SDLE exam: free questions, blueprint and pass score

Results: A scaled score on a 200-800 reporting scale, with a statement of results and a feedback report comparing you with other test takers - announced 2-6 weeks after the test window closes.

Attempts: You may sit each licensure exam up to four times a year, counted from your first attempt, until you pass. You cannot sit twice in the same testing window - the second sitting counts as an attempt and its result is void. Arriving more than 30 minutes late also counts as an attempt unless SCFHS accepts a documented reason. After passing, you get two further attempts to improve your score, for residency selection.

1. Question 1Restorative Dentistrymedium

   An endodontically treated maxillary premolar is to be restored with a post, core and crown. What minimum height of sound tooth structure above the finish line is recommended for an effective ferrule?

   1. A0.5 mm
   2. B1.5-2 mm
   3. C4-5 mm
   4. DNo ferrule is needed if a fibre post is used
   Show answer and explanation▾

   Answer: B. 1.5-2 mm

   A ferrule of at least 1.5-2 mm of vertical sound tooth structure, encircled by the crown, greatly improves fracture resistance. Below this, crown lengthening or orthodontic extrusion should be considered. The post type does not replace the need for a ferrule.

   Reference: Rosenstiel, Land and Fujimoto, Contemporary Fixed Prosthodontics, 5th ed. (2016)

2. Question 2Restorative Dentistryeasy

   A 78-year-old with dry mouth and limited dexterity has several cervical root caries lesions. Which restorative material is most suitable because it bonds chemically to tooth structure and releases fluoride?

   1. AGlass ionomer cement
   2. BDental amalgam
   3. CMicrofilled composite resin with no adhesive
   4. DGold foil
   Show answer and explanation▾

   Answer: A. Glass ionomer cement

   Glass ionomer bonds chemically to enamel and dentine, releases fluoride and tolerates a less-than-ideal moisture field, which makes it well suited to root caries in high-risk older patients. Amalgam needs mechanical retention, composite is technique-sensitive and needs an adhesive, and gold foil is impractical here.

   Reference: Sturdevant's Art and Science of Operative Dentistry, 7th ed. (2019)

3. Question 3Restorative Dentistrymedium

   Which cavity configuration has the highest C-factor, and so the most polymerisation shrinkage stress when restored in composite?

   1. AA Class IV incisal angle restoration
   2. BA Class I occlusal cavity
   3. CA flat, single-surface veneer preparation
   4. DA Class III cavity open labially
   Show answer and explanation▾

   Answer: B. A Class I occlusal cavity

   The C-factor is the ratio of bonded to unbonded surfaces. A Class I box has five bonded walls and one free surface, a C-factor of about 5, the highest. Incremental layering reduces the stress. Veneers and Class IV restorations have far more free surface.

   Reference: Sturdevant's Art and Science of Operative Dentistry, 7th ed. (2019)

4. Question 4Restorative Dentistrymedium

   A patient with new complete dentures keeps biting his cheeks in the premolar and molar region. What is the most likely cause?

   1. AToo much vertical dimension of occlusion
   2. BInadequate horizontal overlap (overjet) of the posterior teeth
   3. COver-extended lingual flanges
   4. DInsufficient relief over the incisive papilla
   Show answer and explanation▾

   Answer: B. Inadequate horizontal overlap (overjet) of the posterior teeth

   Cheek biting usually happens when the posterior teeth are set edge to edge with too little buccal overjet, so the cheek is trapped between the cusps. Grinding the buccal surfaces of the mandibular posterior teeth increases the overjet. Excess vertical dimension causes soreness and clicking, not cheek biting.

   Reference: Zarb, Prosthodontic Treatment for Edentulous Patients, 13th ed. (2013)

5. Question 5Restorative Dentistryeasy

   A mandibular arch has lost all molars and second premolars on both sides; the canines and first premolars remain. What is its Kennedy classification?

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

   Answer: A. Class I

   Kennedy Class I is a bilateral edentulous area behind the remaining natural teeth, a bilateral free-end saddle. Class II is unilateral free-end, Class III is a bounded saddle, and Class IV is a single anterior saddle crossing the midline.

   Reference: McCracken's Removable Partial Prosthodontics, 13th ed. (2016)

6. Question 6Restorative Dentistryeasy

   A crown impression will not reach the laboratory until the next day. Which impression material best keeps its dimensional accuracy when the pour is delayed?

   1. AIrreversible hydrocolloid (alginate)
   2. BCondensation silicone
   3. CAddition silicone (polyvinyl siloxane)
   4. DZinc oxide-eugenol paste
   Show answer and explanation▾

   Answer: C. Addition silicone (polyvinyl siloxane)

   Addition silicone has very low polymerisation shrinkage and no by-product, so it stays accurate for days and can be poured late. Alginate distorts within minutes, condensation silicone shrinks as it releases alcohol, and zinc oxide-eugenol is not used for crown impressions.

   Reference: Anusavice, Phillips' Science of Dental Materials, 12th ed. (2013)

7. Question 7Periodonticsmedium

   A patient's worst interdental clinical attachment loss is 5 mm, with radiographic bone loss into the middle third of the root. No teeth have been lost to periodontitis. What stage of periodontitis is this under the 2017 World Workshop classification?

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

   Answer: C. Stage III

   Interdental CAL of 5 mm or more, with bone loss extending to the middle third of the root or beyond, places the case in Stage III. Stage I is 1-2 mm and Stage II is 3-4 mm. Stage IV adds complexity factors such as the loss of five or more teeth, or the need for complex rehabilitation.

   Reference: Papapanou et al., Periodontitis: Consensus Report of the 2017 World Workshop (J Clin Periodontol 2018)

8. Question 8Periodonticseasy

   A patient using 0.2% chlorhexidine mouthwash twice daily for three weeks reports brown staining on her teeth. Which other side effect is most commonly associated with chlorhexidine?

   1. AAltered taste sensation
   2. BGingival hyperplasia
   3. CXerostomia
   4. DTooth sensitivity to sweets
   Show answer and explanation▾

   Answer: A. Altered taste sensation

   The common side effects of chlorhexidine are extrinsic brown staining of teeth and tongue, altered taste and increased supragingival calculus. Gingival hyperplasia is linked to drugs such as phenytoin, ciclosporin and calcium channel blockers.

   Reference: Newman and Carranza's Clinical Periodontology, 13th ed. (2019)

9. Question 9Periodonticsmedium

   On a mandibular first molar, a Nabers probe passes right through the furcation from buccal to lingual, but the furcation is still covered by gingiva and cannot be seen. What is the Glickman furcation grade?

   1. AGrade I
   2. BGrade II
   3. CGrade III
   4. DGrade IV
   Show answer and explanation▾

   Answer: C. Grade III

   Glickman Grade III is a through-and-through defect in which the probe passes completely, but the furcation is still covered by soft tissue. In Grade IV the furcation is clinically visible because of gingival recession. Grades I and II are incipient and cul-de-sac defects.

   Reference: Newman and Carranza's Clinical Periodontology, 13th ed. (2019)

10. Question 10Endodonticseasy

    A patient has spontaneous toothache in a lower molar with a deep restoration. A cold test causes intense pain that lasts about 40 seconds after the stimulus is removed. There is no tenderness to percussion. What is the pulpal diagnosis?

    1. AReversible pulpitis
    2. BSymptomatic irreversible pulpitis
    3. CPulp necrosis
    4. DNormal pulp
    Show answer and explanation▾

    Answer: B. Symptomatic irreversible pulpitis

    Spontaneous pain and lingering pain to cold after the stimulus is removed indicate symptomatic irreversible pulpitis, treated with root canal treatment or pulpotomy. In reversible pulpitis the pain stops within seconds, and a necrotic pulp does not respond to cold at all.

    Reference: Cohen's Pathways of the Pulp, 12th ed. (2021)

11. Question 11Endodonticsmedium

    During root canal preparation, sodium hypochlorite is used to dissolve organic tissue. Which irrigant is used at the end of preparation to remove the inorganic part of the smear layer?

    1. A17% EDTA
    2. BChlorhexidine 2%
    3. CHydrogen peroxide 3%
    4. DSterile saline
    Show answer and explanation▾

    Answer: A. 17% EDTA

    EDTA is a chelating agent that removes the inorganic, mineral component of the smear layer, and is used alongside sodium hypochlorite, which dissolves organic tissue. Chlorhexidine is antimicrobial but does not dissolve tissue or remove smear layer, and saline only flushes the canal.

    Reference: Cohen's Pathways of the Pulp, 12th ed. (2021)

12. Question 12Oral Medicine and Surgeryeasy

    How many milligrams of lidocaine are in one 1.8 mL cartridge of 2% lidocaine with 1:100,000 epinephrine?

    1. A18 mg
    2. B20 mg
    3. C36 mg
    4. D72 mg
    Show answer and explanation▾

    Answer: C. 36 mg

    A 2% solution contains 20 mg/mL, and 20 mg/mL × 1.8 mL = 36 mg per cartridge. Working out milligrams per cartridge is the first step in keeping within a patient's maximum dose.

    Reference: Malamed, Handbook of Local Anesthesia, 7th ed. (2019)

13. Question 13Oral Medicine and Surgerymedium

    A patient taking warfarin for atrial fibrillation needs a single, simple extraction. His INR, checked the day before, is 2.6. What is the most appropriate management?

    1. AStop warfarin for five days before the extraction
    2. BProceed without stopping warfarin, using local haemostatic measures
    3. CRefer to hospital for bridging with heparin
    4. DGive vitamin K before the extraction
    Show answer and explanation▾

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

    With a stable INR below 4, simple extractions can go ahead without stopping warfarin, using local measures such as an oxidised cellulose pack, sutures and tranexamic acid mouthwash. Stopping warfarin or reversing it exposes the patient to thromboembolic risk that outweighs the bleeding risk.

    Reference: SDCEP: Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs, 2nd ed. (2022)

14. Question 14Orthodontics and Pediatric Dentistrymedium

    During caries removal in a vital primary second molar of a 6-year-old, the pulp is exposed. There is no history of spontaneous pain, no swelling and no radiographic sign of periradicular disease. What is the most appropriate treatment?

    1. AExtraction
    2. BPulpotomy, followed by a stainless steel crown
    3. CPulpectomy with a non-resorbable gutta-percha filling
    4. DIndirect pulp cap with a composite restoration
    Show answer and explanation▾

    Answer: B. Pulpotomy, followed by a stainless steel crown

    A carious exposure in a vital primary molar with no signs of irreversible pulpitis or periradicular disease is treated by pulpotomy, using MTA or another accepted agent, and a stainless steel crown. Pulpectomy is for irreversible pulpitis or necrosis, and uses a resorbable filling material, not gutta-percha. An indirect pulp cap is for deep caries without exposure.

    Reference: AAPD Pulp Therapy for Primary and Immature Permanent Teeth, Reference Manual (2023)

15. Question 15Orthodontics and Pediatric Dentistryeasy

    A 10-year-old's permanent upper central incisor has been knocked out at school. Staff cannot replant it on site. Which storage medium should they use while bringing the child to the dentist?

    1. ATap water
    2. BCold milk
    3. CA dry tissue
    4. DAntiseptic mouthwash
    Show answer and explanation▾

    Answer: B. Cold milk

    If immediate replantation is not possible, the tooth should be kept in a physiological medium to preserve the periodontal ligament cells. Milk is the best widely available option; HBSS, saline or the child's saliva are alternatives. Water is hypotonic and damages the cells, and dry storage quickly kills them.

    Reference: IADT Guidelines for the Management of Traumatic Dental Injuries: Avulsion of Permanent Teeth (2020)

1. 1

   Check you are eligible

   BDS or equivalent, or in your internship year, or one year from graduation.

2. 2

   Apply through SCFHS's e-application

   SCFHS processes the application and issues a scheduling permit with your eligibility period. You receive an email with instructions for accessing it.

3. 3

   Book with Prometric

   Use the permit to schedule a date at an SCFHS-approved Prometric centre, in Saudi Arabia or abroad. Scheduling may not be open more than three months ahead, and SCFHS sets the testing windows.

4. 4

   Bring your permit and ID

   Centres open at 7:30 a.m. Bring the scheduling permit, on paper or on your phone, and a passport (or a national or residence ID in Saudi Arabia) with your name exactly as it appears on the permit.

5. 5

   Wait for your results

   Results are released 2-6 weeks after the testing window closes, as a statement of results and a feedback report comparing you with other candidates.