC)
Question:
How do you manage severe ECC in a 3-year-old?
Answer:
Full-mouth rehab (often under GA)
Stainless steel crowns for posterior teeth
Anterior restorations or extractions
Parental counseling (bottle habits, sugars)
Fluoride varnish + recall
If you don’t address the cause (feeding habits), relapse is guaranteed.
, 8. Sedation Case Selection
Question:
Which patient is NOT a candidate for moderate sedation?
Answer:
Contraindications include:
ASA III or higher without medical consult
Airway obstruction risk (e.g., severe tonsillar hypertrophy)
Very young/uncooperative without proper setup
Sedation is not a shortcut for poor behavior management.
9. Dental Infection Management
Question:
Child presents with facial swelling from a dental abscess. What is your management?
Answer:
Establish drainage (definitive treatment: extraction or pulpectomy)
Antibiotics only if systemic involvement (fever, cellulitis)
Antibiotics alone = wrong. Source control is mandatory.
10. Sealant vs Preventive Resin Restoration (PRR)
Question:
When do you choose PRR over sealant?
Answer:
PRR when there is incipient caries into dentin
Sealant when fissures are deep but non-carious
PRR = minimal caries removal + sealant
If you seal over dentin caries blindly, expect failure.
