Pediatric Dentistry Prometric exam questions with answers

1. Question 1Behaviour Guidance, Sedation and Anesthesiamedium

   Which condition is a contraindication to nitrous oxide-oxygen inhalation sedation in a child?

   1. AMild dental anxiety
   2. BControlled asthma
   3. CWell-managed epilepsy
   4. DAcute otitis media
   Show answer and explanation▾

   Answer: D. Acute otitis media

   Nitrous oxide diffuses into closed air spaces and can raise middle ear pressure, so acute otitis media, pneumothorax and bowel obstruction are contraindications. Mild anxiety is the main indication, and controlled asthma is not a contraindication.

2. Question 2Caries Risk and Preventionhard

   A 9-year-old has a non-cavitated occlusal caries lesion on a permanent first molar. What is the evidence-based management?

   1. APrepare and place a conventional class I amalgam
   2. BPlace a resin-based sealant over the lesion
   3. CMonitor only and review in 2 years
   4. DPlace a preformed metal crown
   Show answer and explanation▾

   Answer: B. Place a resin-based sealant over the lesion

   Sealants are recommended for non-cavitated pit and fissure lesions in permanent molars and reduce lesion progression. A conventional restoration removes sound tooth structure unnecessarily.

3. Question 3Caries Risk and Preventionmedium

   Parents of a 3-year-old with multiple cavitated lesions consent to 38% silver diamine fluoride. Which effect must be explained before application?

   1. ATemporary yellow staining of the surrounding enamel
   2. BLoss of tooth vitality in most teeth
   3. CNeed for local anesthesia before use
   4. DPermanent black staining of the treated lesions
   Show answer and explanation▾

   Answer: D. Permanent black staining of the treated lesions

   SDF arrests caries but stains carious tissue black permanently, which affects consent, especially for anterior teeth. It is non-invasive and needs no local anesthesia.

4. Question 4Dental Traumamedium

   A 12-year-old avulsed a permanent incisor with a closed apex 30 minutes ago; it was stored in milk. After replantation, what splint is recommended?

   1. ARigid splint for 6 weeks
   2. BFlexible splint for 4 months
   3. CFlexible splint for 2 weeks
   4. DNo splint is needed
   Show answer and explanation▾

   Answer: C. Flexible splint for 2 weeks

   Replanted avulsed teeth are stabilised with a passive flexible splint for 2 weeks. Rigid or prolonged splinting increases the risk of replacement resorption.

5. Question 5Interceptive Orthodontics and Space Managementeasy

   A 6-year-old lost a mandibular primary first molar early; the primary second molar is sound. Which appliance is appropriate?

   1. ADistal shoe
   2. BNance palatal arch
   3. CBand and loop
   4. DRemovable functional appliance
   Show answer and explanation▾

   Answer: C. Band and loop

   Unilateral loss of a single primary molar is managed with a band and loop on the adjacent tooth. A distal shoe is used only when the first permanent molar is unerupted and the primary second molar is lost.

6. Question 6Growth, Development and Eruptionmedium

   A 7-year-old's radiograph shows the maxillary first permanent molar locked under the distal crown of the primary second molar, with resorption of that primary molar's distal root. What is the diagnosis?

   1. AEctopic eruption of the first permanent molar
   2. BAnkylosis of the primary second molar with infraocclusion
   3. CPrimary failure of eruption
   4. DDentigerous cyst of the first molar
   Show answer and explanation▾

   Answer: A. Ectopic eruption of the first permanent molar

   Ectopic eruption occurs when the first permanent molar erupts mesially and resorbs the distal root of the second primary molar; it is commoner in the maxilla. Ankylosis presents with infraocclusion, not a locked erupting molar.

7. Question 7Restorative Dentistry for Childrenhard

   An 8-year-old has a severely hypomineralised, hypersensitive lower first permanent molar with poor long-term prognosis. Radiographs show early calcification of the second molar furcation. What is the best long-term plan?

   1. ARoot canal treatment and cast crown now
   2. BPlanned extraction timed for second molar eruption
   3. CFluoride varnish only, with review at 15 years of age
   4. DExtraction delayed until after age 14
   Show answer and explanation▾

   Answer: B. Planned extraction timed for second molar eruption

   Extracting a poor-prognosis first molar when the second molar furcation is beginning to calcify (about 8-10 years) favours spontaneous space closure. Delaying extraction past this window reduces the chance of good mesial drift.

8. Question 8Restorative Dentistry for Childreneasy

   Which approach defines atraumatic restorative treatment?

   1. AHand excavation and high-viscosity glass ionomer
   2. BRotary cavity preparation and amalgam
   3. CLaser cavity preparation and bonded resin composite
   4. DAir abrasion preparation and compomer
   Show answer and explanation▾

   Answer: A. Hand excavation and high-viscosity glass ionomer

   ART uses hand instruments to remove soft caries and seals the cavity with high-viscosity glass ionomer, without rotary instruments or electricity. The other methods require powered equipment.

9. Question 9Pulp Therapymedium

   During caries removal in a primary molar with no spontaneous pain, the pulp is exposed and coronal bleeding stops after 3 minutes with a damp cotton pellet. What is the appropriate treatment?

   1. APulpectomy with gutta-percha
   2. BDirect pulp cap with calcium hydroxide
   3. CPulpotomy with MTA
   4. DExtraction and space maintainer
   Show answer and explanation▾

   Answer: C. Pulpotomy with MTA

   Carious exposure with vital radicular pulp, shown by hemostasis within about 5 minutes, indicates pulpotomy; MTA has strong evidence. Direct pulp capping of carious exposures in primary teeth has poor success.

10. Question 10Pulp Therapymedium

    A deep carious lesion in a primary molar has no history of spontaneous pain and no radiographic pathology. Complete excavation would likely expose the pulp. What is recommended?

    1. AIndirect pulp treatment with a sealed restoration
    2. BComplete excavation followed by a vital pulpotomy
    3. CPulpectomy under rubber dam isolation
    4. DExtraction to avoid later infection
    Show answer and explanation▾

    Answer: A. Indirect pulp treatment with a sealed restoration

    Leaving affected dentine over the pulp under a well-sealed restoration has high success when the pulp is healthy or reversibly inflamed. Deliberately exposing the pulp converts a conservative case into pulpotomy.

11. Question 11Pulp Therapymedium

    In primary teeth, for which situation is direct pulp capping considered?

    1. ACarious exposure with a history of spontaneous pain
    2. BExposure with a sinus tract
    3. CExposure with internal resorption
    4. DSmall mechanical exposure of a healthy pulp
    Show answer and explanation▾

    Answer: D. Small mechanical exposure of a healthy pulp

    Direct pulp capping in primary teeth is limited to small mechanical or traumatic exposures of a normal pulp. Carious exposures, sinus tracts and internal resorption indicate deeper inflammation.

12. Question 12Restorative Dentistry for Childrenmedium

    Which statement correctly describes the Hall technique for a carious primary molar?

    1. AComplete caries removal under rubber dam
    2. BNo caries removal; crown cemented with glass ionomer
    3. CCrown cemented with zinc phosphate after pulpotomy
    4. DOcclusal reduction of 2 mm before cementation
    Show answer and explanation▾

    Answer: B. No caries removal; crown cemented with glass ionomer

    The Hall technique seals caries under a preformed metal crown without local anesthesia, tooth preparation or caries removal, using glass ionomer cement. Removing caries or preparing the tooth is the conventional technique.

13. Question 13Restorative Dentistry for Childrenmedium

    A child with blue sclerae and recurrent fractures has amber, translucent teeth. Radiographs show bulbous crowns, cervical constriction and obliterated pulp chambers. What is the diagnosis?

    1. AAmelogenesis imperfecta
    2. BRegional odontodysplasia
    3. CDental fluorosis
    4. DDentinogenesis imperfecta
    Show answer and explanation▾

    Answer: D. Dentinogenesis imperfecta

    Dentinogenesis imperfecta associated with osteogenesis imperfecta shows opalescent teeth, bulbous crowns and pulp obliteration. Amelogenesis imperfecta affects enamel and leaves pulp chambers normal.

14. Question 14Special Health Care Needs and Oral Pathologymedium

    A 10-year-old with severe hemophilia A needs a primary molar extraction. What is the most appropriate preparation?

    1. AGive aspirin for pain control after extraction
    2. BLiaise with the hematologist for factor VIII cover
    3. CUse an inferior alveolar block without cover
    4. DProceed and pack the socket only
    Show answer and explanation▾

    Answer: B. Liaise with the hematologist for factor VIII cover

    Children with hemophilia need hematology input and factor replacement or desmopressin, with tranexamic acid as an adjunct. Aspirin and unprotected inferior alveolar blocks increase bleeding risk.

15. Question 15Special Health Care Needs and Oral Pathologymedium

    A 10-year-old has a painless, bluish, fluctuant swelling on the lower lip that has varied in size for 2 months after lip biting. What is the treatment of choice?

    1. AIncision and drainage of the swelling under local anesthetic
    2. BExcision with adjacent minor salivary glands
    3. CTopical corticosteroid for 2 weeks
    4. DSystemic antibiotics for 7 days
    Show answer and explanation▾

    Answer: B. Excision with adjacent minor salivary glands

    Mucoceles are excised together with the feeding minor salivary glands to prevent recurrence. Simple drainage leads to refilling.

Last reviewed September 2026. Questions are original and written to the published exam blueprint; they are not taken from any real paper.