CALIFORNIA RDHAP ORAL HEALTH ASSESSMENT
CERTIFICATION TEST
Q&A
2024
1. A 65-year-old male patient presents with a history of hypertension, diabetes and smoking.
He has not visited a dentist for over 10 years and complains of bleeding gums and loose teeth.
You perform an oral health assessment and find generalized severe chronic periodontitis with
probing depths of 6-8 mm, bleeding on probing, calculus deposits, tooth mobility and
furcation involvement. What is the most appropriate initial treatment plan for this patient?
a) Scaling and root planing, oral hygiene instruction, smoking cessation counseling and
referral to a periodontist.
b) Extraction of all teeth, denture fabrication and referral to a physician for medical
management.
c) Fluoride varnish application, oral hygiene instruction, smoking cessation counseling and
referral to a dentist for restorative treatment.
d) Scaling and root planing, oral hygiene instruction, smoking cessation counseling and
antibiotic therapy.
*Answer: a) Scaling and root planing, oral hygiene instruction, smoking cessation counseling
and referral to a periodontist.*
Rationale: This is the most appropriate initial treatment plan for a patient with severe chronic
periodontitis, as it aims to reduce the inflammation, infection and risk factors, and to consult
with a specialist for further evaluation and management.
2. A 25-year-old female patient presents with a history of bulimia nervosa and frequent
vomiting episodes. She has not visited a dentist for over 5 years and complains of tooth
sensitivity and enamel erosion. You perform an oral health assessment and find generalized
moderate erosion of the enamel on the palatal surfaces of the maxillary teeth and the occlusal
surfaces of the mandibular teeth. The teeth also show signs of attrition and abrasion. What is
the most appropriate initial treatment plan for this patient?
a) Fluoride varnish application, oral hygiene instruction, dietary counseling and referral to a
dentist for restorative treatment.
b) Scaling and root planing, oral hygiene instruction, dietary counseling and referral to a
psychologist for behavioral therapy.
,c) Extraction of all teeth, denture fabrication and referral to a physician for medical
management.
d) Fluoride varnish application, oral hygiene instruction, dietary counseling and referral to a
psychologist for behavioral therapy.
*Answer: d) Fluoride varnish application, oral hygiene instruction, dietary counseling and
referral to a psychologist for behavioral therapy.*
Rationale: This is the most appropriate initial treatment plan for a patient with bulimia
nervosa and enamel erosion, as it aims to reduce the sensitivity, prevent further damage,
address the underlying cause and consult with a mental health professional for support.
3. A 35-year-old male patient presents with a history of HIV infection and antiretroviral
therapy. He has not visited a dentist for over 3 years and complains of oral ulcers and pain.
You perform an oral health assessment and find multiple shallow ulcers with erythematous
borders on the buccal mucosa, tongue and palate. You also notice white patches on the lateral
borders of the tongue that cannot be scraped off. What is the most likely diagnosis for this
patient?
a) Aphthous stomatitis
b) Oral candidiasis
c) Oral herpes simplex
d) Oral hairy leukoplakia
*Answer: d) Oral hairy leukoplakia*
Rationale: This is the most likely diagnosis for a patient with HIV infection and antiretroviral
therapy who presents with multiple ulcers and white patches on the tongue that cannot be
scraped off. Oral hairy leukoplakia is caused by Epstein-Barr virus infection and is associated
with immunosuppression.
4. A 45-year-old female patient presents with a history of rheumatoid arthritis and
corticosteroid therapy. She has not visited a dentist for over 2 years and complains of dry
mouth and difficulty swallowing. You perform an oral health assessment and find reduced
salivary flow, fissured tongue, angular cheilitis, dental caries and candidiasis. What is the
most likely diagnosis for this patient?
a) Sjögren's syndrome
b) Xerostomia
c) Burning mouth syndrome
d) Lichen planus
*Answer: b) Xerostomia*
Rationale: This is the most likely diagnosis for a patient with rheumatoid arthritis and
corticosteroid therapy who presents with dry mouth and difficulty swallowing. Xerostomia is
the subjective sensation of dry mouth due to reduced salivary flow or altered salivary
composition. It can be caused by various factors such as medications, systemic diseases or
radiation therapy.
, 5. A 55-year-old male patient presents with a history of alcohol abuse and tobacco use. He has
not visited a dentist for over 15 years and complains of a non-healing sore on his lower lip.
You perform an oral health assessment and find a 1-cm ulcerated lesion with raised and
indurated borders on the vermilion border of the lower lip. The lesion is tender to touch and
bleeds easily. What is the most likely diagnosis for this patient?
a) Actinic cheilitis
b) Squamous cell carcinoma
c) Mucocele
d) Herpes labialis
*Answer: b) Squamous cell carcinoma*
Rationale: This is the most likely diagnosis for a patient with alcohol abuse and tobacco use
who presents with a non-healing sore on his lower lip. Squamous cell carcinoma is the most
common type of oral cancer and it often affects the lower lip. It is associated with risk factors
such as chronic sun exposure, alcohol abuse and tobacco use.
6. A 65-year-old female patient presents with a history of osteoporosis and bisphosphonate
therapy. She has not visited a dentist for over 6 months and complains of jaw pain and
swelling. You perform an oral health assessment and find exposed necrotic bone in the
mandibular posterior region, with signs of infection and inflammation. The patient also
reports a history of tooth extraction in that area 3 months ago. What is the most likely
diagnosis for this patient?
a) Osteomyelitis
b) Osteonecrosis of the jaw
c) Osteoradionecrosis
d) Osteogenesis imperfecta
*Answer: b) Osteonecrosis of the jaw*
Rationale: This is the most likely diagnosis for a patient with osteoporosis and bisphosphonate
therapy who presents with jaw pain and swelling. Osteonecrosis of the jaw is a rare but
serious complication of bisphosphonate therapy, which inhibits bone resorption and
remodeling. It is characterized by exposed necrotic bone in the jaw that fails to heal after
minor trauma or surgery.
7. A 75-year-old male patient presents with a history of Parkinson's disease and levodopa
therapy. He has not visited a dentist for over 4 years and complains of difficulty chewing and
speaking. You perform an oral health assessment and find bradykinesia, rigidity, tremors,
drooling, dysphagia, dysarthria, dental caries, periodontal disease and denture problems. What
are some of the oral health implications of Parkinson's disease for this patient?
a) Reduced salivary flow, increased plaque accumulation, increased risk of aspiration
pneumonia and malnutrition.
b) Increased salivary flow, decreased plaque accumulation, decreased risk of aspiration
CERTIFICATION TEST
Q&A
2024
1. A 65-year-old male patient presents with a history of hypertension, diabetes and smoking.
He has not visited a dentist for over 10 years and complains of bleeding gums and loose teeth.
You perform an oral health assessment and find generalized severe chronic periodontitis with
probing depths of 6-8 mm, bleeding on probing, calculus deposits, tooth mobility and
furcation involvement. What is the most appropriate initial treatment plan for this patient?
a) Scaling and root planing, oral hygiene instruction, smoking cessation counseling and
referral to a periodontist.
b) Extraction of all teeth, denture fabrication and referral to a physician for medical
management.
c) Fluoride varnish application, oral hygiene instruction, smoking cessation counseling and
referral to a dentist for restorative treatment.
d) Scaling and root planing, oral hygiene instruction, smoking cessation counseling and
antibiotic therapy.
*Answer: a) Scaling and root planing, oral hygiene instruction, smoking cessation counseling
and referral to a periodontist.*
Rationale: This is the most appropriate initial treatment plan for a patient with severe chronic
periodontitis, as it aims to reduce the inflammation, infection and risk factors, and to consult
with a specialist for further evaluation and management.
2. A 25-year-old female patient presents with a history of bulimia nervosa and frequent
vomiting episodes. She has not visited a dentist for over 5 years and complains of tooth
sensitivity and enamel erosion. You perform an oral health assessment and find generalized
moderate erosion of the enamel on the palatal surfaces of the maxillary teeth and the occlusal
surfaces of the mandibular teeth. The teeth also show signs of attrition and abrasion. What is
the most appropriate initial treatment plan for this patient?
a) Fluoride varnish application, oral hygiene instruction, dietary counseling and referral to a
dentist for restorative treatment.
b) Scaling and root planing, oral hygiene instruction, dietary counseling and referral to a
psychologist for behavioral therapy.
,c) Extraction of all teeth, denture fabrication and referral to a physician for medical
management.
d) Fluoride varnish application, oral hygiene instruction, dietary counseling and referral to a
psychologist for behavioral therapy.
*Answer: d) Fluoride varnish application, oral hygiene instruction, dietary counseling and
referral to a psychologist for behavioral therapy.*
Rationale: This is the most appropriate initial treatment plan for a patient with bulimia
nervosa and enamel erosion, as it aims to reduce the sensitivity, prevent further damage,
address the underlying cause and consult with a mental health professional for support.
3. A 35-year-old male patient presents with a history of HIV infection and antiretroviral
therapy. He has not visited a dentist for over 3 years and complains of oral ulcers and pain.
You perform an oral health assessment and find multiple shallow ulcers with erythematous
borders on the buccal mucosa, tongue and palate. You also notice white patches on the lateral
borders of the tongue that cannot be scraped off. What is the most likely diagnosis for this
patient?
a) Aphthous stomatitis
b) Oral candidiasis
c) Oral herpes simplex
d) Oral hairy leukoplakia
*Answer: d) Oral hairy leukoplakia*
Rationale: This is the most likely diagnosis for a patient with HIV infection and antiretroviral
therapy who presents with multiple ulcers and white patches on the tongue that cannot be
scraped off. Oral hairy leukoplakia is caused by Epstein-Barr virus infection and is associated
with immunosuppression.
4. A 45-year-old female patient presents with a history of rheumatoid arthritis and
corticosteroid therapy. She has not visited a dentist for over 2 years and complains of dry
mouth and difficulty swallowing. You perform an oral health assessment and find reduced
salivary flow, fissured tongue, angular cheilitis, dental caries and candidiasis. What is the
most likely diagnosis for this patient?
a) Sjögren's syndrome
b) Xerostomia
c) Burning mouth syndrome
d) Lichen planus
*Answer: b) Xerostomia*
Rationale: This is the most likely diagnosis for a patient with rheumatoid arthritis and
corticosteroid therapy who presents with dry mouth and difficulty swallowing. Xerostomia is
the subjective sensation of dry mouth due to reduced salivary flow or altered salivary
composition. It can be caused by various factors such as medications, systemic diseases or
radiation therapy.
, 5. A 55-year-old male patient presents with a history of alcohol abuse and tobacco use. He has
not visited a dentist for over 15 years and complains of a non-healing sore on his lower lip.
You perform an oral health assessment and find a 1-cm ulcerated lesion with raised and
indurated borders on the vermilion border of the lower lip. The lesion is tender to touch and
bleeds easily. What is the most likely diagnosis for this patient?
a) Actinic cheilitis
b) Squamous cell carcinoma
c) Mucocele
d) Herpes labialis
*Answer: b) Squamous cell carcinoma*
Rationale: This is the most likely diagnosis for a patient with alcohol abuse and tobacco use
who presents with a non-healing sore on his lower lip. Squamous cell carcinoma is the most
common type of oral cancer and it often affects the lower lip. It is associated with risk factors
such as chronic sun exposure, alcohol abuse and tobacco use.
6. A 65-year-old female patient presents with a history of osteoporosis and bisphosphonate
therapy. She has not visited a dentist for over 6 months and complains of jaw pain and
swelling. You perform an oral health assessment and find exposed necrotic bone in the
mandibular posterior region, with signs of infection and inflammation. The patient also
reports a history of tooth extraction in that area 3 months ago. What is the most likely
diagnosis for this patient?
a) Osteomyelitis
b) Osteonecrosis of the jaw
c) Osteoradionecrosis
d) Osteogenesis imperfecta
*Answer: b) Osteonecrosis of the jaw*
Rationale: This is the most likely diagnosis for a patient with osteoporosis and bisphosphonate
therapy who presents with jaw pain and swelling. Osteonecrosis of the jaw is a rare but
serious complication of bisphosphonate therapy, which inhibits bone resorption and
remodeling. It is characterized by exposed necrotic bone in the jaw that fails to heal after
minor trauma or surgery.
7. A 75-year-old male patient presents with a history of Parkinson's disease and levodopa
therapy. He has not visited a dentist for over 4 years and complains of difficulty chewing and
speaking. You perform an oral health assessment and find bradykinesia, rigidity, tremors,
drooling, dysphagia, dysarthria, dental caries, periodontal disease and denture problems. What
are some of the oral health implications of Parkinson's disease for this patient?
a) Reduced salivary flow, increased plaque accumulation, increased risk of aspiration
pneumonia and malnutrition.
b) Increased salivary flow, decreased plaque accumulation, decreased risk of aspiration
