DLOSCE Prescription Tasks: How to Answer the Antibiotic and Analgesic Questions (2026)
The DLOSCE ends with two prescription tasks that many candidates practise the least. They follow a fixed format, they reward a fixed method, and every answer comes from published US guidelines. Here is exactly how they work, how to read a regimen line, and how to classify every medication with confidence.
How the prescription tasks work
The DLOSCE contains exactly two prescription tasks: one involves antibiotics and the other involves analgesics.1
These three classifications are always presented. The regimen options change with each medication.2
Where prescriptions sit in the DLOSCE1
Five percent sounds small, but these are some of the most predictable points on the exam. Nothing here is a judgement call once you know the guidelines.
How to read a regimen line
Every regimen option follows the same format, for example 500mg, #21, 1T TID x7d.2
| Abbreviation | Meaning | Abbreviation | Meaning |
|---|---|---|---|
# |
total quantity dispensed | T |
tablet |
BID |
twice a day | TID |
three times a day |
QID |
four times a day | q6h |
every 6 hours |
PRN |
as needed | x7d |
for 7 days |
Try it: which regimen adds up?
1 × 3 × 7 = 21. This is the amoxicillin regimen from the ADA guideline, at the 7-day end of its 3 to 7 day range.3
1 × 3 × 7 = 21, not 28. A patient following the directions would have 7 tablets left over.
1 × 4 × 7 = 28. This matches four-times-a-day regimens such as penicillin VK or cephalexin 500 mg.3
2 × 3 × 7 = 42, not 56.
The 5-step method for every prescription task
Your patient-box scan
Tap each item as you check it on a practice case.
The antibiotic task: what the guidelines say
The ADA’s 2019 guideline on antibiotics for dental pain and swelling is the reference to know.3
| Situation (immunocompetent adult) | Antibiotics? |
|---|---|
| Irreversible pulpitis, with or without symptomatic apical periodontitis | No |
| Pulp necrosis with symptomatic apical periodontitis, or a localized acute apical abscess, when definitive dental treatment is done | No (strong recommendation) |
| Localized acute apical abscess when definitive dental treatment is NOT immediately available | Yes, plus an urgent referral |
| Any of these with systemic involvement (for example fever or malaise) | Yes, with definitive treatment |
“Definitive, conservative dental treatment” in the guideline means pulpotomy, pulpectomy, nonsurgical root canal treatment or incision for drainage of an abscess.3
Regimens to know, in DLOSCE format
| Patient | Drug | Regimen |
|---|---|---|
| No penicillin allergy (preferred) | Amoxicillin | 500mg, #21, 1T TID x7d |
| No penicillin allergy | Penicillin VK | 500mg, #28, 1T QID x7d |
| Penicillin allergy WITHOUT anaphylaxis, angioedema or hives | Cephalexin | 500mg, #28, 1T QID x7d |
| Penicillin allergy WITH anaphylaxis, angioedema or hives | Azithromycin | 250mg, #6, 2T day 1, then 1T daily x4d |
| Penicillin allergy WITH anaphylaxis, angioedema or hives | Clindamycin | 300mg, #28, 1T QID x7d |
| First-line failed (add-on) | Metronidazole | 500mg, #21, 1T TID x7d |
| First-line failed (switch) | Amoxicillin-clavulanate | 500/125mg, #21, 1T TID x7d |
Bonus: antibiotic prophylaxis (AHA 2021)
Prophylaxis is for high-risk cardiac patients only, such as those with prosthetic heart valves or material, previous infective endocarditis, certain congenital heart disease and cardiac transplant recipients with valve disease, before procedures that manipulate the gingiva or periapical region or perforate the mucosa.6
Single adult dose, 30 to 60 minutes before the procedure: amoxicillin 2 g (in DLOSCE format 500mg, #4, 4T 30-60 min before); with a penicillin allergy, cephalexin 2 g (only without anaphylaxis, angioedema or hives), azithromycin or clarithromycin 500 mg, or doxycycline 100 mg. Clindamycin is no longer recommended for dental prophylaxis.6
Prophylaxis is generally not recommended before dental procedures for patients with prosthetic joints.9
The analgesic task: what the guidelines say
The ADA’s 2024 guideline on acute dental pain puts NSAIDs first and opioids last.4
When an NSAID becomes “Contraindicated”
Aspirin or NSAID sensitivityAsthma, hives or allergic-type reactions after aspirin or another NSAID.8
Ulcer or GI bleedingNSAIDs carry a boxed warning for stomach bleeding, ulceration and perforation.8
Pregnancy at 20 weeks or laterThe FDA advises avoiding NSAIDs from 20 weeks of pregnancy.7
Interacting conditions and drugsAnticoagulants such as warfarin, kidney disease and heart failure all call for caution with NSAIDs.8
Four worked cases
Our own practice cases, reasoned from the guidelines above. Try each one before you open the answer.
Case 1: a localized abscess, and root canal treatment cannot start for five days
Patient box: 34-year-old, localized swelling over tooth 30, pulp necrosis, no fever, no allergies, no medications. Drainage was not possible today and root canal treatment is booked in five days.
Reasoning: definitive treatment is not immediately available and there is a localized acute apical abscess, so the ADA guideline supports an antibiotic plus an urgent referral.3 Amoxicillin is the preferred first-line drug; penicillin VK is the other first-line option; cephalexin and clindamycin are penicillin-allergy alternatives this patient does not need.
Regimen: amoxicillin 500mg, #21, 1T TID x7d.
Case 2: hives after amoxicillin
Patient box: the same abscess, but the history says the patient broke out in hives after amoxicillin.
Reasoning: amoxicillin is contraindicated. Because the reaction was hives, cephalexin is also contraindicated under the ADA and AHA rule. Azithromycin or clindamycin is the allergy alternative.36
Regimen: azithromycin 250mg, #6, 2T day 1, then 1T daily x4d, or clindamycin 300mg, #28, 1T QID x7d.
Case 3: pain after an extraction, with a history of a bleeding stomach ulcer
Patient box: 45-year-old after a simple extraction. Bleeding peptic ulcer last year. No other medications.
Reasoning: the ulcer history rules out NSAIDs, so ibuprofen and naproxen are contraindicated. Acetaminophen alone at a full therapeutic dose becomes the first-line choice. An opioid is not first-line.48
Regimen: acetaminophen 1,000 mg per dose as needed, staying under 4,000 mg a day. As an over-the-counter drug, no quantity is given.2
Case 4: a patient who takes alprazolam asks for “something strong”
Patient box: 52-year-old after surgical extraction, no stomach or kidney history, takes alprazolam (a benzodiazepine) for anxiety.
Reasoning: an NSAID with or without acetaminophen is first-line. Opioids should not be offered to a patient taking a benzodiazepine, so the hydrocodone-acetaminophen option is contraindicated.4
Regimen: for example, ibuprofen 400 mg with acetaminophen 500 mg.
7 traps that cost prescription points
Ignoring the type of allergyHives, angioedema or anaphylaxis rules out cephalexin; a mild rash history does not.
Antibiotics after definitive treatmentOnce drainage or root canal treatment is done and there is no systemic involvement, antibiotics are not recommended.
Leaving a medication blankEvery medication on the list needs a classification and a regimen.
Numbers that do not add upCheck tablets × doses × days against the # every time.
Missing the weeks of pregnancyFrom 20 weeks, NSAIDs are avoided.
Missing an interactionMetronidazole with alcohol, clarithromycin with simvastatin or lovastatin, opioids with benzodiazepines.
Reaching for the opioidNSAIDs and acetaminophen come first. Opioids are a rare last step.
How to prepare: our full plans
Practise the prescription format until it is automatic, then sit full timed tests.
The Study Boards DLOSCE courseBuilt around the real exam format:
- 4,500 questions across every DLOSCE topic
- 34 timed tests, including a dedicated prescription test
- 45 days of access, for $399
- US-licensed dentists answering your questions
Free DLOSCE guidesStart with these:
Frequently asked questions
How many prescription tasks are on the DLOSCE?
Can I get partial credit?
Do I have to write the prescription myself?
Which guidelines should I study?
Are the regimens on this page the official answer key?
DLOSCE Course by The Study Boards
4,500 questions, 34 timed tests including a dedicated prescription test, and US-licensed dentists answering your questions. 45 days for $399.
Stuck on a prescription case?
Message us on WhatsApp. Our Admin Team with Dr. T and Dr. Kaur will help you with your DLOSCE preparation.
References
- American Board of Dental Examiners (ADEX). DLOSCE Candidate Manual, 2026: content outline and weights, prescription tasks, scoring. adextesting.org
- ADEX. DLOSCE Practice Questions (official), prescription task example: treatment classifications and regimen format. adextesting.org
- Lockhart PB, et al. Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling. JADA 2019;150(11):906-921. ADA chairside guides: treatment available and treatment not available
- Carrasco-Labra A, et al. Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in adolescents, adults, and older adults. JADA 2024;155(2):102-117. doi.org
- ADA. Pharmacologic management of acute dental pain in children: chairside guide (2023 guideline, JADA 2023;154(9):814-825). ada.org
- Wilson WR, et al. Prevention of viridans group streptococcal infective endocarditis: a scientific statement from the American Heart Association. Circulation 2021;143(20):e963-e978. Reprinted by the AAPD: aapd.org
- US Food and Drug Administration. FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later (2020). fda.gov
- FDA prescribing information for ibuprofen (boxed warning, contraindications, warnings and precautions). DailyMed
- ADA. Antibiotic prophylaxis prior to dental procedures (prosthetic joints, 2015 guidance). ada.org
- FDA. Restrictions on the use of codeine and tramadol in children (2017). fda.gov
Updated October 2026. Educational content for exam preparation, not clinical advice. Always follow current guidelines and the full prescribing information.