National Board Dental Examination / Integrated National Board Dental Examination (INBDE) Patient Assessment, Diagnosis, and Treatment Planning Syllabus

Patient Assessment, Diagnosis, and Treatment Planning syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Patient Assessment, Diagnosis, and Treatment Planning in National Board Dental Examination / Integrated National Board Dental Examination (INBDE), not a summary of it.

1. 1

   History and Clinical Examination

   4 topics

   • Comprehensive medical and dental history taking
     • Chief complaint and history of present illness
     • ASA physical status classification
   • Extraoral and intraoral examination
     • Head and neck and TMJ evaluation
     • Oral cancer screening protocol
   • Vital signs and medical risk assessment
   • Periodontal charting and dental hard tissue evaluation
2. 2

   Diagnostic Imaging and Tests

   4 topics

   • Intraoral and extraoral radiographic techniques
     • Periapical, bitewing, and panoramic imaging
     • Cone-beam computed tomography indications
   • Radiographic interpretation and normal anatomy
   • Radiation biology and protection (ALARA)
   • Pulp vitality testing and adjunct diagnostic aids
3. 3

   Diagnosis and Risk-Based Treatment Planning

   4 topics

   • Differential diagnosis formulation
   • Caries risk and periodontal risk assessment
   • Sequencing of comprehensive treatment plans
     • Phased care: systemic, disease control, definitive, maintenance
     • Prognosis determination
   • Evidence-based and patient-centered decision making
4. 4

   Medical Emergencies and Patient Monitoring

   4 topics

   • Prevention and preparedness for office emergencies
   • Management of syncope, allergic reactions, and anaphylaxis
   • Cardiac, respiratory, and diabetic emergencies
     • Chest pain and myocardial infarction
     • Hypoglycemia and seizure response
   • Basic life support and emergency drug kit

Patient Assessment, Diagnosis, and Treatment Planning flashcards for National Board Dental Examination / Integrated National Board Dental Examination (INBDE)

18 of 52 cards from the Patient Assessment, Diagnosis, and Treatment Planning deck — real questions with worked answers.

1. What does the acronym SOAP stand for in clinical documentation?

   Subjective (patient's reported symptoms/history), Objective (clinical and exam findings), Assessment (diagnosis), and Plan (treatment plan).

2. In medical history taking, what does the mnemonic SAMPLE stand for?

   Signs/Symptoms, Allergies, Medications, Past medical history, Last oral intake, and Events leading to the presentation.

3. What is the difference between a chief complaint and the history of present illness (HPI)?

   The chief complaint is the patient's main reason for the visit stated in their own words; the HPI is the detailed chronological description of that complaint (onset, duration, character, aggravating/relieving factors).

4. What ASA Physical Status classification describes a patient with a severe systemic disease that is a constant threat to life?

   ASA IV (e.g., uncontrolled severe disease such as recent MI, severe COPD, or poorly controlled symptomatic conditions).

5. List the six ASA Physical Status classifications.

   ASA I: normal healthy; ASA II: mild systemic disease; ASA III: severe systemic disease (not incapacitating); ASA IV: severe disease that is a constant threat to life; ASA V: moribund, not expected to survive without operation; ASA VI: declared brain-dead organ donor.

6. What are the normal adult ranges for the four primary vital signs (BP, HR, RR, temperature)?

   Blood pressure <120/80 mmHg; heart rate 60-100 bpm; respiratory rate 12-20 breaths/min; oral temperature ~37 degrees C (98.6 degrees F).

7. Per current guidelines, what blood pressure readings define Stage 1 and Stage 2 hypertension?

   Stage 1: systolic 130-139 OR diastolic 80-89 mmHg; Stage 2: systolic >=140 OR diastolic >=90 mmHg. (Elevated = 120-129 systolic and <80 diastolic.)

8. At what blood pressure reading should elective dental treatment generally be deferred and the patient referred urgently?

   A hypertensive crisis: systolic >=180 mmHg and/or diastolic >=120 mmHg, especially with symptoms (target-organ damage signs).

9. What structures are evaluated during an extraoral head and neck examination?

   Face symmetry/skin, lymph nodes (submental, submandibular, cervical), TMJ function, muscles of mastication, thyroid gland, and salivary glands.

10. What is the proper sequence for a comprehensive lymph node examination of the neck?

    Bilateral systematic palpation of node chains: submental, submandibular, anterior/posterior cervical, supraclavicular, pre/post-auricular, and occipital nodes, noting size, mobility, tenderness, and consistency.

11. In TMJ examination, what does crepitus typically indicate versus clicking?

    Crepitus (grating sound) suggests degenerative joint disease/osteoarthritis with loss of cartilage; clicking/popping typically indicates disc displacement with reduction.

12. What is the normal range of maximum interincisal mouth opening in adults?

    Approximately 40-60 mm; less than ~40 mm (often <35 mm) is considered restricted (trismus).

13. What six probing depth sites are recorded per tooth in periodontal charting?

    Mesiobuccal, mid-buccal, distobuccal, mesiolingual, mid-lingual, and distolingual.

14. How is clinical attachment level (CAL) calculated from probing depth and gingival margin position?

    CAL = probing depth + recession (distance from CEJ to gingival margin). If margin is coronal to the CEJ, the gingival overgrowth amount is subtracted instead.

15. Describe the Miller classification for tooth mobility.

    Class I: <1 mm horizontal movement; Class II: >1 mm horizontal movement; Class III: >1 mm horizontal PLUS vertical (depressible) movement.

16. Describe the Glickman classification of furcation involvement.

    Grade I: incipient, suprabony, probe just enters furcation; Grade II: probe enters but does not pass through (cul-de-sac); Grade III: through-and-through but covered by tissue; Grade IV: through-and-through, clinically visible.

17. What is the difference between gingivitis and periodontitis?

    Gingivitis is reversible inflammation confined to the gingiva with no attachment/bone loss; periodontitis involves irreversible loss of connective tissue attachment and alveolar bone.

18. In the 2017 AAP/EFP periodontitis staging, what differentiates Stage I from Stage IV?

    Stage I is early periodontitis (CAL 1-2 mm, coronal third bone loss); Stage IV is advanced disease with CAL >=5 mm, bone loss extending to apical third, and complex rehabilitation needs (tooth loss, masticatory dysfunction).

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