Free practice quiz
NBDHE Prep Course (NBDHE): free quiz
10 questions from the program. See your score right away, then unlock the explanation of every answer.
- Question 1 of 10
A hygienist is charting a 14-year-old with newly erupted permanent mandibular first molars. On tooth #19, plaque retention is greatest in the linear depression on the facial surface that separates the mesiobuccal and distobuccal cusps. Before instrumentation, which documentation is most accurate within the dental hygiene assessment?
A is correct: mandibular molars commonly have a buccal developmental groove separating buccal cusps, a plaque-retentive morphology relevant to charting and instrumentation. D is tempting, but a transverse ridge crosses the occlusal table and is more characteristic of premolars. C describes periodontal attachment loss in a root furcation, not a crown groove. B may be a dentist’s role if caries is diagnosed, but the hygienist should not recommend restoration from morphology alone.
Assess the landmark, intervene with appropriate biofilm removal and instruction, refer suspicious caries or defects to the dentist, and document the finding accurately. - Question 2 of 10
A 24-year-old patient presents for recare with generalized marginal redness, bleeding on probing, 2–3 mm probing depths, no clinical attachment loss, and heavy supragingival plaque near the gingival margin. The patient asks why the tissue is inflamed if there is no “deep infection.” As the dental hygienist, which care action best addresses the biofilm ecology driving this condition?
B is tempting because antibiotics affect bacteria, but gingivitis biofilm is primarily managed by mechanical disruption; prescribing is outside routine hygienist authority. A is correct: supragingival biofilm maturation shifts the local ecology toward inflammation, and daily plaque control plus professional disruption can reverse gingivitis. D is a dentist/periodontist surgical action and is not indicated without attachment loss or deeper periodontal findings. C supports caries prevention but does not address the main inflammatory biofilm cause. Assess plaque and bleeding patterns, intervene with biofilm removal and coaching, refer if periodontal destruction or pathology is suspected, and document findings and education.
- Question 3 of 10
A 22-year-old patient reports sipping sports drinks throughout the day. Assessment shows heavy plaque near the gingival margins and a noncavitated, chalky white lesion on the facial surface of tooth #8. Probing depths are 1–3 mm, and the patient has normal salivary flow. Within dental hygiene scope, which action best addresses the caries process at this visit?
D is dentist-centered and overtreats a potentially remineralizable noncavitated lesion. A misses early intervention; radiographs may not show early enamel demineralization. C is best: frequent sugar/acid exposure and plaque are risk indicators, while the chalky white area is an early disease sign; fluoride, biofilm control, diet counseling, documentation, and reevaluation support remineralization. A is not first-line and implies medication management beyond routine dental hygiene prevention.
ASSESS lesion activity and caries risk; INTERVENE with fluoride, plaque control, and diet counseling; REFER/consult for cavitation or restorative needs; DOCUMENT findings, education, preventive agents, and follow-up. - Question 4 of 10
A 62-year-old patient arrives for periodontal maintenance. During the medical history update, the patient reports chest pressure at rest yesterday that required nitroglycerin and was accompanied by shortness of breath. The patient has not contacted a physician. Vital signs today are BP 158/92 mm Hg and pulse 96 bpm. What is the most appropriate dental hygiene action?
A is correct: recent chest pressure at rest with dyspnea suggests unstable cardiac status, so elective care should be deferred and medical evaluation obtained. B is unsafe because absence of current pain does not make yesterday’s unstable symptoms controlled. C is tempting, but prophylactic nitroglycerin does not clear an unstable history for routine care. D recognizes referral, but prescribing antianginal drugs is a physician-level decision, not a dentist or hygienist role. ASSESS symptoms and vitals; INTERVENE by deferring elective care; REFER for medical evaluation; DOCUMENT findings, consultation, and disposition.
- Question 5 of 10
A 58-year-old patient presents for periodontal maintenance. After 5 minutes seated, the dental hygienist records BP 188/112 mm Hg, pulse 96/min, respirations 18/min. The patient denies chest pain, dyspnea, headache, or neurologic symptoms and says morning antihypertensive medication was missed. A repeat reading is 186/110 mm Hg. What is the best dental hygiene action?
BP above 180 systolic or 110 diastolic, confirmed after rest, requires postponing elective dental hygiene care and medical referral even without symptoms. D is unsafe because absence of symptoms does not make severe hypertension acceptable for routine instrumentation. A is tempting for emergencies, but oxygen is not indicated without respiratory distress or other emergency signs, and care should not continue. B is correct: reassess, defer, notify the dentist, refer for medical evaluation, and document. C is wrong provider/scope: medication management is medical/dentist-directed when legally appropriate, not a dental hygiene decision to enable elective care.
- Question 6 of 10
A 57-year-old patient who uses smokeless tobacco reports a sore spot on the right lateral tongue present for 3 weeks. Intraoral examination reveals a 1.2 cm non-wipeable red-and-white patch with slight induration. The patient has no fever and is scheduled for periodontal maintenance today. What is the most appropriate dental hygiene action?
C is best: a persistent, indurated, non-wipeable red-white lateral tongue lesion in a tobacco user is suspicious and requires documentation and prompt dentist/oral pathology evaluation. B delays referral and assumes candidiasis. A treats periodontal needs but does not address possible pathology. D may be needed, but biopsy/diagnosis is performed by an authorized dentist or specialist, not the entry-level hygienist.
ASSESS lesion features; INTERVENE by communicating concern; REFER to dentist/oral pathology; DOCUMENT location, size, color, duration, and actions. - Question 7 of 10
A 24-year-old patient presents for a routine dental hygiene visit. Assessment findings include firm, coral-pink gingiva with stippling, scalloped knife-edged margins, probing depths of 1–3 mm, no bleeding on probing, and radiographic crestal bone about 1–2 mm apical to the CEJ. The patient reports no medical concerns. Which action is most appropriate for the dental hygienist?
A is correct: firm coral-pink gingiva, 1–3 mm probing depths, no bleeding, and crestal bone near the CEJ are consistent with periodontal health and should be documented as a baseline. C is incorrect because periodontitis requires clinical attachment loss or other disease indicators; nonsurgical periodontal therapy is not indicated. D is tempting as a surgical action, but gingivectomy is dentist/periodontist-directed and scalloped margins are normal. B is incorrect because antibiotics are not used for routine healthy periodontal care. Assess normal findings, intervene with prevention, refer only for abnormal findings, and document baseline measurements.
- Question 8 of 10
During periodontal charting, a 29-year-old patient has inflamed gingiva around the mandibular anterior teeth. On tooth 24 facial, the probing depth is 5 mm, and the gingival margin is 5 mm coronal to the CEJ. Radiographs show no crestal bone loss. Which interpretation and dental hygiene action is most appropriate?
CAL is calculated from the CEJ to the base of the sulcus or pocket. When the gingival margin is coronal to the CEJ, subtract that coronal tissue height from probing depth: 5 mm − 5 \(mm = 0 mm CAL\). D is incorrect because adding values applies when recession is apical to the CEJ. C is tempting because the probing depth is 5 mm, but no attachment loss is present, so this is a pseudopocket from enlargement/inflammation. B is correct: assess, debride biofilm within scope, educate, document, and reevaluate. A may be a dentist/periodontist procedure when indicated, not an entry-level hygienist action.
- Question 9 of 10
A 46-year-old patient presents for periodontal assessment. Interdental clinical attachment loss is 5–6 mm at several nonadjacent teeth. Bitewings show bone loss extending to the middle third of multiple roots. Several posterior sites probe 6–7 mm with bleeding. No teeth have been lost due to periodontitis, and the patient reports no chewing difficulty. Which dental hygiene action best applies periodontitis staging concepts?
C is best: CAL ≥5 mm, bone loss to the middle third, and 6–7 mm pockets suggest Stage III severity/complexity. The hygienist documents, communicates, and provides nonsurgical care within scope. A understages and undertreats. D is tempting because advanced disease may need complex care, but definitive surgical-restorative planning is dentist/specialist scope and Stage IV needs additional complexity such as tooth loss or masticatory dysfunction. B uses outdated classification logic. ASSESS CAL, probing, bleeding, radiographs; INTERVENE with risk-based nonsurgical therapy; REFER/consult for dentist-periodontist evaluation; DOCUMENT staging indicators and communication.
- Question 10 of 10
A 45-year-old patient presents for periodontal maintenance. Assessment findings include generalized interproximal plaque, moderate subgingival calculus, bleeding on probing, 4–5 mm periodontal pockets on posterior teeth, and inconsistent flossing. The patient asks why the visit plan includes nonsurgical periodontal instrumentation and self-care coaching. Which statement is the most appropriate dental hygiene diagnosis?
B is best: it translates assessment data into a modifiable dental hygiene problem and supports periodontal debridement and self-care instruction. D is tempting because periodontal findings are present, but prescribing systemic antibiotics and making a provider-level treatment decision exceeds routine hygiene scope. A may identify a dentist’s restorative concern, but it is not a dental hygiene diagnosis for this visit. C is judgmental, poorly documented, and ignores indicated periodontal care. Assess biofilm, calculus, bleeding, pockets, and risk factors; intervene with appropriate nonsurgical periodontal therapy and education; refer/consult with the dentist for diagnoses or treatment beyond hygiene scope; document findings, rationale, care provided, and follow-up.
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