DLOSCE Practice Questions: 10 Free Sample Questions With Answers
Ten original, exam-style cases written by our faculty, covering every major DLOSCE topic. Read the patient box, commit to an answer, then open the explanation. Each one teaches the idea behind the question, not just the letter.
How DLOSCE questions work
The DLOSCE tests clinical judgment. Almost every question starts with a patient, and you decide what is wrong and what to do. There are three question types.
One correct answerPick one option. Right earns 1 point. Anything else earns 0.
One or more correct answersPick every correct option. Partial credit is possible, but one incorrect pick earns 0 for the whole question.
Prescription tasksTwo tasks, one antibiotic and one analgesic. Each is worth 0 to 4 points.
Age and sex, the chief complaint, background and history, and current findings. If an area is empty, treat the information as unknown or not available. For example, if no allergies are listed, assume no known allergies.
Official 2026 DLOSCE topic weights
From the ADEX 2026 DLOSCE candidate manual. Restorative and Prosthodontics alone are 43% of the exam, so they deserve the most practice.
Diagnosis, treatment planning and occlusion are tested across all of these topics. Cases include pediatric, geriatric, special needs and medically complex patients. Teeth are named with the Universal system: 1 to 32 for permanent teeth and A to T for primary teeth.
10 DLOSCE practice questions with answers
These are original questions written by The Study Boards faculty in the DLOSCE style. They are not real exam items. Answer first, then tap “Show answer and explanation”.
Patient: 41-year-old man. Chief complaint: “My front tooth hurts when I bite, and it has turned darker.”
Background: Fell off a bicycle 2 years ago and hit his upper front teeth. Takes no medications. No known allergies.
Current findings: Tooth #8 is grey. Cold test: #7 positive, #8 no response, #9 positive. Electric pulp test on #8: no response. Percussion on #8: positive. Palpation over #8: negative. Radiograph: widened periodontal ligament space at the apex of #8. No sinus tract.
What is the most likely diagnosis for tooth #8?
Show answer and explanation
Answer: C
The idea: every endodontic diagnosis has two halves. The pulp half comes from vitality tests (cold and electric pulp test). The apical half comes from percussion, palpation, the radiograph and any swelling or sinus tract.
Apply it: #8 gives no response to cold or the electric test, and it has a trauma history and grey colour. The pulp has died, so the pulp diagnosis is pulp necrosis. It hurts to tap (percussion positive) and the PDL is widened at the apex, so the apical diagnosis is symptomatic apical periodontitis.
Why the others are wrong: A and B need a living pulp that still responds to cold; #8 does not. D needs a draining sinus tract; there is none. E is for a tooth that already had root canal treatment; this one has not.
Patient: 62-year-old woman, in for a routine filling.
Background: Stable angina, uses nitroglycerin as needed. High blood pressure, controlled with amlodipine. No known allergies.
Current findings: During the procedure she says she feels crushing pressure in her chest. She is awake and talking. Blood pressure 148/92 mmHg, pulse 96.
You stop treatment and sit her upright. Which drug should be given first?
Show answer and explanation
Answer: B
The idea: angina is chest pain caused by the heart muscle not getting enough oxygen. Nitroglycerin widens blood vessels and quickly reduces how hard the heart has to work.
Apply it: she has known angina, typical chest pressure, and her blood pressure is well above 90 systolic, so nitroglycerin is safe to give. Give 0.4 mg under the tongue and repeat every 5 minutes, up to 3 doses. If the pain does not go away, treat it as a possible heart attack: call emergency services and give aspirin 325 mg to chew if she is not allergic. Oxygen can also be given.
Why the others are wrong: epinephrine is for anaphylaxis. Glucose is for low blood sugar. Albuterol is for an asthma attack. Diphenhydramine is for a mild allergic reaction. None of these treat angina.
Watch out: do not give nitroglycerin if systolic pressure is below 90 mmHg or the patient recently took an erectile dysfunction drug such as sildenafil.
Patient: 47-year-old man. Chief complaint: “My gums bleed and my back teeth feel loose.”
Background: Non-smoker. No diabetes. No known allergies.
Current findings: Generalized probing depths of 4 to 6 mm. Worst interdental clinical attachment loss is 6 mm on #3 and #14. Class II furcation involvement on #30. Radiographs show bone loss reaching the middle third of the roots. No teeth have been lost to periodontitis.
Using the 2017 AAP/EFP classification, what is the stage of periodontitis?
Show answer and explanation
Answer: C
The idea: the stage describes how severe the disease is and how complex it will be to treat. You stage from the worst interdental attachment loss, then move the stage up if complexity factors are present.
| Stage | Worst interdental CAL | Typical extras |
|---|---|---|
| I | 1 to 2 mm | Probing depth up to 4 mm, horizontal bone loss |
| II | 3 to 4 mm | Probing depth up to 5 mm, horizontal bone loss |
| III | 5 mm or more | Probing depth 6 mm or more, vertical defects of 3 mm or more, Class II or III furcation, up to 4 teeth lost to periodontitis |
| IV | 5 mm or more | Everything in Stage III plus 5 or more teeth lost, or need for complex rehabilitation (for example bite collapse or fewer than 10 opposing pairs) |
Apply it: worst CAL is 6 mm, probing reaches 6 mm and there is a Class II furcation. That is Stage III. It is not Stage IV, because no teeth have been lost and the bite has not collapsed.
Patient: 66-year-old man, new patient exam.
Background: Smokes, 45 pack-years. Drinks about 4 alcoholic drinks a day. No known allergies.
Current findings: A 2 cm painless patch on the right floor of the mouth, with mixed red and white areas. It cannot be wiped off. He says it has been there at least 3 months. No sharp tooth, rough restoration or denture edge touches the area.
What is the most appropriate next step?
Show answer and explanation
Answer: C
The idea: a red and white patch that cannot be wiped off is called speckled leukoplakia (erythroleukoplakia). Of all white and red lesions, it is the one most likely to show dysplasia or cancer. Only a tissue sample, read under a microscope, gives the diagnosis.
Apply it: heavy smoking, heavy drinking, a high-risk site (floor of mouth), red areas, and no local cause to explain it. Every one of these raises the risk. The lesion is large, so take a sample from the most suspicious area (incisional biopsy) or refer urgently.
Why the others are wrong: A and E delay diagnosis of a possible cancer. B fits a lesion that wipes off, like thrush; this one does not. D destroys the tissue you need for a diagnosis. The “remove the cause and re-check in 2 weeks” approach is only for lesions with an obvious cause, such as a sharp tooth, and there is none here.
Patient: 30-year-old woman, recall visit.
Background: Started amitriptyline 8 months ago and now has a dry mouth. Sips soda through the workday. Lives in a city with fluoridated water. No known allergies.
Current findings: 4 new cavitated carious lesions since her visit 12 months ago.
Which measures are appropriate? Select ONE OR MORE. Any incorrect selection earns no credit.
Show answer and explanation
Correct: A, B, C Neutral: F Incorrect: D, E
The idea: caries risk rises when saliva drops and sugar comes often. High-risk patients get more fluoride, diet change and closer follow-up.
Apply it: 4 new lesions in a year plus dry mouth plus frequent soda means high risk. High-strength fluoride toothpaste (A) and professional varnish every 3 months (B) strengthen enamel. Fewer sugary drinks (C) remove the fuel for bacteria.
Why D and E are incorrect: a high-risk patient needs shorter recalls, not longer ones. And a dentist should never tell a patient to stop a prescribed medicine on the spot; contact her physician to ask about alternatives.
Why F is neutral: the evidence on xylitol is mixed, so it neither earns nor loses credit.
How it would be marked: A + B + C = full credit. A + B + C + F = still full credit. Any answer that includes D or E = zero, even with all three correct options picked.
Patient: 72-year-old woman. Chief complaint: “My new dentures click when I talk, and my gums and jaw muscles are sore.”
Background: New complete upper and lower dentures delivered 2 weeks ago. No known allergies.
Current findings: Generalized soreness on both ridges. When she says “s” words, the teeth touch. Her lips strain to close at rest.
What is the most likely cause?
Show answer and explanation
Answer: B
The idea: occlusal vertical dimension (OVD) is the height of the face when the teeth are together. At rest, the jaw should open slightly more, leaving a small gap (the freeway space, usually 2 to 4 mm). Dentures must keep that gap.
Apply it: if the dentures are too tall, the gap disappears. The teeth hit during speech (clicking, contact on “s” sounds), the ridges are loaded all the time (soreness), the muscles never rest (fatigue), and the lips strain to close. All of these point to too much OVD.
Why the others are wrong: too little OVD (A) gives the opposite picture: a collapsed face, cracks at the corners of the mouth, and weak chewing. C causes gagging or a sore spot at the back of the palate. D causes a loose denture. E crowds the tongue but does not cause clicking.
Patient: 24-year-old man. Chief complaint: “Severe throbbing pain where my tooth was taken out. It goes to my ear.”
Background: Tooth #17 extracted 3 days ago. Pain started on day 2. Smokes. No known allergies.
Current findings: Empty socket with exposed bone and a bad smell. Temperature 37.0 °C. No swelling and no pus.
What is the most appropriate management?
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Answer: C
The idea: this is alveolar osteitis (dry socket). The blood clot breaks down early, the bone is exposed, and pain starts on day 2 to 4. It is inflammation, not an infection. Smoking raises the risk.
Apply it: the timing, exposed bone, bad smell and normal temperature with no swelling or pus all fit dry socket. Treatment is local: rinse the socket gently with saline, place a soothing medicated dressing, give pain relief, and review every 1 to 2 days until it settles.
Why the others are wrong: antibiotics (A) do not treat dry socket, because there is no infection. There is nothing to drain (B). Firm scraping (D) adds pain and is not recommended. A CT scan (E) is not needed for a clear clinical picture.
Patient: 7-year-old boy.
Background: Tooth K (primary lower left second molar) was extracted last week because of caries. Healthy. No known allergies.
Current findings: #19 (permanent lower left first molar) is fully erupted. The radiograph shows #20 developing, with about one third of its root formed and covered by bone. Good oral hygiene.
What is the best management?
Show answer and explanation
Answer: B
The idea: when a primary second molar is lost early, the permanent first molar behind it tips forward into the gap, mostly in the first few months. That steals room from the premolar that has not come in yet.
Apply it: #20 has only one third of its root and is still under bone, so it is a long way from erupting. The space must be held. Only one tooth is missing, on one side, and #19 is fully erupted to carry a band. That is the classic case for a band and loop.
Why the others are wrong: A lets #19 drift forward. C is used only when the first permanent molar has not erupted yet. D is usually chosen when teeth are lost on both sides of the arch. E removes a healthy tooth and is not indicated.
Patient: 68-year-old man, needs #30 extracted.
Background: Atrial fibrillation, takes warfarin. No known allergies.
Current findings: INR checked this morning: 2.4. Single simple extraction planned.
Which steps are appropriate? Select ONE OR MORE. Any incorrect selection earns no credit.
Show answer and explanation
Correct: A, B, E Incorrect: C, D
The idea: for most dental extractions, the risk of a stroke from stopping warfarin is greater than the risk of bleeding from continuing it. Bleeding is controlled locally instead. INR measures how thin the blood is; a simple extraction is usually safe when it is below 3.5.
Apply it: his INR of 2.4 is in range, it was checked the same day (E), so you keep the warfarin going (A) and control bleeding at the site (B).
Why C and D are incorrect: stopping warfarin on your own puts him at risk of a stroke; any change must come from his physician. Ibuprofen and other NSAIDs increase bleeding risk with warfarin; acetaminophen is the safer choice for pain.
Patient: 35-year-old woman, 68 kg.
Background: Healthy. Takes no medications. No known allergies.
Current findings: #3 has pulp necrosis with an acute apical abscess. Swelling spreads into the cheek. Temperature 38.4 °C and she feels unwell. You drained the abscess and cleaned the canals today.
An antibiotic is needed. Choose the drug, then fill in the four parts of the prescription.
Show answer and explanation
One accepted answer: amoxicillin 500 mg capsules. Dispense 21. Take 1 capsule three times a day (every 8 hours) for 7 days.
The idea: antibiotics are added when an infection spreads beyond the tooth or causes body-wide signs such as fever and feeling unwell. Draining the infection and treating the tooth always comes first. For a healthy adult with no penicillin allergy, the ADA’s 2019 guideline names amoxicillin 500 mg three times a day for 3 to 7 days.
Apply it: she has spreading swelling and a fever, so the antibiotic is justified on top of drainage. One capsule, three times a day, for 7 days is 21 capsules. Re-check her in 2 to 3 days.
If she were allergic to penicillin: the same guideline suggests cephalexin 500 mg four times a day when there is no history of anaphylaxis, angioedema or hives with penicillin; if there is such a history, azithromycin (500 mg on day 1, then 250 mg on days 2 to 5).
Exam habit: on the real task, check every drug in the list against the patient box (allergies, other medicines, pregnancy) before you pick one.
How DLOSCE prescription tasks are scored
There are two prescription tasks: one antibiotic and one analgesic. You read a patient box, decide which medicines from a list are appropriate, and complete each prescription.
Free official DLOSCE resources
ADEX now runs the DLOSCE as the computer-based part of the ADEX Dental Examination. Its test prep page offers three free tools. Use all three before test day.
Official practice questionsShows the question formats and screen layout. ADEX notes these are reviewed less strictly than real exam items, so use them to learn the format, not as your main question bank.
3D model tutorialLets you practise rotating, moving and zooming the 3D tooth models used in some questions.
Acronyms and abbreviationsThe short forms that may appear on the exam. Learn them so they never slow you down.
Find all three on the ADEX DLOSCE test prep page. For a full list of books and question banks by topic, read our guide to DLOSCE study materials.
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Current as of 5 October 2026. Exam format, topic weights, scoring and retake rules are from the ADEX 2026 DLOSCE candidate manual. The 10 practice questions and explanations are original TSB content, not exam items. Drug guidance follows the ADA 2019 clinical practice guideline on antibiotics for dental pain and swelling. Rules can change; confirm with ADEX before you register. Educational content, not clinical or licensing advice.