Dental Radiography
Question Bank
Course Introduction
Dental Radiography is a foundational course that introduces students to the principles and practices of radiographic imaging in dentistry. The course covers the physics of X-rays, radiation safety protocols, and the operation of dental radiographic equipment. Students learn various techniques for intraoral and extraoral image acquisition, interpretation of radiographs, and the identification of normal and pathological structures. Emphasis is placed on minimizing radiation exposure to patients and staff while ensuring diagnostic-quality images, as well as understanding legal and ethical considerations in dental imaging.
Recommended Textbook
Essentials of Dental Radiography for Dental Assistants and Hygienists 10th Edition by Evelyn Thomson
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Chapter 1: Dental Radiography: Historical Perspective and Future Trends
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Q1) The development of radiation protection as a science is credited to:
A) A. Cieszy ski.
B) W. D. Coolidge.
C) W. H. Rollins.
D) F. Mouyen.
Answer: C
Q2) The positioning indicating device (PID) is sometimes called a "cone" because the PID of early dental x-ray machines was of a pointed shape.
A) Both the statement and reason are correct and related.
B) Both the statement and reason are correct but NOT related.
C) The statement is correct, but the reason is NOT.
D) The statement is NOT correct, but the reason is correct.
E) NEITHER the statement NOR the reason is correct.
Answer: A
Q3) Early scientists and researchers working in the field of radiography were not aware that continued exposure produced accumulations of radiation effects in the body.
A)True
B)False
Answer: True
Page 3
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Chapter 2: Characteristics and Measurement of Radiation
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Q1) What is the term for atoms that have gained or lost electrons and electrical neutrality?
Answer: Ions. The number of protons (positive charges) in an atom normally equals the number of electrons (negative charges). When an electron is removed from a neutral atom, it loses electrical neutrality and becomes an ion.
Q2) The amount of energy deposited in the teeth or soft tissue by any type of radiation is called the:
A) exposure amount.
B) absorbed dose.
C) dose equivalent.
D) background radiation.
Answer: B
Q3) The majority of x-rays produced by dental x-ray machines are formed by general (bremsstrahlung) radiation.
A)True
B)False
Answer: True
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Chapter 3: The Dental X-Ray Machine: Components and Function
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Q1) The filament is on the negative side of the vacuum tube in the dental x-ray machine. A)True
B)False
Answer: True
Q2) Inside the dental x-ray machine, what does the speed of the electrons determine?
Answer: The energy (penetrating power) of the x-rays produced
Q3) Electricity is defined as electrons in motion.
A)True
B)False
Answer: True
Q4) The collimator is a lead diaphragm that restricts the dimensions of the useful beam. A)True
B)False
Answer: True
Q5) What does adjusting the kilovolt peak (kVp) do?
Answer: Changes the penetrating ability of the x-rays. The kVp selected determines the speed of electrons traveling from the cathode to the anode, which, in turn, determines the penetrating power of the x-rays produced
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Chapter 4: Factors Affecting Radiographic Quality
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Q1) Theoretically, the ideal focal spot would be a point source.
A)True
B)False
Q2) Which of the following is recommended for increasing radiographic contrast while maintaining radiographic density?
A) Increase kVp and increase exposure time.
B) Decrease kVp and decrease exposure time.
C) Increase kVp and decrease exposure time.
D) Decrease kVp and increase exposure time.
Q3) Each of the following results in image unsharpness EXCEPT one. Which one is the EXCEPTION?
A) Patient movement during exposure
B) Image receptor positioned close to the teeth
C) A short PID
D) The use of intensifying screens
Q4) What is long-scale contrast?
Q5) Only one film should be placed in contact with the intensifying screens used for extraoral radiography.
A)True
B)False
6
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Chapter 5: Effects of Radiation Exposure
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Q1) White blood cells (lymphocytes) and reproductive cells (oocytes) are two exceptions to the Law of Bergonié and Tribondeau, which states cells that do not divide and are very specialized are radioresistant.
A)True
B)False
Q2) Which of the following statements regarding radiation injury is FALSE?
A) The amount of injury to an individual depends on the volume of tissue radiated.
B) The lethal dose (LD 50/30) for humans is 1.5 grays.
C) Younger, more rapidly dividing cells are more likely to incur damage.
D) Individuals vary in radiation sensitivity within the same species.
Q3) Cancer is a stochastic effect of exposure to radiation.
A)True
B)False
Q4) Which of these periods immediately follows radiation exposure?
A) The period of injury
B) The latent period
C) The reparable damage period
D) The recovery period
Q5) Why are children more susceptible to radiation than adults?
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Chapter 6: Radiation Protection
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Q1) A personnel monitoring device can NOT:
A) record the amount of radiation received.
B) measure the amount of radiation received.
C) protect the operator from receiving radiation.
D) indicate the type of radiation received.
Q2) Which film speed requires the least amount of radiation exposure to produce a diagnostic-quality image?
A) D
B) E
C) F
D) G
Q3) The sum of inherent and added filtration is called .
Q4) Based on evidence-based selection criteria for keeping radiation exposure ALARA, an adult recall patient with no risk factors for caries would most likely be assessed for bitewing radiographs annually.
A)True
B)False
Q5) What undesirable effect does collimation reduce?
Q6) Currently, what film speed is recommended to reduce radiation exposure?
Q7) Should the patient wear a thyroid collar during panoramic radiography?
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Chapter 7: Dental X-Ray Film and Processing Methods
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Q1) Graininess of a radiographic image results from:
A) large silver halide crystals.
B) the addition of radiosensitive dyes.
C) a decrease in film speed.
D) film packets that contain two films.
Q2) The appearance of clear/white or radiopaque structures on the radiograph is a result of the developer step during film processing.
A)True
B)False
Q3) Film packets may contain one or two films.
A)True
B)False
Q4) Which film size is ideal for positioning a periapical radiograph in the narrow canine region on an adult patient?
A) Size #0
B) Size #1
C) Size #2
D) Size #3
Q5) What type of film is needed to copy a dental radiograph?
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Chapter 8: Digital Radiography and Image Acquisition
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Q1) Developer contains hydroquinone and elon.
A)True
B)False
Q2) Oxidation is the process during which the chemicals of the developing and fixing solutions combine with oxygen and lose their strength.
A)True
B)False
Q3) Each of the following statements regarding automatic film processing is correct EXCEPT one. Which one is the EXCEPTION?
A) It requires diligent care for optimal performance.
B) Chemical solutions are heated to match the temperature used in manual processing.
C) If processor rollers are not kept clean, films can emerge streaked.
D) It uses a roller transport system to move the film through the processing cycle.
Q4) The life of processing solutions can be extended by replenishment.
A)True
B)False
Q5) Which processing solution prevents further film development?
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Chapter 9: Infection Control
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Q1) Which of the following features of digital imaging software currently available provides the best aid to interpreting digital images?
A) Density/contrast manipulation
B) Colorization
C) Embossing
D) Reversing the gray scale
Q2) By what mechanism are PSP plates reusable?
Q3) What is the difference between a digital image and a radiograph?
Q4) The more pixels in a digital image, the:
A) lower the resolution and the sharper the image.
B) lower the resolution and the less sharp the image.
C) higher the resolution and the sharper the image.
D) higher the resolution and the less sharp the image.
Q5) There are two methods of acquiring a digital image.
A)True
B)False
Q6) Film-based radiographs contain analog data.
A)True
B)False
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Q7) How can two images, taken over time, be compared using digital subtraction?
Chapter 10: Legal and Ethical Responsibilities
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Q1) Which of these statements is FALSE?
A) Microbial aerosols are pathogens present in blood that cause disease in humans.
B) Asepsis means "freedom from infection."
C) An antiseptic is an agent used on living tissue to kill or reduce numbers of bacteria.
D) Contamination is soiling by contact or mixing.
Q2) Which of the following will benefit the most from using film packets with a protective barrier?
A) Manual processing
B) Automatic processing
C) Daylight loaders
D) Rapid (chairside) processing
Q3) Are some patients likely to be reluctant to admit infectious conditions?
Q4) The radiographer should use powdered, nonsterile gloves made of latex or vinyl when placing intraoral radiographs.
A)True
B)False
Q5) What is an antiseptic?
Q6) How often should protective clothing be changed?
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Chapter 11: Patient Relations and Education
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Q1) As prudent risk management, radiographs should be retained as part of a client's record for 7 years.
A)True
B)False
Q2) Each of the following statements regarding dental radiographic equipment regulations is correct EXCEPT one. Which one is the EXCEPTION?
A) Most states require registration of dental x-ray machines.
B) Inspection of dental x-ray machines is usually conducted every 2-4 years.
C) Fees are usually collected for inspection of x-ray machines.
D) The dentist can perform inspections of dental x-ray machines.
Q3) There are national guidelines regarding who can place and expose dental radiographs.
A)True
B)False
Q4) Dental radiographs must be retained by the dentist for 10 years after the patient leaves the practice.
A)True
B)False
Q5) Who owns a patient's dental radiographs?
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Chapter 12: Introduction to Radiographic Examinations
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Q1) Educating patients about the importance of dental radiographs in comprehensive oral health care depends on the radiographer's ability to communicate.
A)True
B)False
Q2) A patient can refuse dental radiographs and still be treated.
A)True
B)False
Q3) If the radiographer feels the procedure is unnecessary or uncomfortable, these feelings will be conveyed to the patient.
A)True
B)False
Q4) If placement of an intraoral image receptor is uncomfortable for the patient, the radiographic procedure should be postponed.
A)True
B)False
Q5) Respectfulness and courtesy are examples of interpersonal skills.
A)True
B)False
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Chapter 13: The Periapical Examinationparalleling Technique
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Q1) Why is it important to not position the embossed dot on the film near the apices of the teeth?
Q2) Which of these statements is FALSE?
A) The two basic techniques employed in intraoral radiography are bisecting and paralleling.
B) The paralleling technique arose through application of the rule of isometry.
C) Both the paralleling and the bisecting techniques can be modified to meet special conditions.
D) The paralleling technique is newer than the bisecting technique.
Q3) A minimum of how many periapical radiographs should make up a full mouth survey for most adult patients?
A) 10
B) 12
C) 14
D) 16
Q4) Where should the open end of the PID be placed relative to the patient for radiographic exposures?
Q5) Why is the paralleling technique the technique of choice over the bisecting technique for intraoral radiographs?
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Chapter 14: The Periapical Examinationbisecting Technique
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Q1) If using an image receptor holder with an external aiming device, the <KT>indicator ring attachment must be slid all the way down the metal arm of the device to be as close to the patient's skin as possible without touching the patient prior to the exposure.
A)True
B)False
Q2) The paralleling technique does not meet the shadow-casting principle that requires placement of the image receptor close to the teeth of interest.
A)True
B)False
Q3) To compensate for the increased object-image receptor distance needed to achieve parallelism:
A) the target-image receptor distance should be decreased.
B) the target-image receptor distance should also be increased.
C) the object-image receptor distance should also be increased.
D) the object-image receptor distance should be decreased.
Q4) How is correct horizontal angulation achieved when using the paralleling technique?
Q5) With the paralleling technique, where is the central ray directed?
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Chapter 15: The Bitewing Examination
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Q1) Which of the following statements regarding patient preparation for dental radiography is NOT correct?
A) The patient should be protected with a lead/lead-equivalent apron and thyroid collar.
B) The patient's occipital protuberance should be against the headrest during exposure.
C) The patient's eyeglasses may be left in place to protect the eyes.
D) Objects in the mouth such as dentures, partials, and retainers should be removed prior to exposure.
Q2) Changes in vertical angulation are indicated when the patient's palatal vault is high or low.
A)True B)False
Q3) An isometric triangle is a triangle with sides that are inversely related to the base. A)True B)False
Q4) To determine accurate and correct angles and points of entry, how should the patient be positioned?
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Chapter 16: The Occlusal Examination
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Q1) A periodontally involved patient would benefit more from vertical bitewing radiographs than traditionally placed bitewing radiographs.
A)True
B)False
Q2) Because the proximal surfaces of the molars are in a buccolingual relationship to the patient's sagittal plane, conventional image receptor placement parallel to the buccal surfaces of the molars often results in overlapping of the contact area and closure of the embrasure spaces.
A)True
B)False
Q3) Which of the following statements regarding bitewing image receptor holders is NOT correct?
A) Disposable bitewing holder tabs and loops are available.
B) Two stick-on paper bite tabs may be attached to lengthen the bite tab.
C) Bitewing loop holders are limited to use with vertical bitewing radiographs.
D) Stick-on bitewing tabs are available for both film and digital sensors.
Q4) For bitewing radiographs, the radiographer should strive to ensure placement of the image receptor so that more of which arch, maxillary or mandibular, will be imaged?
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Chapter 17: The Panoramic Examination
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Q1) A vertical, zero-degree angulation is used for exposure of which occlusal radiograph?
A) Maxillary posterior topographical
B) Mandibular anterior topographical
C) Mandibular posterior topographical
D) Mandibular cross-sectional
Q2) If the patient's head is in correct position, predetermined vertical angulations and points of entry may be used.
A)True
B)False
Q3) What is the purpose of the occlusal radiographic exam?
Q4) Occlusal radiographs can be placed and exposed in five regions of the oral cavity. A)True
B)False
Q5) The vertical angulation used for topographical occlusal radiographs follows the rules of the bisecting technique used for periapical radiographs.
A)True B)False
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Chapter 18: Identifying and Correcting Undiagnostic
Radiographs
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Q1) A distomesial projection of the x-ray beam results in more severe overlapping in the posterior region of the radiograph.
A)True
B)False
Q2) Cone cutting of the radiographic image most likely results from an error made in which of the following steps?
A) Placement of the image receptor
B) Horizontal angulation
C) Vertical angulation
D) Centering the x-ray beam
Q3) Elongation error causes the images to appear stretched out.
A)True
B)False
Q4) A white line will appear on a processed film at the point where a film packet was bent or subjected to excessive pressure.
A)True
B)False
Q5) What is film fog?
Q6) What causes an iridescent stain on the radiograph?
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Chapter 19: Quality Control and Environmental Safety in Dental Radiography
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Q1) Radiographic competencies of the dental assistant and dental hygienist include each of the following EXCEPT one. Which one is the EXCEPTION?
A) The ability to recognize quality radiographs
B) The ability to identify the cause of poor-quality radiographs
C) The ability to complete necessary state documentation of safe operating equipment
D) The ability to apply appropriate corrective actions to failed quality control tests
Q2) Which of the following statements regarding processing solutions is correct?
A) A dental radiographic normalizing and monitoring device can be used to monitor the developer.
B) When the developer solution oxidizes and deteriorates, the radiographic images darken.
C) The fixer is the most critical of processing solutions and demands careful attention.
D) Use of the step wedge to monitor the developer should occur at the end of each day.
Q3) What is the key to peak performance of an automatic processor?
Q4) What is a reference film?
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Chapter 20: Image Orientation and Introduction to Interpretation
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Q1) Identify those materials and chemicals used for dental radiography that are considered hazardous wastes.
Q2) Developer and fixer should be stored in their original containers.
A)True
B)False
Q3) List personal protective equipment (PPE) required for safe handling of processing chemicals.
Q4) An emergency eyewash station must be within 25 feet of where processing chemicals are handled.
A)True
B)False
Q5) Switching from film-based radiography to digital imaging systems will eliminate the need for protocol for disposing of hazardous wastes.
A)True
B)False
Q6) The EPA sets and enforces regulations that protect the radiographer from infection in the oral health care setting.
A)True
B)False
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Chapter 21: Recognizing Normal Radiographic Anatomy
Intraoral Radiographs
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Q1) Dental assistants and hygienists may:
A) make a final diagnosis from dental radiographs alone.
B) make a final diagnosis from dental radiographs and the clinical examination.
C) interpret dental radiographs and use them to help educate the patient regarding oral conditions.
D) place and expose dental radiographs but not read them.
Q2) Which is the preferred method of mounting films?
Q3) Radiographs may be best interpreted by holding the film up to the overhead room light.
A)True
B)False
Q4) Which statement(s) regarding film mounting is (are) true?
A) It allows the radiographs to be viewed in a systematic order.
B) It helps to prevent lost films.
C) It provides a means for labeling the films with pertinent data.
D) All of the above.
Q5) Maxillary molars generally have how many roots?
Page 23
Q6) Which method of film mounting is no longer recommended?
Q7) What pieces of equipment are necessary for optimum film viewing?
Q8) What part of an intraoral film distinguishes the patient's right and left sides?
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Chapter 22: Recognizing Normal Radiographic Anatomy
Panoramic Radiographs
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Q1) The incisive foramen is most likely to be recorded on an intraoral radiograph of the: A) maxillary anterior region.
B) maxillary posterior region.
C) mandibular anterior region.
D) mandibular posterior region.
Q2) The genial tubercles are most likely to be recorded on an intraoral radiograph of the: A) maxillary anterior region.
B) maxillary posterior region.
C) mandibular anterior region.
D) mandibular posterior region.
Q3) What is the thin radiolucent line that delineates the midline of the palate and the junction of the right and left maxilla called?
Q4) Which of the following is the correct term for a tooth that fails to erupt?
A) Supernumerary tooth
B) Impacted tooth
C) Primary tooth
D) Permanent tooth
Q5) How does cortical bone appear on a radiograph?
Page 25
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Chapter 3: Radiographic Appearance of Dental Materials and Foreign Objects
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Q1) Which of the following restorative materials appears the most radiolucent?
A) Silicate
B) Gutta-percha
C) Stainless steel crown
D) Implant
Q2) When a developmental anomaly occurs in which the enamel invaginates within the body of the tooth, it is called "mesiodens."
A)True
B)False
Q3) Base material (calcium hydroxide pastes) and cements exhibit approximately the same degree of radiopacity as:
A) enamel.
B) dentin.
C) bone.
D) amalgam.
Q4) The term "idiopathic resorption" can apply to either external or internal resorption.
A)True
B)False
Q5) What type of malignant tumor arises from an epithelial origin?
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Chapter 24: The Use of Radiographs in the Detection of Dental Caries
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Q1) Which of these statements is FALSE?
A) Cemental caries may be called "root caries."
B) Root caries may be misinterpreted as cervical burnout.
C) Arrested caries are caries that are no longer active.
D) Rampant caries refers to decay that occurs under a restoration or around margins.
Q2) Which of the following is least likely to be imaged on a radiograph?
A) Incipient occlusal caries
B) Moderate proximal surface caries
C) Advanced proximal surface caries
D) Severe root caries
Q3) An optical illusion caused by the overlapping of teeth that mimics decay is called the "Mach band effect."
A)True
B)False
Q4) What term is applied to an optical illusion in which radiolucent lines are caused by overlapping images of the teeth?
Q5) Occlusal caries occur on the smooth surfaces of the posterior teeth.
A)True
B)False
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Chapter 25: The Use of Radiographs in the Evaluation of
Periodontal Diseases
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Q1) Which of the following is NOT a limitation of radiographs in the evaluation of periodontal disease?
A) They record an exaggerated assessment of actual clinical involvement of the disease.
B) They provide a two-dimensional representation of three-dimensional structures.
C) Changes in soft tissue are not recorded.
D) They cannot distinguish between treated versus untreated disease.
Q2) Radiographs are two-dimensional images of three-dimensional objects.
A)True
B)False
Q3) Widening of the periodontal ligament space at the crest of the interproximal bone is called:
A) triangulation.
B) furcation involvement.
C) horizontal bone loss.
D) a local contributing factor.
Q4) Localized bone loss is the same diagnosis as generalized bone loss.
A)True
B)False
28
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Chapter 26: Describing Radiographic Anomalies, Lesions, and Opportunistic Screening
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Q1) The first pediatric radiographic survey may not be necessary until:
A) all primary teeth have erupted and prevent a visual inspection of interproximal surfaces.
B) the arches have developed sufficiently to accommodate placement of the image receptor.
C) the age of 6, when cooperation is more likely.
D) the child presents with signs or symptoms of oral disease.
Q2) Children have the same basic needs for oral health care as do adults.
A)True
B)False
Q3) By how much should adult exposure times be reduced for a 12-year-old child patient?
A) One-half the exposure time used for the adult patient
B) One-third the exposure time used for the adult patient
C) One-fourth the exposure time used for the adult patient
D) One-fifth the exposure time used for the adult patient
Q4) The radiographer must be able to communicate and explain the procedure so that the child understands what is expected.
A)True
B)False
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Chapter 27: Pediatric Radiographic Techniques
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Q1) Telling the patient that you do not like having radiographs taken will help the patient cooperate with the procedure.
A)True
B)False
Q2) To suppress a gag reflex, the patient must continue breathing during the exposure of the radiograph and must be told not to hold the breath.
A)True
B)False
Q3) If the patient mentions gagging, the radiographer should dismiss his or her concern as all in the mind.
A)True
B)False
Q4) Should a hearing aid be removed prior to a panoramic radiographic exposure?
Q5) The personal eyewear worn by many patients with visual disabilities will need to be removed during the radiographic procedure.
A)True
B)False
Q6) Should the radiographer expose the anterior or posterior projections first?
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Chapter 28: Radiographic Techniques for Patients With Special Needs
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Q1) Which of the following statements regarding film duplication is FALSE?
A) The film duplicator machine uses an ultraviolet light source.
B) It is possible to duplicate a single film or a full mouth series at a single printing.
C) Duplication must be performed in the darkroom under safelight conditions.
D) Standard radiographic film is used in the duplication process.
Q2) The definitive method of localization relies on the SLOB rule.
A)True
B)False
Q3) If the vertical angulation is not increased when exposing periapical radiographs of a patient with a low palatal vault, the cusps of the crowns may be cut off of the image.
A)True
B)False
Q4) The right-angle method of localization is based on the shadow-casting principle. A)True
B)False
Q5) Can radiographs be exposed during endodontic therapy?
Q6) Should exposure settings for edentulous areas be the same as for areas with teeth present?
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Chapter 29: Radiographic Techniques for Specific Oral Conditions
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Q1) Why should cassettes and intensifying screens be examined prior to use?
Q2) Extraoral films are more sensitive to light than intraoral films.
A)True
B)False
Q3) Extraoral film is packaged in a similar manner to intraoral films.
A)True
B)False
Q4) Orthodontists frequently use extraoral radiographs.
A)True
B)False
Q5) Which of these extraoral radiographs is most often used to show the base of the skull?
A) Lateral cephalometric
B) Transcranial
C) Submentovertex
D) Posteroanterior
Q6) Of what is the front cover of a rigid extraoral film cassette constructed?
Q7) What is a lateral cephalometric radiograph?
Q8) Of what is a grid used in extraoral radiographic techniques composed? Page 32
Q9) How many intensifying screens are inside a cassette?
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Chapter 30: Radiographic Techniques
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Q1) The nasopharyngeal air space is located between the tongue and the palate.
A)True
B)False
Q2) What happens to the radiographic image if intensifying screens and film are not in tight contact?
Q3) Each of the following is an advantage of panoramic radiographs EXCEPT one. Which one is the EXCEPTION?
A) Panoramic radiographs are a simple procedure.
B) They are less likely to cause patient discomfort.
C) There is decreased image distortion.
D) There is a reduced radiation dose.
Q4) Each of the following may be used to position the patient within the focal trough EXCEPT one. Which one is the EXCEPTION?
A) Chin rest
B) Forehead rest
C) Film holder
D) Bite block
Q5) Panoramic radiography is based on the principles of tomography.
A)True
B)False
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