3 Dental Pathology and Microbiology
Multiple choice questions
1. While giving oral health dietary advice, the clinician is likely to recommend that a patient avoids excessive consumption of which one of the following in order to reduce the occurrence of enamel demineralisation?
(a) Ascorbic acid
(b) Citric acid
(c) Lactic acid
(d) Phosphoric acid
(e) Sulphuric acid
2. A teenage girl has completed a diet sheet after two cavities were discovered at her routine examination. Which one of the following products is identified as a source of non-milk extrinsic sugar in her diet?
(a) Apple juice
(b) Plain yoghurt
(c) Potatoes
(d) Strawberries
(e) Sweetcorn
3. During a dental examination, the clinician discovers an area of early enamel demineralisation on the lower left first molar tooth. Which one of the following is the most likely presentation of this area?
(a) Cavity
(b) Periapical abscess
(c) Reversible pulpitis
(d) Root caries
(e) White spot lesion
4.A tooth is normally composed of three types of calcified tissue surrounding the pulp chamber. Which one of the following tissues forms the bulk of both the crown and the root?
(a) Collagen fibres
(b) Fibrils
(c) Hollow tubes
(d) Inorganic prisms
(e) Intercellular substance
5. There are many different types of bacteria normally present in the oral cavity. Which one of the following organisms is most likely to be associated with the onset of dental caries?
(a) Actinomyces
(b) Bacteroides
(c) Lactobacillus
(d) Staphylococcus
(e) Streptococcus
6. A patient attends for an examination complaining of a sore tongue, and the dentist diagnoses xerostomia. This is more likely to be seen in patients taking which one of the following medications?
(a) Analgesics
(b) Antihistamines
(c) Bisphosphonates
(d) Diuretics
(e) Hormone replacement
7. Periodontal disease can be exacerbated by many medical factors. Which one of the following conditions is not directly linked to the severity of periodontal disease?
(a) Asthma
(b) Diabetes
(c) Leukaemia
(d) Stress
(e) Vitamin C deficiency
8. An elderly edentulous patient has recently had a set of full acrylic dentures provided. He returns to the surgery 6 weeks later complaining of a white patch on his palate, which is sore when touched. Which one of the following microorganisms is most likely to have caused this condition?
(a) Actinomyces
(b) Bacillus fusiformis
(c) Candida albicans
(d) Herpes simplex
(e) Staphylococcus aureus
9. The pH scale is a measure of the acidity or alkalinity of a solution, with pH 1 being the most acidic, pH 14 the most alkaline and pH 7 being neutral. Which one of the following is the usual pH value in the oral cavity several hours after food consumption?
(a) 4.5
(b) 5.0
(c) 5.5
(d) 7.0
(e) 8.5
10. Saliva is the watery fluid secreted by the salivary glands that is naturally present in the healthy oral cavity. Which one of the following constituents of saliva is involved in calculus formation?
(a) Enzymes
(b) Immunoglobulins
(c) Inorganic ions
(d) Leucocytes
(e) Water
11. A 19-year-old patient attends the surgery as an emergency, with severe oral pain, halitosis and ulcerated gingivae. The dentist diagnoses a specific oral infection. Which one of the following microorganisms is most likely to be involved?
(a) Actinomyces
(b) Borrelia vincenti
(c) Candida albicans
(d) Herpes simplex
(e) Lactobacillus
12. A mother attends to seek advice on the necessity of fluoride drops for her young child. The dentist advises that it is not required because the region has a fluoridated water supply. Which one of the following is the most likely concentration of fluoride that has been added to the water supply?
(a) 0.01 ppm
(b) 0.1 ppm
(c) 1 ppm
(d) 10 ppm
(e) 100 ppm
13. On examination of a patient, the dentist notices supragingival calculus forming at the lingual margins of the lower incisors. Which one of the following instruments would you set out in order for this to be removed?
(a) Bristle brush
(b) Curette
(c) Cushing scaler
(d) Hoe
(e) Sickle scaler
14. Many diseases are due to infection with a particular microorganism. Which one of the following is an example of an infection not caused by a microorganism?
(a) Creutzfeldt–Jakob disease
(b) Hepatitis C
(c) Meningitis
(d) Poliomyelitis
(e) Swine influenza
15. A 45-year-old male patient attends the surgery for a routine dental examination. The dentist identifies tooth surface wear and faceting on the upper and lower incisors, caused by bruxism. Which one of the following is the correct definition for this type of tooth surface loss?
(a) Abfraction
(b) Abrasion
(c) Attrition
(d) Caries
(e) Erosion
16. Various microorganisms can infect the body, causing diseases. Which one of the following describes a microorganism in its non-infective state?
(a) Bacterium
(b) Fungus
(c) Protozoan
(d) Spore
(e) Virus
17. The presence and build-up of dental plaque is directly related to the incidence of dental diseases. That associated with periodontitis is specifically found in which one of the following?
(a) Fissures
(b) Gingival crevice
(c) Interproximal areas
(d) Occlusal pits
(e) True pockets
18. Oral cancer is a serious, often fatal, condition that has been linked to tobacco use and high alcohol intake. Which one of the following is the most likely manifestation of this condition?
(a) Basal cell carcinoma
(b) Lymphoma
(c) Melanoma
(d) Osteosarcoma
(e) Squamous cell carcinoma
19.A pregnant patient attends complaining of sensitivity to sweet foods in the upper right sextant, and the dentist suspects an interproximal lesion. Which one of the following diagnostic techniques should be used to confirm the presence of a cavity in this case?
(a) Application of ethyl chloride
(b) Horizontal bitewing radiograph
(c) Transillumination
(d) Use of Briault probe
(e) Use of caries dye
20. Bacteria are single-celled microorganisms responsible for causing many diseases, some of which are relevant to the dental team. Which one of the following bacteria live in colonies arranged as chains of circular microorganisms?
(a) Bacilli
(b) Lactobacilli
(c) Spirochaetes
(d) Staphylococci
(e) Streptococci
21. Bacteria involved in the onset of caries are those capable of producing weak organic acids that demineralise enamel. These acids are produced when the bacteria digest oral food debris. Which one of the following food components is the source of these organic acids?
(a) Aspartame
(b) Fructose
(c) Lactose
(d) Non-milk extrinsic sugars
(e) Polysaccharides
22. The three pairs of major salivary glands are the parotid glands, the submandibular glands and the sublingual glands. A patient attends the surgery with bilateral swelling of the parotid salivary glands, and is diagnosed with which one of the following conditions?
(a) Diphtheria
(b) Measles
(c) Mumps
(d) Poliomyelitis
(e) Rubella
23. When the body undergoes a disease process or is attacked by a pathogenic organism, the tissues involved may exhibit one of several outcomes. Which one of the following outcomes presents as a harmless swelling within the tissue due to an abnormal overgrowth of cells?
(a) Benign tumour
(b) Cyst
(c) Infection
(d) Malignant tumour
(e) Ulcer
24. The supporting structures of the teeth are collectively known as the periodontium. Which one of the following describes the point at which the tooth is attached to the periodontium?
(a) Gingival crevice
(b) Gingival papilla
(c) Junctional epithelium
(d) Lamina dura
(e) Periodontal ligament
25. A 35-year-old patient attends for a routine dental examination during which the dentist detects the presence of calculus in the patient’s mouth. In which one of the following areas is this most likely to be found?
(a) Buccal pits
(b) Interproximal areas
(c) Lingual area of incisors
(d) Occlusal fissures
(e) Palatal area of incisors
26. Several infections occur in the oral cavity that are of relevance to the dental team. Which one of the following infections is caused by a virus?
(a) Acute necrotising ulcerative gingivitis
(b) Herpetic stomatitis
(c) Lateral periodontal abscess
(d) Localised osteitis
(e) Pericoronitis
27. In the absence of effective oral hygiene techniques, chronic gingivitis will eventually progress into chronic periodontitis. Which one of the following must be present for a diagnosis of periodontitis to be made?
(a) False pocket
(b) Micro-ulcers
(c) Subgingival calculus
(d) Supragingival calculus
(e) True pocket
28. When the body undergoes a disease process or is attacked by a pathogenic organism, the tissues involved may exhibit one of several outcomes. Which one of the following outcomes presents as a shallow break in the skin or mucous membrane?
(a) Benign tumour
(b) Cyst
(c) Infection
(d) Malignant tumour
(e) Ulcer
29. Various viral infections are of relevance to the dental team, including those that cause diseases affecting the head and neck region. Which one of the following viruses causes ‘cold sores’?
(a) Epstein–Barr
(b) Herpes simplex
(c) Herpes varicella
(d) Herpes zoster
(e) Paramyxovirus
30. Acute necrotising ulcerative gingivitis is an acute periodontal condition that often occurs in young adults with poor oral hygiene. Which one of the following microorganisms has been specifically linked to this condition?
(a) Bacillus fusiformis
(b) Candida albicans
(c) Porphyromonas gingivalis
(d) Staphylococcus aureus
(e) Streptococcus mutans
31. When attacked by pathogens, the body has several lines of defence that should prevent a disease from developing in a healthy person. Which one of the following is the last line of defence before the disease process begins?
(a) Inflammatory response
(b) Mucous membrane
(c) Saliva
(d) Skin
(e) Sweat
32. When a patient is suffering from dental pain, they are usually advised to take analgesics while dental treatment is carried out to solve the problem. Which one of the following analgesics should be avoided in asthmatic patients?
(a) Aspirin
(b) Codeine
(c) Dihydrocodeine
(d) Ibuprofen
(e) Paracetamol
33. When patients have poor oral hygiene generally, their gingivae gradually become inflamed and chronic gingivitis develops. Which one of the following is the most likely cause of the initial inflammation?
(a) Bacteria
(b) Calculus
(c) Food debris
(d) Toxins
(e) Weak acids
34. In the first months of life, babies often develop resistance to specific pathogenic microorganisms by inheriting it from their mother. Which one of the following terms describes this process?
(a) Acquired immunity
(b) Dead vaccine
(c) Live vaccine
(d) Natural immunity
(e) Passive immunity
35. Many patients suffer from chronic gingivitis. At an oral health assessment, this condition can be diagnosed by the presence of which one of the following signs?
(a) Furcation lesions
(b) Gingival hyperplasia
(c) Subgingival calculus
(d) Tooth mobility
(e) True pockets
36. When a tooth becomes infected by a pathogenic microorganism, the pulp tissue undergoes an inflammatory response. Which one of the following describes the final stage of this response?
(a) Heat
(b) Loss of function
(c) Pain
(d) Redness
(e) Swelling
37. During an attack by pathogenic microorganisms, many defence cells and microorganisms are killed, and pus forms. Which one of the following terms describes when pus manages to spread into the surrounding tissues?
(a) Abscess
(b) Acute infection
(c) Cellulitis
(d) Chronic infection
(e) Virulent infection
38. Before being allowed to work at the chair side in the dental surgery, all clinical dental personnel require to be vaccinated against a range of pathogenic microorganisms. It is most likely that personnel will have developed an acquired immunity to which one of the following diseases?
(a) AIDS
(b) Chickenpox
(c) Hepatitis B
(d) Rubella
(e) Tetanus
39. On attendance for a dental examination, the dentist identifies a cold sore on the patient’s lower lip and asks for the appointment to be rescheduled. When explaining the reason for this to the patient, which one of the following microorganisms are you likely to refer to?
(a) Actinomyces
(b) Borrelia vincenti
(c) Candida albicans
(d) Herpes simplex
(e) Lactobacillus
40. Thrush is a fungal disease that can affect the oral cavity, resulting in conditions such as denture stomatitis. It is usually successfully treated by the use of antifungal agents, in the form of tablets, lozenges or oral rinses. Which one of the following drugs is used to treat this condition?
(a) Amoxicillin
(b) Erythromycin
(c) Metronidazole
(d) Nystatin
(e) Penicillin V
41. When the body undergoes a disease process or is attacked by a pathogenic organism, the tissues involved may exhibit one of several outcomes. Which one of the following outcomes presents as a slow-growing abnormal sac of fluid within the tissues?
(a) Benign tumour
(b) Cyst
(c) Infection
(d) Malignant tumour
(e) Ulcer
42. The combination of bacteria and food debris produces a thin, sticky and proteinaceous layer called plaque. Plaque builds up most readily in stagnation areas around the oral cavity. Which one of the following stagnation areas is associated with the development of periodontal disease?
(a) Buccal pit
(b) Crown margin
(c) Denture clasp
(d) Gingival crevice
(e) Interproximal area
43. Various microorganisms can infect the body, causing diseases. Which one of the following is a microorganism whose effects can be prevented by vaccination?
(a) Bacteria
(b) Fungi
(c) Protozoa
(d) Spore
(e) Virus
44. During the inflammatory response of body tissues to an invading microorganism, some of the defence cells are able to recognise the pathogen as foreign to normal tissue cells. Which one of the following terms describes these foreign bodies?
(a) Antibodies
(b) Antigens
(c) Antitoxins
(d) Immunoglobulins
(e) Toxins