Oral Radiology Study Guide Questions
Course Introduction
Oral Radiology is a foundational course that explores the principles, techniques, and interpretation of radiographic imaging in dentistry. The course covers the physics of X-rays, radiation safety, types of dental radiographs, and the proper positioning of patients and equipment. Emphasis is placed on the identification of normal anatomical landmarks, recognizing common pathologies, and understanding the role of radiology in diagnosis and treatment planning. Students will gain practical experience in taking and analyzing intraoral and extraoral radiographic images, as well as knowledge of advancements such as digital radiography and three-dimensional imaging techniques.
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 most significant advancement in the early days of radiography came in 1913 when W. D. Coolidge:
A) became the first to alert the profession of the dangers of radiation exposure and advocated for the science of radiation protection.
B) exposed a prototype of a dental radiograph, setting the stage for preventive oral health care.
C) developed a variable, high kilovoltage x-ray machine compatible with the paralleling technique.
D) introduced an x-ray tube that allowed for an x-ray output that could be predetermined and accurately controlled.
Answer: D
Q2) The first dental radiograph was produced using an exposure time of:
A) 0.5 second.
B) 1 minute.
C) 5 minutes.
D) 25 minutes.
E) 1 hour.
Answer: D
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Chapter 2: Characteristics and Measurement of Radiation
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Q1) Electrons have a positive charge.
A)True
B)False
Answer: False
Q2) Kinetic energy is the internal energy within the atom that holds its components together.
A)True
B)False
Answer: False
Q3) When x-rays pass through matter, which interaction results in x-rays being scattered in all directions?
A) The coherent effect
B) The photoelectric effect
C) The Compton effect
Answer: C
Q4) The photoelectric effect is an all-or-nothing energy loss.
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) Voltage is the measurement of the number of electrons moving through a wire conductor.
A)True
B)False
Answer: False
Q2) What is the term for the measurement of the number of electrons moving through a wire conductor?
Answer: Amperage measures the number of electrons that move through a conductor.
Q3) Which of the following removes the soft x-rays for the x-ray beam as it exits the port?
A) The positioning indicating device (PID)
B) The collimator
C) The filter
D) The transformer
Answer: C
Q4) What is the purpose of a "deadman" exposure switch?
Answer: Required by law, the purpose of the deadman switch is safety. X-rays cannot be generated unless the radiographer's finger is actively depressing the button.
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Chapter 4: Factors Affecting Radiographic Quality
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Q1) Thicker intensifying screens increase the sharpness of extraoral radiographs.
A)True
B)False
Q2) Image magnification can be decreased by:
A) increasing the target-object distance.
B) increasing the object-image receptor distance.
C) decreasing the target-surface distance.
D) increasing the focal spot size.
Q3) Radiographic image unsharpness is generally caused by movement of the patient, image receptor, or tube head during exposure.
A)True
B)False
Q4) Each of the following is a term used to describe visual image characteristics EXCEPT one. Which one is the EXCEPTION?
A) Sharpness
B) Contrast
C) Milliamperage
D) Density
Q5) What is radiographic contrast?
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Chapter 5: Effects of Radiation Exposure
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Q1) Which of these is NOT a symptom of acute radiation syndrome.
A) Constipation
B) Nausea
C) Hemorrhage
D) Hair loss
Q2) What theory of radiation damage to cells results from free radicals combining to form toxins such as hydrogen peroxide?
A) Primary
B) Secondary
C) Indirect
D) Direct
Q3) The structures of the oral and facial regions are relatively radioresistant.
A)True
B)False
Q4) Scientists do not know whether low levels of radiation exposure carry health risks.
A)True
B)False
Q5) When do the effects of irradiation occur?
Q6) Do scientists believe that radiation damage to reproductive cells is cumulative?
Page 7
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Chapter 6: Radiation Protection
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Q1) Guidelines for prescribing radiographs are based on:
A) medical and dental histories.
B) clinical examination.
C) signs and symptoms.
D) All of the above.
Q2) The best way to reduce patient risk from radiation exposure is to keep exposures ALARA.
A)True
B)False
Q3) Which of the following statements about the position indicating device (PID) is correct?
A) The shorter the PID, the less divergent the beam.
B) The longer the PID, the greater the radiation dose to the patient.
C) Pointed, closed-end plastic cone PIDs should no longer be used.
D) A recessed PID creates a shorter target-surface distance.
Q4) What are the three categories of methods for protecting oral health care personnel from radiation exposure?
Q5) The sum of inherent and added filtration is called .
Q6) Should the patient wear a thyroid collar during panoramic radiography?
Q7) Currently, what film speed is recommended to reduce radiation exposure?
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Chapter 7: Dental X-Ray Film and Processing Methods
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Q1) What type of film is needed to copy a dental radiograph?
Q2) Which of the following statements regarding extraoral film is FALSE?
A) It is used outside the mouth.
B) It comes individually wrapped in protective paper.
C) It is called a "screen film."
D) It uses intensifying screens.
Q3) During periapical radiograph film packet placement, the embossed dot should be positioned toward the apices of the teeth.
A)True
B)False
Q4) Bitewing radiographs image the entire tooth, from crown to root tip.
A)True
B)False
Q5) 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.
Q6) What is the color of the tube side of the film packet?
Q7) Which side of the film packet faces the source of radiation?
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Chapter 8: Digital Radiography and Image Acquisition
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Q1) The <KT>developing agent</KT> will only have an effect on the exposed silver halide crystals at recommended time-temperature.
A)True
B)False
Q2) Each of the following statements regarding darkroom safelighting is true EXCEPT one. Which one is the EXCEPTION?
A) Walls should be painted black.
B) You should allow longer wavelength red-orange light to pass through the safelight filter.
C) Shorter wavelength blue-green light is removed by the safelight filter.
D) Four feet is the minimum distance between the safelight and the countertop.
Q3) What is the name of the component of developer that prevents development of unexposed silver halide crystals?
Q4) How does the temperature of the chemistry used in automatic processors compare to the temperature of the chemistry used for manual processing?
Q5) A thermometer is mandatory for archival manual processing.
A)True
B)False
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Chapter 9: Infection Control
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Q1) Which requires less radiation to produce an image, digital or conventional film-based radiographs?
Q2) Digitization uses a computer to superimpose two standardized radiographic images, causing the like areas of the image to "cancel" each other out, leaving only the changes visible.
A)True
B)False
Q3) By what mechanism are PSP plates reusable?
Q4) Which of these is NOT an advantage of digital imaging over film-based imaging?
A) There is less radiation exposure.
B) It eliminates the need for a darkroom.
C) It is easier to place into position in the oral cavity.
D) Images may be manipulated to enhance interpretation.
Q5) Line pairs refers to the total number of shades of gray visible in an image. A)True B)False
Q6) Photostimulable phosphor plates are light-sensitive.
A)True
B)False
Q7) What is the digital equivalent of film fog?
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Chapter 10: Legal and Ethical Responsibilities
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Q1) Each of the following statements regarding the use of daylight loader attachments on automatic processors is correct EXCEPT one. Which one is the EXCEPTION?
A) The operator must remove the light-filter cover when placing and removing items.
B) The advantage of these devices is that time-saving shortcuts are acceptable.
C) Clean, dry hands can be slid through light-tight baffles to access the unit.
D) The key to infection control is to never slide anything through the baffles except clean, dry hands.
Q2) The radiographer should be able to aseptically open all film packets in a full mouth series in 2 minutes or less to avoid excessive exposure to safelight.
A)True
B)False
Q3) The radiographer should use powdered, nonsterile gloves made of latex or vinyl when placing intraoral radiographs.
A)True
B)False
Q4) Are some patients likely to be reluctant to admit infectious conditions?
Q5) What are infectious diseases?
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Chapter 11: Patient Relations and Education
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Q1) Some states require additional credentials beyond passing the National Board Dental Hygiene Examination or Dental Assisting National Board Examination to place and expose dental radiographs.
A)True
B)False
Q2) The legal right of the patient to refuse radiographs is a form of:
A) the statute of limitations.
B) liability.
C) self-determination.
D) disclosure.
Q3) There are national guidelines regarding who can place and expose dental radiographs.
A)True
B)False
Q4) Providing the radiographers with a radiation monitoring device is good risk management.
A)True
B)False
Q5) Who owns a patient's dental radiographs?
Q6) Generally, how frequently must x-ray machines be inspected?
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Chapter 12: Introduction to Radiographic Examinations
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Q1) Prior to leaving the operatory to make an exposure, the radiographer should ask the patient, "Can you hold still, please?"
A)True
B)False
Q2) If placement of an intraoral image receptor is uncomfortable for the patient, the radiographic procedure should be postponed.
A)True
B)False
Q3) Which of the following statements regarding interpersonal skills is best?
A) The radiographer should praise the patient for their assistance with the procedure.
B) Acknowledge mistakes with an easygoing "Oops," indicating that it is not serious.
C) It is natural to show frustration with a patient who is having difficulty managing the procedure.
D) If a patient is feeling discomfort, tell him or her to hang on and be patient.
Q4) Are large amounts of radiation harmful?
Q5) Can intraoral and panoramic radiographs be prescribed for the same patient?
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Chapter 13: The Periapical Examinationparalleling Technique
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Q1) 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
Q2) Radiographs are shadow images on an image receptor.
A)True
B)False
Q3) The bisecting technique originated from the rule of isometry.
A)True
B)False
Q4) Which of these statements is FALSE?
A) Bitewing radiographs record the apices of teeth and surrounding bone.
B) Bitewing radiographs record the coronal portions of teeth and alveolar crests of both arches.
C) Periapical radiographs may be taken using the bisecting or paralleling technique.
D) Occlusal radiographs record the maxillary or mandibular arch (or a portion thereof) on a single image receptor.
15
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Chapter 14: The Periapical Examinationbisecting Technique
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Q1) When using an image receptor holder with an external aiming device, the patient's head does not need to be precisely positioned.
A)True
B)False
Q2) The paralleling technique is preferred over the bisecting technique.
A)True
B)False
Q3) Which of the following is NOT a disadvantage of the paralleling technique?
A) The best images are obtained with the more difficult to position long 16-inch PID.
B) Image receptor positioning is difficult for patients with small mouths.
C) There is a limited number of image receptor holders that accommodate the paralleling technique.
D) It is more likely to excite an exaggerated gag reflex to achieve parallel position in the posterior region.
Q4) Name an image receptor holder designed for the paralleling technique that does not have an external aiming device.
Q5) Incorrectly aligning the point of entry will result in what type of error?
Q6) How is the correct point of entry achieved when using the paralleling technique?
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Chapter 15: The Bitewing Examination
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Q1) What is the preferred target-surface distance when using the bisecting technique?
Q2) Which of the following will correct a foreshortened image?
A) Increasing the vertical angulation
B) Decreasing the vertical angulation
C) Directing the central ray perpendicular to the plane of the image receptor
D) Directing the central ray perpendicular to the long axis of the tooth
Q3) When using the bisecting technique, the patient should bite down on the image receptor bite block as close to the teeth as necessary.
A)True
B)False
Q4) The recommended vertical angulation for exposing a mandibular incisor periapical radiograph using the bisecting technique is:
A) -10 degrees
B) -15 degrees
C) -20 degrees
D) -5 degrees
Q5) What must the radiographer do prior to confidently using predetermined vertical angulations when applying the bisecting technique?
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Chapter 16: The Occlusal Examination
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Q1) What type of error results when the image receptor is not centered within the x-ray beam?
Q2) The smallest available image receptor should be used to take bitewings on the child patient.
A)True
B)False
Q3) A periodontally involved patient would benefit more from vertical bitewing radiographs than traditionally placed bitewing radiographs.
A)True
B)False
Q4) Using an image receptor holder with an external aiming device will most likely eliminate what error?
A) Overlapping
B) Unequal distribution of arches recorded
C) Cone cutting
D) Incorrect placement of the image receptor
Q5) What is the name of the location the central ray is directed toward on the patient's face?
Q6) Which two angulations are critical to producing quality bitewing radiographs?
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Chapter 17: The Panoramic Examination
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Q1) If the patient's head is in correct position, predetermined vertical angulations and points of entry may be used.
A)True
B)False
Q2) The horizontal angulation for topographical occlusal radiographs is determined by directing the central rays at the image receptor perpendicularly through the teeth embrasures (spaces).
A)True
B)False
Q3) The occlusal examination may be made alone or to supplement periapical or bitewing radiographs.
A)True
B)False
Q4) The thyroid collar may be in the path of the primary beam during which occlusal technique?
A) Maxillary posterior topographical
B) Mandibular anterior topographical
C) Mandibular posterior topographical
D) Mandibular cross-sectional
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Chapter 18: Identifying and Correcting Undiagnostic Radiographs
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Q1) Dark spots on the film are caused by premature contact with the developer.
A)True
B)False
Q2) Electronic noise is the digital equivalent of film fog.
A)True
B)False
Q3) Failing to record the apical region of the teeth on a periapical radiograph 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
Q4) Assembling an image receptor holder with external aiming device incorrectly may lead to conecut error.
A)True
B)False
Q5) A scratched safelight filter or incorrect bulb wattage can result in film fog.
A)True
B)False
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Chapter 19: Quality Control and Environmental Safety in Dental Radiography
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Q1) Only the dentist has the authority to carry out quality control tests on radiographic systems used in the practice.
A)True
B)False
Q2) What is quality assurance in dental radiography?
Q3) 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
Q4) Operator competency can reduce patient radiation exposure.
A)True
B)False
Q5) When not in use, should the PID be pointing up?
Q6) What is the key to peak performance of an automatic processor?
Q7) What is a reference film?
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Chapter 20: Image Orientation and Introduction to Interpretation
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Q1) The radiographer should not handle the lead foils from film packets unless the hands are protected with gloves.
A)True
B)False
Q2) If disinfectant should contact the skin, the recommended treatment is to flush immediately with copious amounts of water.
A)True
B)False
Q3) Which of these is NOT considered PPE?
A) Mask
B) Gloves
C) Eyewear
D) Radiation monitoring device
Q4) What gloves best protect the radiographer during processing chemical replenishment?
A) Plastic overgloves
B) Nitrile utility gloves
C) Vinyl treatment gloves
D) Powdered latex gloves
Q5) List the requirements of an emergency eyewash station.
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Chapter 21: Recognizing Normal Radiographic Anatomy
Intraoral Radiographs
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Q1) Which of these statements is FALSE?
A) Once exposed and processed, heat can no longer affect dental film.
B) Misplaced radiographs can result in risk-management problems.
C) Radiographs should be retained indefinitely.
D) Radiographs should be handled with care to avoid smudging or scratching.
Q2) What is radiographic interpretation?
Q3) To optimize viewing of digital radiographs, the computer monitor should be located in an area of bright light.
A)True
B)False
Q4) If a film packet is placed in the patient's mouth correctly, which side will face the source of radiation?
A) The white, unprinted side with the embossed dot concave
B) The white, unprinted side with the embossed dot convex
C) The colored, printed side with the embossed dot concave
D) The colored, printed side with the embossed dot convex
Q5) Which is the preferred method of mounting films?
Q6) The lingual method of mounting radiographs positions the embossed dot convex.
A)True
B)False
Page 23
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Chapter 22: Recognizing Normal Radiographic Anatomy
Panoramic Radiographs
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Q1) How does the lateral fossa appear on a dental radiograph?
Q2) Radiographs taken on a 5-year-old child will most likely image 20 primary teeth.
A)True
B)False
Q3) Which of the following lists the structures in order of decreasing radiopacity?
A) Pulp, dentin, cementum, enamel
B) Enamel, dentin, cementum, pulp
C) Pulp, cementum, dentin, enamel
D) Enamel, cementum, dentin, pulp
Q4) The oblique ridge 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.
Q5) Cancellous bone appears extremely radiopaque.
A)True
B)False
Page 25
Q6) What is the thin radiolucent line that delineates the midline of the palate and the junction of the right and left maxilla called?
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Chapter 3: Radiographic Appearance of Dental Materials and Foreign Objects
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Q1) Which of these statements is FALSE?
A) Post and core restorations resemble implants radiographically.
B) Retention pins have a shape that is easy to identify on the radiograph.
C) Retention pins are located in the dentin only.
D) Post and core restorations are always observed in conjunction with endodontic filling material.
Q2) What is the term applied to tumors that do little or no harm?
Q3) A granuloma is a mass of granulation tissue.
A)True
B)False
Q4) When a developmental anomaly occurs in which the enamel invaginates within the body of the tooth, it is called "mesiodens."
A)True
B)False
Q5) A condition where the cementum of adjacent teeth is joined together is called "condensing osteitis."
A)True
B)False
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Q6) What is the most commonly encountered form of benign tumor in the arches?
Chapter 24: The Use of Radiographs in the Detection of Dental Caries
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Q1) The borders of buccal and lingual caries are usually ill-defined radiographically.
A)True
B)False
Q2) For dental caries to be recorded on a radiograph, there has to be a decrease in calcium and phosphorus of approximately 40-50 percent.
A)True
B)False
Q3) 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.
Q4) Radiographs are often prescribed to detect caries on which surfaces of the teeth?
Q5) The depth of buccal or lingual caries can be determined by observing the radiographs.
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) Describe the earliest radiographic evidence of periodontal disease.
Q2) What is the earliest case type of periodontal disease in which furcation involvement is seen radiographically?
Q3) Radiographs may provide information regarding which of the following periodontal conditions?
A) Gingival inflammation
B) Local contributing factors
C) The presence of active disease
D) The depth of the pockets
Q4) Radiographs can serve as a baseline and as a means for determining treatment success or failure.
A)True
B)False
Q5) Which periodontal disease case type demonstrates early bone loss, up to 30 percent?
Q6) Can radiographs be used to differentiate treated versus untreated disease?
Q7) How does the two-dimensional nature of radiographs limit their utility as a diagnostic aid?
Q8) What is triangulation? Page 28
Q9) Can gingivitis be detected radiographically?
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Chapter
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Q1) Which of the following extraoral radiographs is commonly assessed for in conjunction with intraoral radiographs for the child patient?
A) Transcranial
B) Panoramic
C) Waters
D) Reverse Towne
Q2) Because the image receptor may lay flatter in the oral cavity of a child, the ______ angulation may be _________ to assist in recording more of the periapical region.
A) horizontal, increased
B) horizontal, decreased
C) vertical, increased
D) vertical, decreased
Q3) At what age would a child most likely benefit from the exposure of 4 bitewing and 14 periapical radiographs when a complete mouth examination is required?
A) 5
B) 10
C) 13
D) 15
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Chapter 27: Pediatric Radiographic Techniques
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Q1) Placing the image receptor to expose the anterior regions first can help avoid exciting a gag reflex.
A)True
B)False
Q2) Should the radiographer allow the patient to help decide the correct position of the image receptor intraorally?
Q3) How should pregnant patients who need dental radiographs be prepared for the procedure?
Q4) Currently, the ADA recommendation is that elective radiographs may be taken on the pregnant female. Unnecessary radiographs may be taken only when the female is determined not to be pregnant.
A) The first sentence is true. The second sentence is false.
B) The first sentence is false. The second sentence is true.
C) Both sentences are true
D) Both sentences are false.
Q5) Should the radiographer expose the anterior or posterior projections first?
Q6) Is receipt of large amounts of therapeutic radiation to the head and neck area a contraindication to future dental radiographs?
Q7) Should a hearing aid be removed prior to a panoramic radiographic exposure?
Page 31
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Chapter 28: Radiographic Techniques for Patients With Special Needs
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Q1) Localization methods provide a way for the radiographer to read a third dimension into two-dimensional radiographs.
A)True
B)False
Q2) Disto-oblique periapical radiographs are indicated for each of the following EXCEPT one. Which one is the EXCEPTION?
A) Suspected pathology located in the tuberosity area
B) Imaging impacted third molars
C) A patient who cannot tolerate posterior placement of the image receptor
D) Detection of interproximal caries
Q3) To avoid overlap of contact areas on a molar bitewing radiograph, the image receptor should be positioned perpendicularly to the midpoint of the maxillary first molar.
A)True
B)False
Q4) Which localization technique requires the exposure of only one radiograph?
A) The definitive evaluation method
B) The right-angle method
C) The tube-shift method
Q5) What is a duplicate radiograph?
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Chapter 29: Radiographic Techniques for Specific Oral Conditions
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Q1) Each of the following statements regarding extraoral film is correct EXCEPT one. Which one is the EXCEPTION?
A) Handle by the edges only.
B) Remove from the box slowly.
C) Slide across the intensifying screens when placing it in the cassette.
D) Load into the cassette just prior to use.
Q2) Why should cassettes and intensifying screens be examined prior to use?
Q3) Which of the following statements regarding grids is correct?
A) They may be used with both intraoral and extraoral radiography.
B) They are composed of thin lead strips alternating with a radiolucent material.
C) They reduce the amount of radiation needed to produce an image.
D) They may add to the potential to increase film fog.
Q4) When placing a film into a cassette, it should be slid across the intensifying screens to ensure that it lies as close to the screens as possible.
A)True
B)False
Q5) What is a lateral cephalometric radiograph?
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Q6) Of what is the back cover of a rigid extraoral film cassette constructed?
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Chapter 30: Radiographic Techniques
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Sample Questions
Q1) What happens to the radiographic image if intensifying screens and film are not in tight contact?
Q2) If the patient's chin is tipped up, the image appears as an exaggerated smile.
A)True
B)False
Q3) Each of the following will appear radiopaque on a panoramic radiograph EXCEPT one. Which one is the EXCEPTION?
A) The lateral pterygoid plate
B) The zygomatic process
C) The genial tubercles
D) The infraorbital foramen
Q4) Which of the following would correct an exaggerated smile appearance of a panoramic radiograph?
A) Instruct the patient to straighten his or her posture.
B) Instruct the patient to close his or her lips around the bite block.
C) Reposition the midsaggital plane perpendicular to the floor.
D) Reposition the ala-tragus line at 5 degrees positive.
Q5) Panoramic radiography is based on the principles of tomography.
A)True
B)False
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