Sample the Odontiq question bank below: genuine ADC-style clinical scenarios with full worked explanations, written and reviewed to match the style, depth and difficulty of the Australian Dental Council Written Examination. Read the case, choose your answer, then reveal the explanation. When you're ready, start a free adaptive session against 5,000+ blueprint-weighted questions.
A 73-year-old woman is brought to your clinic 90 minutes after tripping and falling face-first onto a concrete step at home. She has a laceration of the upper lip and complains that her upper front teeth 'feel loose and the bite is wrong'. On examination, teeth 11, 21 and 22 move together as a single block when gently tested, there is a palpable step in the labial alveolar bone, gingival tearing in the 21/22 region, and the segment is displaced palatally causing premature contact. The teeth are firm within the segment and not individually displaced. Her medical history includes atrial fibrillation managed with apixaban 5 mg twice daily, type 2 diabetes (most recent HbA1c 7.2%), hypertension, and osteoporosis treated with annual intravenous zoledronic acid (last infusion 4 months ago). She is alert, oriented, and her airway, breathing and circulation are stable.
The injury involves a gingival laceration and the alveolar fracture will require suturing. Considering her medication, which is the most important piece of information to obtain before proceeding?
A.Her most recent INR result
B.Whether she takes aspirin in addition to apixaban
C.The timing of her last apixaban dose and her current renal function (eGFR)
D.The date of her first ever zoledronic acid infusion
E.Her fasting blood glucose level on the morning of the injury
Show answer & explanation
Correct answer: C — The timing of her last apixaban dose and her current renal function (eGFR)
Apixaban is a direct factor Xa inhibitor whose anticoagulant effect peaks 2–4 hours after dosing and is cleared partly renally; knowing the timing of the last dose and renal function allows you to gauge current bleeding risk and plan local haemostasis and procedure timing. The INR is irrelevant for apixaban because, unlike warfarin, it is not monitored or reflected by the INR — selecting it reveals a common and clinically dangerous error. Concurrent aspirin would be useful but is secondary to characterising the DOAC itself. The date of the first zoledronic acid infusion does not change acute bleeding management. A single fasting glucose is unhelpful with an HbA1c of 7.2% already documenting reasonable control. Learning point: Therapeutic Guidelines emphasise that DOACs are not monitored by INR; bleeding risk is assessed by dose timing and renal function.
Question 2General Medicine
Mia, a 15-year-old girl, attends with her mother. She has end-stage renal disease secondary to reflux nephropathy and has received maintenance haemodialysis three times weekly (Monday/Wednesday/Friday) for 14 months via an arteriovenous (AV) fistula in her left forearm. She is currently active on the renal transplant waiting list. Her medications are amlodipine, calcium carbonate (phosphate binder), recombinant erythropoietin and folic acid. She presents on a Tuesday with a 3-day history of throbbing pain from a grossly carious, non-restorable lower right first molar (46); extraction is planned. Recent bloods show Hb 105 g/L, platelets 140 ×10⁹/L, elevated urea, and an INR of 1.0. Her blood pressure today is 128/82 mmHg and she is otherwise well.
When recording Mia's vital signs and delivering local anaesthesia, which is the single most important precaution?
A.Use the left fistula arm for blood pressure so its patency can be confirmed before treatment
B.Avoid using the left arm (containing the AV fistula) for blood pressure measurement, venepuncture or constriction
C.Avoid all local anaesthetic solutions that contain adrenaline
D.Withhold local anaesthesia until repeat dialysis biochemistry is obtained on the day
E.Inflate the cuff on the fistula arm slowly to reduce the pressure on the vessel
Show answer & explanation
Correct answer: B — Avoid using the left arm (containing the AV fistula) for blood pressure measurement, venepuncture or constriction
An AV fistula is the patient's dialysis lifeline. The arm bearing the fistula must never be used for blood pressure cuffs, venepuncture or any constriction, as this can damage or thrombose the access. Use the opposite (right) arm. Deliberately cuffing the fistula arm 'to check patency' risks occluding it; standard low-dose adrenaline-containing local anaesthetic is appropriate and helps haemostasis — blanket avoidance is unwarranted in a patient with controlled BP; routine same-day biochemistry is not required to deliver local anaesthesia in a stable patient; cuffing the fistula arm at all — slowly or not — is contraindicated. Learning point: protecting vascular access is a core safety check in dialysis patients — document the fistula site and flag the limb as not to be used.
Question 3Infection Prevention & Control
A 64-year-old man attends your practice for management of multiple carious teeth and extraction of a non-restorable lower right first molar (36 retained roots). His medical history is significant: he underwent bilateral lung transplantation eight months ago for end-stage idiopathic pulmonary fibrosis and is maintained on triple immunosuppression (tacrolimus, mycophenolate mofetil and prednisolone 10 mg daily). His transplant physician has cleared him for dental care but has emphasised his heightened susceptibility to opportunistic respiratory infection. Your surgery uses conventional dental units supplied from the mains via the unit's internal lines. The practice last performed a shock disinfection of the dental unit waterlines (DUWLs) several months ago and routine maintenance has been inconsistent. You are aware that stagnant DUWLs readily develop biofilm and that aerosol-generating procedures will be required for this patient.
To verify that your routine (non-surgical) DUWL output water is fit for use before treating this patient, which monitoring approach and benchmark is most appropriate?
A.Visually inspect the water for clarity and odour before each session
B.Measure the residual free chlorine of the mains supply only
C.Test the water pH and accept any value between 6.5 and 8.5
D.Culture an output water sample for heterotrophic plate count, accepting ≤200 CFU/mL
E.Assume compliance because a shock disinfection was done within the last year
Show answer & explanation
Correct answer: D — Culture an output water sample for heterotrophic plate count, accepting ≤200 CFU/mL
Microbiological sampling of the water delivered at the handpiece/triplex, cultured for heterotrophic (aerobic) bacteria, with an accepted target of ≤200 CFU/mL (consistent with potable water), is the validated way to confirm DUWL output quality. Clarity/odour cannot detect biofilm bacteria; mains residual chlorine says nothing about contamination occurring within the unit's internal lines; pH is irrelevant to microbial load; a single past shock treatment without ongoing testing does not demonstrate current compliance (the case notes inconsistent maintenance). Learning point: ADA guidelines set ≤200 CFU/mL as the quality benchmark for non-surgical DUWL output and recommend periodic microbiological monitoring of output water rather than reliance on visual or proxy measures.
Question 4Paediatric Dentistry & Orthodontics
A 49-year-old woman attends your general practice complaining that she has trouble chewing comfortably on her right side and notices an occasional click from her left jaw joint. She is medically fit, takes no regular medication and has not had orthodontic treatment. On examination her oral hygiene is fair. The upper left first and second premolars and first molar (24, 25, 26) occlude lingual to their mandibular antagonists. When you guide her gently into her first tooth contact the dental midlines are coincident, but as she closes into maximum intercuspation the mandible deviates to the left and the lower midline shifts approximately 2 mm to that side. There is matched wear faceting on the left posterior teeth and mild masseteric tenderness on palpation. A panoramic radiograph and bitewings show no active caries, generalised horizontal alveolar bone loss of about 30%, and widened periodontal ligament spaces around 24-26. Probing depths are 4-5 mm with bleeding on probing in the upper left quadrant.
To confirm the functional component and plan treatment accurately, which additional record is most useful at this stage?
A.Diagnostic casts mounted in centric relation to quantify the centric relation–maximum intercuspation discrepancy
B.A stimulated salivary flow rate measurement
C.Pulp vitality testing of all posterior teeth
D.A seven-day diet diary
E.An overnight sleep study
Show answer & explanation
Correct answer: A — Diagnostic casts mounted in centric relation to quantify the centric relation–maximum intercuspation discrepancy
Mounting study casts in centric relation allows you to measure and document the slide between first contact and maximum intercuspation, confirming and quantifying the functional shift and helping plan tooth movement. Salivary flow testing assesses caries/xerostomia risk, not occlusion; vitality testing is relevant to pulpal diagnosis but not to confirming a functional shift; a diet diary informs caries-risk counselling; and a sleep study investigates sleep-disordered breathing — none of these address the occlusal/positional question being asked. Learning point: investigations should be selected to answer the specific clinical question — here, articulator-mounted casts in CR are the targeted tool for analysing and recording a functional mandibular displacement.
Question 5Pain & Anxiety Management
Geoff, a 58-year-old dairy farmer, lives on a property 2.5 hours' drive from the nearest regional centre. He attends your practice requesting that all his remaining upper teeth, including three retained roots, be removed in a single visit because repeated trips to town are difficult during the milking season. He is extremely dental-phobic and asks specifically for "being put to sleep with the drip" (intravenous sedation). His medical history includes hypertension (perindopril), type 2 diabetes (metformin; HbA1c 7.2%), and a BMI of 35 with a neck circumference of 45 cm. His wife reports loud snoring and witnessed pauses in breathing at night; his Epworth Sleepiness Scale is 14, and he has never been investigated for sleep apnoea. He drinks four standard drinks most evenings and smokes 10 cigarettes per day. On examination his Mallampati score is III and his blood pressure today is 148/88 mmHg.
Before committing to any sedation technique, which tool would most usefully quantify Geoff's perioperative airway/sleep-apnoea risk?
A.DASS-21 (Depression, Anxiety and Stress Scale)
B.MELD score
C.CHA₂DS₂-VASc score
D.Repeating the Epworth Sleepiness Scale
E.STOP-BANG questionnaire
Show answer & explanation
Correct answer: E — STOP-BANG questionnaire
The STOP-BANG questionnaire (Snoring, Tiredness, Observed apnoea, Pressure/hypertension, BMI >35, Age >50, Neck >40 cm, male Gender) is the validated perioperative screening tool for obstructive sleep apnoea risk — and Geoff already scores high on nearly every item, flagging him as high risk for airway obstruction under sedation. DASS-21 measures psychological distress, not airway risk. MELD assesses liver-disease/transplant prognosis. CHA₂DS₂-VASc estimates stroke risk in atrial fibrillation. The Epworth scale measures daytime sleepiness but does not stratify perioperative airway risk and is already known (14). Learning point: structured OSA screening (STOP-BANG) is a key part of sedation suitability assessment; a high score should prompt caution and escalation rather than chair-side deep sedation.
Question 6Periodontics
A 64-year-old man is referred by his GP for management of "bleeding gums and drifting front teeth". His medical history includes type 2 diabetes mellitus diagnosed 12 years ago (most recent HbA1c, taken 6 weeks ago, is 8.8%), permanent atrial fibrillation managed with apixaban 5 mg twice daily, and hypertension treated with perindopril. His BMI is 31 and he smokes 15 cigarettes per day (30 pack-year history). On examination there is heavy generalised supra- and subgingival calculus, generalised bleeding on probing of 65%, probing depths of 5–7 mm at most molars and 4–5 mm interproximally elsewhere, generalised 1–3 mm recession, and grade I–II mobility of several teeth. No suppuration or abscess is present. A periapical and bitewing series shows generalised horizontal bone loss of 30–50% of root length with angular (vertical) defects at the mesial aspects of the first molars. No teeth have been lost to date.
Which baseline clinical information is most important to record at this visit to allow meaningful re-evaluation of therapy later?
A.The single deepest probing depth in each quadrant only
B.A full-mouth six-point pocket chart with bleeding on probing, recession and plaque scores
C.Mobility grading of the anterior teeth alone
D.A repeat bitewing series only
E.The patient's self-reported bleeding frequency only
Show answer & explanation
Correct answer: B — A full-mouth six-point pocket chart with bleeding on probing, recession and plaque scores
Comprehensive baseline data — six-point probing depths, bleeding on probing, recession (to derive attachment levels) and plaque scores across all teeth — provide the reproducible endpoints needed to judge response to step 1–2 therapy at re-evaluation. Recording only the deepest pocket per quadrant misses site-specific change and most disease activity; anterior mobility alone is a narrow, non-specific measure; repeat radiographs are not indicated at every visit and bone change lags behind clinical healing; self-reported bleeding is subjective and unreliable. Learning point: objective, site-level periodontal charting is the foundation of monitoring; without a complete baseline you cannot demonstrate the effectiveness of non-surgical therapy or justify escalation.
Frequently asked questions
Are these real ADC exam questions?
No. The ADC does not release its exam questions. These are original, blueprint-aligned practice questions written and reviewed to mirror the style, clinical depth and difficulty of the ADC Written Examination — not leaked or recalled content.
How many questions are on the ADC Written Examination?
The ADC Written Examination contains 320 multiple-choice questions — 280 scored and 40 unscored — set as clinical scenarios across the five competency domains.
What does the ADC written exam cover?
Questions are weighted to a blueprint across five domains (Clinical Information Gathering, Diagnosis & Management Planning, Clinical Treatment & Evaluation, Professionalism, and Health Promotion) and 13 clinical disciplines such as periodontics, oral surgery, endodontics and paediatric dentistry.
How should I practise for the ADC written exam?
Practise with blueprint-weighted questions, always read the worked explanation (right or wrong), target your weakest disciplines, and sit full-length timed mock exams to build exam stamina. Odontiq does all four — start free, no card required.
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