General Dentist Prometric exam questions with answers

1. Question 1Restorative Dentistry (Operative Dentistry & Prosthodontics)easy

   Which mechanism is primarily responsible for the adhesion of conventional glass ionomer cement to enamel and dentine?

   1. AMicromechanical retention into acid-etched enamel prisms
   2. BIonic bonding between carboxylate groups and calcium in the tooth
   3. CCovalent bonding to collagen through a hybrid layer
   4. DPurely mechanical retention from undercuts in the preparation
   Show answer and explanation▾

   Answer: B. Ionic bonding between carboxylate groups and calcium in the tooth

   Glass ionomer cements bond chemically through ionic exchange between the polyacrylic acid carboxylate groups and calcium in hydroxyapatite, which is why they can be used without etching. Micromechanical retention into etched enamel is the bonding mechanism of resin composites, a common source of confusion.

2. Question 2Restorative Dentistry (Operative Dentistry & Prosthodontics)medium

   A root-filled maxillary premolar is to be restored with a post and crown. What height of sound vertical tooth structure above the core margin is generally recommended for an effective ferrule?

   1. AAt least 0.5 mm
   2. BAt least 4-5 mm
   3. CNo ferrule is needed if a fibre post is used
   4. DAt least 1.5-2 mm
   Show answer and explanation▾

   Answer: D. At least 1.5-2 mm

   A ferrule of at least 1.5-2 mm of sound, parallel-walled tooth structure encircled by the crown significantly improves the fracture resistance of endodontically treated teeth. A ferrule of 0.5 mm offers little protection, and the post type does not remove the need for a ferrule.

3. Question 3Periodonticseasy

   A patient using 0.2% chlorhexidine mouthwash twice daily for 4 weeks complains of an adverse effect. Which is the most common?

   1. ABrown extrinsic staining of teeth and tongue
   2. BGingival enlargement around the teeth
   3. CXerostomia with secondary candidiasis
   4. DGeneralised dentine hypersensitivity
   Show answer and explanation▾

   Answer: A. Brown extrinsic staining of teeth and tongue

   Chlorhexidine commonly causes reversible brown extrinsic staining of teeth, restorations and tongue, as well as taste disturbance, especially with prolonged use or with tea and coffee. Gingival enlargement is associated with drugs such as phenytoin, ciclosporin and calcium channel blockers, not chlorhexidine.

4. Question 4Periodonticshard

   A 50-year-old non-smoker without diabetes has a maximum interdental clinical attachment loss of 5 mm, radiographic bone loss extending to the middle third of the root, a maximum probing depth of 7 mm and has lost one tooth due to periodontitis. Using the 2017 classification, what stage is this?

   1. AStage II
   2. BStage I
   3. CStage III
   4. DStage IV
   Show answer and explanation▾

   Answer: C. Stage III

   Stage III periodontitis is defined by interdental CAL of 5 mm or more, bone loss extending to the middle third of the root or beyond, tooth loss due to periodontitis of 4 or fewer teeth, and complexity factors such as probing depths of 6 mm or more. Stage IV requires additional features such as loss of 5 or more teeth or the need for complex rehabilitation because of masticatory dysfunction, which are absent here.

5. Question 5Endodonticsmedium

   A patient has spontaneous throbbing pain in a lower molar that keeps him awake. Cold testing produces intense pain that lingers for more than a minute after the stimulus is removed, and there is no tenderness to percussion. What is the most appropriate diagnosis and treatment?

   1. AReversible pulpitis; remove caries and place a sedative dressing
   2. BPulp necrosis; incision and drainage with antibiotics
   3. CSymptomatic irreversible pulpitis; pulpectomy and root canal treatment
   4. DDentine hypersensitivity; apply a desensitising varnish
   Show answer and explanation▾

   Answer: C. Symptomatic irreversible pulpitis; pulpectomy and root canal treatment

   Spontaneous pain and lingering pain after cold indicate symptomatic irreversible pulpitis, which is treated by pulpectomy and root canal treatment (or extraction), with antibiotics not indicated. Reversible pulpitis produces short, sharp pain that subsides within seconds of removing the stimulus. A necrotic pulp would not respond to cold testing.

6. Question 6Oral Medicine, Oral Pathology & Diagnostic Sciencesmedium

   A 72-year-old woman who received intravenous zoledronic acid for metastatic breast cancer has exposed, necrotic bone in the posterior mandible that has persisted for 10 weeks after an extraction. She has never had radiotherapy to the jaws. What is the most likely diagnosis?

   1. AMedication-related osteonecrosis of the jaw
   2. BOsteoradionecrosis of the mandible
   3. CAlveolar osteitis of the socket
   4. DChronic suppurative osteomyelitis of the jaw
   Show answer and explanation▾

   Answer: A. Medication-related osteonecrosis of the jaw

   Exposed bone persisting for more than 8 weeks in a patient with current or previous antiresorptive or antiangiogenic therapy and no history of jaw radiation meets the definition of medication-related osteonecrosis of the jaw. Osteoradionecrosis requires previous radiotherapy to the area, and alveolar osteitis resolves within weeks of an extraction.

7. Question 7Oral Medicine, Oral Pathology & Diagnostic Scienceshard

   A biopsy of a multilocular radiolucency in the posterior mandible of a 25-year-old shows a cyst lined by a thin, corrugated parakeratinised epithelium with a palisaded basal layer. He also has multiple basal cell carcinomas. Which condition is most likely?

   1. ADentigerous cyst in cleidocranial dysplasia
   2. BAmeloblastoma in Gardner syndrome
   3. CRadicular cyst in Peutz-Jeghers syndrome
   4. DOdontogenic keratocyst in Gorlin-Goltz syndrome
   Show answer and explanation▾

   Answer: D. Odontogenic keratocyst in Gorlin-Goltz syndrome

   A corrugated parakeratinised lining with a palisaded basal cell layer is diagnostic of an odontogenic keratocyst, and multiple keratocysts with basal cell carcinomas indicate naevoid basal cell carcinoma (Gorlin-Goltz) syndrome, linked to PTCH1 mutations. Ameloblastomas have a different histology (stellate reticulum-like cells), and Gardner syndrome is associated with osteomas and supernumerary teeth.

8. Question 8Oral & Maxillofacial Surgerymedium

   Three days after an uneventful lower molar extraction, a patient reports severe throbbing pain radiating to the ear. The socket is empty with exposed bone and a foul odour, and there is no fever or swelling. What is the most appropriate management?

   1. APrescribe systemic antibiotics and review in one week
   2. BIrrigate with saline and place an obtundent dressing, with analgesia
   3. CCurette the socket vigorously to induce fresh bleeding
   4. DRefer urgently for incision and drainage under general anaesthesia
   Show answer and explanation▾

   Answer: B. Irrigate with saline and place an obtundent dressing, with analgesia

   The features describe alveolar osteitis (dry socket), managed with local measures: gentle saline irrigation, an obtundent or antiseptic dressing and analgesia. It is not an infection, so systemic antibiotics are not routinely indicated without signs of spreading infection, and vigorous curettage is painful and may worsen the condition.

9. Question 9Oral & Maxillofacial Surgeryhard

   A patient taking warfarin for atrial fibrillation needs a simple extraction of one lower premolar. Her INR, checked yesterday, is 2.6 and stable. According to UK SDCEP guidance, what is the most appropriate approach?

   1. AProceed without stopping warfarin, using local haemostatic measures
   2. BStop warfarin for 5 days and extract when the INR is normal
   3. CSwitch to heparin bridging and extract the next day
   4. DProceed only after giving oral vitamin K the night before
   Show answer and explanation▾

   Answer: A. Proceed without stopping warfarin, using local haemostatic measures

   SDCEP advises that patients on warfarin with a stable INR below 4, checked ideally within 24 hours (and no more than 72 hours) before treatment, can have extractions without interrupting anticoagulation, using local haemostatic measures such as sutures and an oxidised cellulose pack. Stopping warfarin or reversing it exposes the patient to thromboembolic risk that outweighs the low bleeding risk.

10. Question 10Pediatric Dentistrymedium

    A cooperative 6-year-old has a deep carious lesion in a vital primary lower second molar. During caries removal the pulp is exposed and bleeding stops within a few minutes with a damp cotton pellet. There is no history of spontaneous pain and no radiographic pathology. What is the most appropriate treatment?

    1. ADirect pulp cap with calcium hydroxide and a composite
    2. BPulpectomy and filling with zinc oxide-eugenol
    3. CPulpotomy followed by a preformed metal crown
    4. DExtraction and placement of a space maintainer
    Show answer and explanation▾

    Answer: C. Pulpotomy followed by a preformed metal crown

    A carious exposure in a vital primary molar with controllable bleeding and no signs of irreversible inflammation or radicular pathology is managed by pulpotomy, removing the coronal pulp and placing a medicament such as MTA, followed by a preformed metal crown. Direct pulp capping of carious exposures in primary teeth has a poor success rate, and pulpectomy is for irreversibly inflamed or necrotic pulps.

11. Question 11Pediatric Dentistryeasy

    Which permanent teeth usually erupt first, at around 6 years of age?

    1. AMaxillary central incisors
    2. BMandibular first molars
    3. CMandibular canines
    4. DMaxillary first premolars
    Show answer and explanation▾

    Answer: B. Mandibular first molars

    The mandibular first permanent molars and mandibular central incisors usually erupt first, at about 6-7 years, marking the start of the mixed dentition. Maxillary central incisors typically erupt slightly later, at around 7-8 years, and canines and premolars erupt between about 10 and 12 years.

12. Question 12Orthodonticseasy

    A 12-year-old has a Class II molar relationship, retroclined maxillary central incisors, proclined lateral incisors and a deep overbite. Which incisor classification applies?

    1. AClass II division 1
    2. BClass III
    3. CClass I
    4. DClass II division 2
    Show answer and explanation▾

    Answer: D. Class II division 2

    Class II division 2 is defined by retroclined upper central incisors with a lower incisor edge lying behind the cingulum plateau, often with proclined laterals and an increased overbite. Class II division 1 involves proclined or average upper incisors with an increased overjet.

13. Question 13Common Foundations: Local Anesthesia, Pharmacology, Pain & Medical Emergencieshard

    A 20 kg child needs local anaesthesia with 2% lidocaine with 1:100,000 adrenaline in 1.8 mL cartridges. Using a maximum dose of 4.4 mg/kg, what is the maximum number of cartridges that can be given?

    1. AAbout 3.9 cartridges
    2. BAbout 1.2 cartridges
    3. CAbout 4.9 cartridges
    4. DAbout 2.4 cartridges
    Show answer and explanation▾

    Answer: D. About 2.4 cartridges

    The maximum dose is 4.4 x 20 = 88 mg. Each 1.8 mL cartridge of 2% lidocaine contains 20 mg/mL x 1.8 mL = 36 mg, so 88 / 36 = 2.4 cartridges. A figure of about 3.9 results from using the 7 mg/kg figure, and about 1.2 results from treating the solution as 4%; overdosing small children is a recognised cause of local anaesthetic toxicity.

14. Question 14Common Foundations: Local Anesthesia, Pharmacology, Pain & Medical Emergenciesmedium

    During treatment, an adult with known epilepsy has a generalised tonic-clonic seizure that is still continuing after 5 minutes. After protecting the patient from injury and giving oxygen, which drug is most appropriate in a dental practice?

    1. ABuccal midazolam 10 mg
    2. BIntramuscular adrenaline 0.5 mg
    3. CSublingual glyceryl trinitrate 400 micrograms
    4. DOral glucose gel 10 g
    Show answer and explanation▾

    Answer: A. Buccal midazolam 10 mg

    A convulsive seizure lasting 5 minutes or more should be treated with a benzodiazepine; buccal midazolam 10 mg for an adult is the drug carried in dental emergency kits. Glucose gel is considered if hypoglycaemia is suspected but is not given orally to a convulsing patient, and adrenaline is for anaphylaxis.

15. Question 15Infection Control, Patient Safety, Ethics & Professionalismmedium

    Which method provides the most direct evidence that a steam steriliser cycle has killed microorganisms?

    1. AA chemical indicator strip that changes colour on exposure
    2. BA biological indicator with Geobacillus stearothermophilus spores
    3. CA printout showing the time, temperature and pressure reached
    4. DAutoclave tape on the outside of the instrument pouch
    Show answer and explanation▾

    Answer: B. A biological indicator with Geobacillus stearothermophilus spores

    Biological indicators use highly heat-resistant Geobacillus stearothermophilus spores and directly show whether the cycle achieved microbial kill. Chemical indicators and physical printouts confirm that certain conditions were reached, and autoclave tape only shows that the package went through a cycle, not that sterilisation was achieved.

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