DLOSCE · Free original practice

Free DLOSCE practice questions

Work through Patient Box cases, multi-select questions that score the way the DLOSCE does, and one prescription task. Every option comes with an explanation and a source.

Last updated 2026-11-08.

ADEX official DLOSCE preparation How the DLOSCE is scored

Question 1 of 21 · Restorative

Patient Box: Root caries after head-and-neck radiation

Age / sex: 71-year-old man
Chief complaint: "My mouth is always dry, and my teeth keep decaying near the gums."
Medical history: Oropharyngeal cancer treated with radiation therapy to the head and neck, completed 2 years ago; hypertension
Current medications: Lisinopril 20 mg daily
Vital signs: BP 132/80 mm Hg; pulse 72/min
Dental history: Four new carious lesions restored in the last 24 months; brushes twice a day with an over-the-counter fluoride toothpaste; wears a mandibular removable partial denture
Clinical findings: Severe dry mouth with no pooled saliva; visible plaque at the gingival margins; generalized gingival recession with exposed root surfaces; several interproximal restorations; noncavitated carious lesions on the facial root surfaces of #21, #22, #27 and #28
Radiographic findings: No cavitated lesions; no periapical radiolucencies

Fictional patient. If an area is not listed, treat it as unknown or not available; no allergy listed means no known allergies.

Select ONE OR MORE correct answers. Any INCORRECT selection earns NO CREDIT for this question.

On the ADA Caries Risk Assessment Form for patients older than 6 years, which findings in this patient are high-risk conditions?

A.Radiation therapy to the head and neckB.Brushing twice a day with a fluoride toothpasteC.Exposed root surfacesD.Visible plaqueE.Four new lesions restored in the last 24 monthsF.Interproximal restorationsG.Severe dry mouthH.A removable partial denture

Sources for these questions (30)

American Dental Association. Caries Risk Assessment Form (Age >6) (2009, 2011). Contributing, general health and clinical conditions; scoring instructions (High Risk = one or more conditions in the High Risk column). https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/library/oral-health-topics/topic_caries_over6.pdf
American Dental Association. Chairside guide: evidence-based clinical practice guideline on nonrestorative treatments for carious lesions, permanent teeth (2018). Summary of recommendations and clinical pathway. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/chairside_guide_nonrestorative_treatments_for_carious_lesions_on_permanent_teeth.pdf
American Dental Association. Chairside guide: evidence-based clinical practice guideline on restorative treatments for caries lesions, permanent teeth (2024). Carious tissue removal and direct restorative material recommendations, clinical pathway, footnotes 1–15 and good practice statement. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/13406_chairside_guide_caries_lesions_permanent_teeth.pdf
U.S. Food and Drug Administration. FDA issues recommendations for certain high-risk groups regarding mercury-containing dental amalgam. September 24, 2020. List of high-risk groups and non-mercury alternatives. https://www.fda.gov/news-events/press-announcements/fda-issues-recommendations-certain-high-risk-groups-regarding-mercury-containing-dental-amalgam
American Dental Association. Pregnancy, Oral Health Topics, last updated July 14, 2025. Key Points. https://www.ada.org/resources/ada-library/oral-health-topics/pregnancy
Edwards D, Allison JR, Coulter J, Durham J, Beecroft EV. Symptomatic irreversible pulpitis and other orofacial pain: overcoming challenges in diagnosis and management. Br Dent J. 2025;238(7):517–526. Table 1, AAE-based pulp and apical diagnoses with management options. https://pmc.ncbi.nlm.nih.gov/articles/PMC11991903
Rojas-Rueda S, Villalobos-Tinoco J, Conner C, Colvert S, Nurrohman H, Jurado CA. Bonding protocols for lithium disilicate veneers: a narrative review and case study. Biomimetics (Basel). 2025;10(3):188. Section 4.3, Ceramic Surface Treatment. https://pmc.ncbi.nlm.nih.gov/articles/PMC11940404
van den Breemer CR, Gresnigt MM, Cune MS. Cementation of glass-ceramic posterior restorations: a systematic review. Biomed Res Int. 2015;2015:148954. Introduction and section 3.1.1. https://pmc.ncbi.nlm.nih.gov/articles/PMC4628770
Lupu IC, Tatarciuc MS, Vitalariu AM, Bobu L, Diaconu DA, Vasluianu RI. Bonding strategies for zirconia fixed restorations: a scoping review of surface treatments, cementation protocols, and long-term durability. Biomimetics (Basel). 2025;10(9):632. Introduction, sections 4.2 and 4.7, and Conclusions. https://pmc.ncbi.nlm.nih.gov/articles/PMC12468000
Wang HL, Avila-Ortiz G, Monje A, et al. AO/AAP consensus on prevention and management of peri-implant diseases and conditions: summary report. J Periodontol. 2025;96(6):519–541. Introduction; Focused Questions 3 and 4; Conclusions, bullet-point risk factor assessment and supportive peri-implant therapy. https://pmc.ncbi.nlm.nih.gov/articles/PMC12273748
Kumar PS, Kan J, Galarraga-Vinueza ME, et al. Risk for peri-implant diseases and defects: report of workgroup 1 of the joint AO/AAP consensus conference on prevention and management of peri-implant diseases. Clin Adv Periodontics. 2025;15(2):93–102. Results, risk markers for peri-implantitis and risk of peri-implantitis. https://pmc.ncbi.nlm.nih.gov/articles/PMC12266310
MSD Manual Professional Edition. Peri-Implant Diseases and Conditions, reviewed April 2024. Peri-implant mucositis and peri-implantitis. https://www.msdmanuals.com/professional/dental-disorders/periodontal-disorders/peri-implant-diseases-and-conditions
MSD Manual Professional Edition. Dental Appliances, reviewed August 2026. Denture problems. https://www.msdmanuals.com/professional/dental-disorders/common-dental-disorders/dental-appliances
MSD Manual Professional Edition. Stomatitis, reviewed March 2026. Candidal stomatitis (denture-induced stomatitis). https://www.msdmanuals.com/professional/dental-disorders/symptoms-of-dental-and-oral-disorders/stomatitis
MSD Manual Professional Edition. Oral Growths, reviewed March 2026. Etiology (oral candidiasis, oral potentially malignant disorders, leukoplakia, erythroplakia) and Evaluation. https://www.msdmanuals.com/professional/dental-disorders/symptoms-of-dental-and-oral-disorders/oral-growths
MSD Manual Professional Edition. Tongue Discoloration and Other Changes, reviewed April 2026. Geographic tongue, hairy tongue and hairy leukoplakia. https://www.msdmanuals.com/professional/dental-disorders/lip-and-tongue-disorders/tongue-discoloration-and-other-changes
MSD Manual Professional Edition. Lichen Planus, reviewed November 2025. Symptoms and Signs, oral lichen planus. https://www.msdmanuals.com/professional/dermatologic-disorders/psoriasis-and-other-papulosquamous-disorders/lichen-planus
American Dental Association. Oral Cancer Guideline: living evidence-informed guideline on the early detection of oral squamous cell carcinoma and potentially malignant disorders, updated August 31, 2026. Good Practice Statements 1–4, Recommendations 1.1–4.2 and clinical pathway. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/2026/ada_oral_cancer_guideline.pdf
Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014;28(1):6–27. Tables 4 and 6; Results, disc displacement recommendations; Discussion. https://pmc.ncbi.nlm.nih.gov/articles/PMC4478082
American Academy of Periodontology. Staging and Grading Periodontitis, tables from Tonetti, Greenwell and Kornman, J Periodontol 2018;89(Suppl 1):S159–S172. Staging and grading tables. https://sites.perio.org/wp-content/uploads/2019/08/Staging-and-Grading-Periodontitis.pdf
American Dental Association. Oral Anticoagulant and Antiplatelet Medications and Dental Procedures, Oral Health Topics, last updated September 28, 2022. Key Points, Introduction, Evidence: Warfarin and Antiplatelet Agents, and Summary. https://www.ada.org/resources/ada-library/oral-health-topics/oral-anticoagulant-and-antiplatelet-medications-and-dental-procedures
MSD Manual Professional Edition. Postextraction Problems, reviewed August 2026. Bleeding. https://www.msdmanuals.com/professional/dental-disorders/dental-emergencies/postextraction-problems
American Dental Association. Chairside guide: antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling when definitive, conservative dental treatment is immediately available (2019). Recommendations and clinical pathway. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/ada_chairside_guide_antibiotics_ta.pdf
American Dental Association. Antibiotics for Dental Pain and Swelling Guideline (2019). Key Points. https://www.ada.org/resources/research/science-and-research-institute/evidence-based-dental-research/antibiotics-for-dental-pain-and-swelling
Marqués-Martínez L, Esteve-Ferre C, Galán-López L, et al. Effectiveness of distal shoe space maintainers for first permanent molar eruption: a systematic review. Children (Basel). 2025;12(12):1642. Introduction and section 4.2. https://pmc.ncbi.nlm.nih.gov/articles/PMC12731900
American Academy of Pediatric Dentistry. Management of the developing dentition and occlusion in pediatric dentistry. The Reference Manual of Pediatric Dentistry. 2025:497–515 (latest revision 2024). Space maintenance. https://www.aapd.org/media/Policies_Guidelines/BP_DevelopDentition.pdf
MSD Manual Professional Edition. Anaphylaxis, reviewed September 2026. Etiology, Diagnosis, Treatment (epinephrine and other treatments) and Key Points. https://www.msdmanuals.com/professional/immunology-allergic-disorders/allergic-autoimmune-and-other-hypersensitivity-disorders/anaphylaxis
American Dental Association. Chairside guide: antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling when definitive, conservative dental treatment is not immediately available (2019). Good practice statement, footnotes 5–9 and clinical pathway, penicillin-allergy branch. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/ada_chairside_guide_antibiotics_tna.pdf
DailyMed. Cephalexin capsules, USP (Teva Pharmaceuticals USA), label published October 15, 2026. Sections 2.1 (recommended adult dosage), 3 (dosage forms and strengths) and 5.1 (hypersensitivity). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=19307ff0-71de-477b-965d-ea243e5ede3a
Cardona V, Ansotegui IJ, Ebisawa M, et al. World Allergy Organization anaphylaxis guidance 2020. World Allergy Organ J. 2020;13(10):100472. Acute treatment of anaphylaxis: call emergency services while injecting epinephrine IM into the anterolateral thigh. https://pmc.ncbi.nlm.nih.gov/articles/PMC7607509