National Dental Hygiene Certification Examination (NDHCE) — Questions and Answers

Question 1: A patient's blood pressure reading is 145/95 mmHg. According to AHA guidelines, this is classified as:

Elevated
Stage 2 hypertension
Normal
Stage 1 hypertension (Correct answer)

Correct answer: Stage 1 hypertension

According to the 2017 AHA/ACC guidelines, a blood pressure of 130–139/80–89 mmHg is Stage 1 hypertension; 145/95 mmHg falls in the Stage 1 to Stage 2 range and is classified as Stage 2 hypertension — however, 140–159/90–99 is Stage 2.

Question 2: Which of the following muscles is responsible for depressing and retracting the tongue during swallowing?

Genioglossus
Palatoglossus
Hyoglossus (Correct answer)
Styloglossus

Correct answer: Hyoglossus

The hyoglossus muscle depresses and retracts the tongue; it originates from the hyoid bone and inserts into the lateral tongue.

Question 3: In treatment planning, why is it important to discuss the potential outcomes and risks with the patient?

To ensure the patient agrees to the most expensive treatment
To comply with legal requirements
To reduce the time spent on each treatment session
To obtain informed consent and align expectations (Correct answer)

Correct answer: To obtain informed consent and align expectations

Discussing potential outcomes and risks with the patient is crucial for obtaining informed consent, which is a legal and ethical requirement. This ensures the patient fully understands the proposed treatment, its benefits, risks, and alternatives, allowing them to make an autonomous decision and setting realistic expectations for the treatment's success and potential challenges.

Question 4: Which hepatitis virus is transmitted via the fecal-oral route and does NOT become chronic?

Hepatitis C (HCV)
Hepatitis D (HDV)
Hepatitis A (HAV) (Correct answer)
Hepatitis B (HBV)

Correct answer: Hepatitis A (HAV)

Hepatitis A virus (HAV) is transmitted via the fecal-oral route, causes acute self-limiting illness, and does not lead to chronic infection.

Question 5: A dental sealant program is an example of which level of disease prevention?

Primary prevention (Correct answer)
Secondary prevention
Tertiary prevention
Primordial prevention

Correct answer: Primary prevention

Dental sealants are a primary prevention measure because they prevent caries before the disease process begins by creating a physical barrier over susceptible pit-and-fissure surfaces.

Question 6: Which of the following factors is least important when prioritizing dental treatments?

Potential for disease progression
Patient's chief complaint
Aesthetic preferences of the patient (Correct answer)
Severity of the condition

Correct answer: Aesthetic preferences of the patient

While aesthetic preferences are important for patient satisfaction, they are generally the least critical factor when prioritizing dental treatments, especially compared to urgent health concerns. Factors like the patient's chief complaint, the severity of the condition, and the potential for disease progression directly impact oral health and function, making them higher priorities for treatment.

Question 7: Which of the following is a common sign of gingivitis?

Deep periodontal pockets
Gingival bleeding (Correct answer)
Tooth mobility
Abscess formation

Correct answer: Gingival bleeding

Gingival bleeding, particularly during brushing, flossing, or probing, is one of the earliest and most common clinical signs of gingivitis. It indicates inflammation of the gum tissue, which becomes more fragile and prone to bleeding due to bacterial plaque accumulation along the gumline.

Question 8: The Wickham's striae pattern of fine white lace-like lines on the buccal mucosa is characteristic of which condition?

Pemphigus vulgaris
Erythema multiforme
Psoriasis
Lichen planus (Correct answer)

Correct answer: Lichen planus

Wickham's striae — interlacing white lines on the buccal mucosa — are pathognomonic of oral lichen planus, an immune-mediated mucocutaneous disease.

Question 9: A patient presents with angular cheilitis, burning tongue, and generalized erythematous mucosa. Which nutritional deficiency should the dental hygienist suspect?

Vitamin C deficiency
Calcium deficiency
B-complex vitamin deficiency (Correct answer)
Vitamin D deficiency

Correct answer: B-complex vitamin deficiency

Angular cheilitis, glossitis, and erythematous mucosa are classic oral manifestations of B-complex vitamin deficiencies, particularly B2 (riboflavin), B3 (niacin), and B12.

Question 10: School-based dental screenings primarily serve which of the following purposes?

To diagnose and treat dental disease in school settings
To replace private dental care for low-income students
To identify children who need follow-up dental care and refer them to providers (Correct answer)
To administer fluoride treatments to all students

Correct answer: To identify children who need follow-up dental care and refer them to providers

School-based dental screenings identify children with dental needs and refer them to dental providers for diagnosis and treatment, acting as an entry point into the dental care system.

Question 11: Which OSHA standard requires dental employers to provide the Hepatitis B vaccine to exposed employees at no cost?

Bloodborne Pathogens Standard (29 CFR 1910.1030) (Correct answer)
Respiratory Protection Standard
Personal Protective Equipment Standard
Hazard Communication Standard

Correct answer: Bloodborne Pathogens Standard (29 CFR 1910.1030)

OSHA's Bloodborne Pathogens Standard (29 CFR 1910.1030) requires employers to offer the Hepatitis B vaccination series to all employees with occupational exposure at no cost within 10 days of initial assignment.

Question 12: The rubber dam is used during dental procedures primarily to:

Improve radiographic image quality
Provide a stretching exercise for the masseter muscle
Reduce patient anxiety during treatment
Isolate the operative field and reduce aerosol contamination (Correct answer)

Correct answer: Isolate the operative field and reduce aerosol contamination

The rubber dam isolates the tooth being treated from saliva, reduces aerosol-borne microbial contamination, and improves operator access and visibility.

Question 13: An exophytic nodule of fibrous connective tissue on the gingiva caused by chronic low-grade irritation is best termed:

Peripheral giant cell granuloma
Pyogenic granuloma
Peripheral ossifying fibroma
Irritation fibroma (Correct answer)

Correct answer: Irritation fibroma

An irritation fibroma (traumatic fibroma) is a reactive hyperplasia of fibrous connective tissue in response to chronic irritation, appearing as a smooth, sessile or pedunculated nodule.

Question 14: Which dental condition would appear radiopaque on a radiograph?

Periapical abscess
Pulp chamber
Dental caries
Amalgam restoration (Correct answer)

Correct answer: Amalgam restoration

Amalgam restorations are highly radiopaque because the metal alloy absorbs X-rays, appearing white on the radiograph.

Question 15: What is the function of the inferior alveolar nerve (IAN) in dental procedures?

Provides sensory innervation to the mandibular teeth, lower lip, and chin (Correct answer)
Controls motor function of the lower lip
Innervates the tongue for taste
Controls the muscles of facial expression

Correct answer: Provides sensory innervation to the mandibular teeth, lower lip, and chin

The inferior alveolar nerve (IAN), a branch of V3, provides sensory innervation to all mandibular teeth, the lower lip, and chin; blocking this nerve is the target of an inferior alveolar nerve block injection.

Question 16: Which hand hygiene method is MOST effective for reducing the number of microorganisms on hands before surgical procedures?

Routine handwashing with soap and water for 15 seconds
Surgical hand antisepsis using antiseptic soap or alcohol-based product with persistent activity (Correct answer)
Wiping hands with disinfectant wipes
Alcohol-based hand rub applied once

Correct answer: Surgical hand antisepsis using antiseptic soap or alcohol-based product with persistent activity

Surgical hand antisepsis uses a specific technique and antiseptic agent with residual (persistent) antimicrobial activity to reduce microorganisms to a minimum before surgical procedures.

Question 17: Which term describes the number of new cases of a disease occurring in a population during a specific time period?

Morbidity rate
Prevalence
Attack rate
Incidence (Correct answer)

Correct answer: Incidence

Incidence measures the rate at which new cases of a disease occur in a population during a defined time period, reflecting disease risk.

Question 18: Which of the following is most effective in preventing dental caries?

Regular fluoride treatments (Correct answer)
Drinking plenty of water
Daily flossing
Chewing sugar-free gum

Correct answer: Regular fluoride treatments

Regular fluoride treatments are highly effective in preventing dental caries because fluoride strengthens tooth enamel. This makes the enamel more resistant to acid attacks produced by bacteria and sugars, which are the primary cause of cavities. While other practices contribute to oral health, fluoride directly enhances the tooth's ability to resist decay.

Question 19: What is the primary goal of a community needs assessment in dental public health?

To identify the oral health problems and resources within a community to guide program planning (Correct answer)
To determine individual patient treatment plans
To recruit dental hygienists for community positions
To evaluate the effectiveness of an existing dental program

Correct answer: To identify the oral health problems and resources within a community to guide program planning

A community needs assessment gathers data on the oral health status, risk factors, resources, and barriers within a community to identify priorities for public health programs.

Question 20: Which bone forms the posterior part of the hard palate?

Sphenoid bone
Vomer bone
Maxillary bone (palatine process)
Palatine bone (horizontal plate) (Correct answer)

Correct answer: Palatine bone (horizontal plate)

The horizontal plates of the paired palatine bones form the posterior one-third of the hard palate, while the palatine processes of the maxilla form the anterior two-thirds.

Question 21: Which type of radiograph provides the most comprehensive view of the entire dentition, jaws, and surrounding structures in a single image?

Bitewing series
Panoramic radiograph (Correct answer)
Full-mouth series
Cephalometric radiograph

Correct answer: Panoramic radiograph

A panoramic radiograph captures a broad view of the entire maxilla, mandible, teeth, TMJ, and surrounding structures on a single extraoral film.

Question 22: What should be the primary focus when creating a treatment plan for a patient with advanced periodontitis?

Infection control and tissue preservation (Correct answer)
Cosmetic improvements
Pain management
Orthodontic correction

Correct answer: Infection control and tissue preservation

Advanced periodontitis is characterized by severe infection, inflammation, and significant destruction of supporting tissues, including bone loss. The primary focus of treatment must be to control the bacterial infection, reduce inflammation, and preserve as much remaining periodontal tissue as possible to prevent further tooth loss and stabilize the patient's oral health.

Question 23: A patient with Addison's disease (primary adrenal insufficiency) may exhibit which distinctive oral finding?

Torus mandibularis
Multifocal melanin pigmentation (Correct answer)
Geographic tongue
Hairy tongue

Correct answer: Multifocal melanin pigmentation

Addison's disease causes elevated ACTH, which stimulates melanocytes, resulting in diffuse or focal melanin hyperpigmentation of the oral mucosa, particularly the buccal mucosa and gingiva.

Question 24: A dental hygienist records a gingival recession of 2 mm and a probing depth of 4 mm. What is the clinical attachment loss (CAL)?

2 mm
8 mm
4 mm
6 mm (Correct answer)

Correct answer: 6 mm

CAL is calculated by adding probing depth to recession: 4 mm + 2 mm = 6 mm, indicating 6 mm of total attachment loss.

Question 25: When assessing tooth mobility, a Grade II mobility reading means:

Movement greater than 1 mm in horizontal direction (Correct answer)
No movement detected
Slight movement (up to 1 mm) in a horizontal direction
Tooth is depressible in its socket

Correct answer: Movement greater than 1 mm in horizontal direction

Grade II tooth mobility indicates movement greater than 1 mm in a horizontal (buccolingual or mesiodistal) direction but no vertical movement.

Question 26: Which of the following best defines a sinus tract (formerly called a fistula) on clinical examination?

A channel through soft or hard tissue that drains a chronic abscess (Correct answer)
A mucosal lesion from prosthetic irritation
An open cavity in the tooth from advanced caries
A deep periodontal pocket with bleeding

Correct answer: A channel through soft or hard tissue that drains a chronic abscess

A sinus tract is a channel or pathway through tissue that provides drainage for a chronic periapical or periodontal abscess, often appearing as a small opening on the gingiva.

Question 27: Which film placement error results in a foreshortened image on a periapical radiograph?

Incorrect horizontal angulation
Insufficient vertical angulation
Film placed backwards
Excessive vertical angulation (Correct answer)

Correct answer: Excessive vertical angulation

Excessive positive (downward) vertical angulation causes the image to appear foreshortened, making teeth look shorter than they actually are.

Question 28: Which screening tool used in dental hygiene practice assesses a patient's oral health literacy?

PSR index
OHI-S
REALD-30 or NVS (Newest Vital Sign) (Correct answer)
HEENT examination

Correct answer: REALD-30 or NVS (Newest Vital Sign)

The Newest Vital Sign (NVS) and REALD-30 are validated tools used to assess health literacy, which helps the clinician tailor patient education appropriately.

Question 29: When should gloves be changed during patient treatment?

Whenever they are visibly soiled or torn, and between patients (Correct answer)
After every instrument change
Only at the beginning and end of the appointment
Only when treating a patient with a known infection

Correct answer: Whenever they are visibly soiled or torn, and between patients

Gloves must be changed whenever they are visibly soiled, torn, or punctured during treatment and must always be changed between patients to prevent cross-contamination.

Question 30: What is the first step in developing a treatment plan for a dental hygiene patient?

Reviewing the patient's medical history (Correct answer)
Conducting an oral cancer screening
Taking radiographs
Performing a periodontal probing

Correct answer: Reviewing the patient's medical history

Reviewing the patient's medical history is the foundational first step in developing a dental hygiene treatment plan. This critical process identifies any systemic conditions, medications, allergies, or previous surgeries that could impact dental treatment, ensuring patient safety and guiding appropriate, personalized care decisions.

Question 31: What is the primary characteristic of periodontitis?

Absence of clinical attachment loss
Presence of dental caries
Inflammation limited to the gingiva
Bone loss around the teeth (Correct answer)

Correct answer: Bone loss around the teeth

Periodontitis is a chronic inflammatory disease that progresses beyond gingivitis, leading to the destruction of the supporting structures of the teeth. Its primary characteristic is irreversible bone loss around the teeth, along with clinical attachment loss and the formation of periodontal pockets, which can ultimately lead to tooth mobility and loss.

National Dental Hygiene Certification Examination (NDHCE)

The NDHCE is a Canadian national certification examination that assesses entry-to-practice knowledge, judgment, and clinical skills of dental hygiene graduates seeking licensure as registered dental hygienists across Canadian provinces.

200

Questions

240 min

Time Limit

70%

To Pass

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These practice questions were written with AI tools. They are not real exam questions. Exam facts are checked against the official sources listed below. Not reviewed by a subject-matter expert. Editorial policy

Sources & references

Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy

fdhrc.ca — Exam format, passing score, retake policy, fees, late registration, score release, exam dates, registration deadline, test dates, eligibility · verified Oct 2026
fdhrc.ysasecure.com — Exam information · verified Oct 2026
oralhealthbc.ca — Score validity · verified Oct 2026