Essentials of Dental Radiography 9th Edition By Evelyn Thomson,Orlen Johnson – Test Bank A+

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Test Bank

Chapter 1

Multiple Choice

1. Who was awarded the first Nobel Prize for physics in 1901, for his experimental work with radiation?
2. W. J. Morton
3. O. Walkhoff
4. W. D. Coolidge
5. W. C. Roentgen
6. Who is credited with introducing the bitewing radiograph?
7. F. W. McCormack
8. H. R. Raper
9. G. M. Fitzgerald
10. C. E. Kells
11. Who developed the hot cathode ray tube?
12. W. D. Coolidge
13. W. A. Price
14. H. R. Raper
15. W. H. Rollins
16. The development of radiation protection as a science is credited to:
17. A. Cieszyński.
18. W. D. Coolidge.
19. W. H. Rollins.
20. F. Mouyen.
21. What New Orleans dentist first made practical use of x-rays in the treatment of dental patients?
22. H. R. Raper
23. G. M. Fitzgerald
24. F. Mouyen
25. C. E. Kells
26. Early researchers working in the field of radiography were not aware that continued exposure to x-rays produced accumulations of radiation effects in the body because x-rays are invisible.
27. Both the statement and reason are correct and related.
28. Both the statement and reason are correct but NOT related.
29. The statement is correct, but the reason is NOT.
30. The statement is NOT correct, but the reason is correct.
31. NEITHER the statement NOR the reason is correct.
32. 7. The most significant advancement in the early days of radiography came in 1913 when W. D. Coolidge:
33. became the first to alert the profession of the dangers of radiation exposure and advocated for the science of radiation protection.
34. exposed a prototype of a dental radiograph, setting the stage for preventive oral health care.
35. developed a variable, high kilovoltage x-ray machine compatible with the paralleling technique.
36. introduced an x-ray tube that allowed for an x-ray output that could be predetermined and accurately controlled.
37. The first dental radiograph was produced using an exposure time of:
38. 0.5 second.
39. 1 minute.
40. 5 minutes.
41. 25 minutes.
42. 1 hour.
43. What component of the dental x-ray machine best limits the size of the x-ray beam to the approximate size of the image receptor?
44. A pointed cone
45. An open round cylinder
46. A rectangular PID
47. A slit collimator
48. Panoramic radiology became popular in the:
49. 1930s.
50. 1940s.
51. 1950s.
52. 1960s.
53. 1970s.
54. Which of the following is NOT true regarding cone beam volumetric imaging?
55. It images a single selected plane of tissues.
56. It is based on computed tomography.
57. It uses less radiation than a panoramic radiograph.
58. It is designed specifically for imaging dental applications.
59. It is purported to become the gold standard for imaging certain oral conditions.
60. Early dental film required long exposure times because:
61. it was hand-wrapped.
62. the emulsion was only on one side.
63. glass plates were used as the base.
64. the packets were not moisture resistant.
65. Each of the following is an advantage of digital imaging EXCEPT one. Which one is the EXCEPTION?
66. It reduces radiation over film-based radiography.
67. It eliminates the need for the darkroom and processing chemistry.
68. It allows the use of pointed cones without radiation hazards.
69. It avoids the need for disposal of hazardous materials such as lead foils from film packets.
70. It produces enhanced two- and three-dimensional images.
71. The <KT>bisecting technique was the first and earliest radiographic technique for exposing intraoral radiographs because the bisecting technique is based on the rule of isometry.
72. Both the statement and reason are correct and related.
73. Both the statement and reason are correct but NOT related.
74. The statement is correct, but the reason is NOT.
75. The statement is NOT correct, but the reason is correct.
76. NEITHER the statement NOR the reason is correct.
77. The <KT>parpaparalleling technique is taught in all dental assisting, dental hygiene, and dental schools because it is the technique of choice for imaging intraoral radiographs.
78. Both the statement and reason are correct and related.
79. Both the statement and reason are correct but NOT related.
80. The statement is correct, but the reason is NOT.
81. The statement is NOT correct, but the reason is correct.
82. NEITHER the statement NOR the reason is correct.
83. The rule of isometry is the basis for what dental radiographic technique?
84. Bisecting
85. Paralleling
86. Panoramic
87. Digital
88. Computed tomography
89. Each of the following is a potential use of dental radiographs EXCEPT one. Which one is the EXCEPTION?
90. Diagnosing dental caries
91. Evaluating development of dentition
92. Detecting missing teeth
93. Assessing patient self-care
94. Evaluating trauma to teeth and supporting bone

1. Producing radiographs of the teeth and/or the oral cavity is called:
2. Radiation producing.
3. Radiology.
4. Roentgenograph.
5. X-raying.
6. Radiography.
7. Dental assistants and dental hygienists meet an important need by providing each of the following EXCEPT one. Which one is the EXEPTION?
8. Exposing radiographs
9. Processing radiographs
10. Mounting radiographs
11. Prescribing radiographs
12. Interpreting radiographs
13. The positioning indicating device (PID) is sometimes called a “cone” because the PID of early dental x-ray machines was of a pointed shape.
14. Both the statement and reason are correct and related.
15. Both the statement and reason are correct but NOT related.
16. The statement is correct, but the reason is NOT.
17. The statement is NOT correct, but the reason is correct.
18. NEITHER the statement NOR the reason is correct.

True/False

1. William Herbert Rollins was awarded the first Nobel Prize for physics.
2. C. Edmund Kells encouraged the practical use of radiographs in dentistry.
3. The radiographer should help the patient hold the image receptor in place during exposure.
4. In the early 1900s dental patients would have to be sent to hospitals or a physician’s office to have a dental radiograph exposed.
5. Early dental x-ray machines were an electrical hazard.
6. Pointed cones should be used to direct radiation from the x-ray tube to the patient.
7. Dental x-ray film available today is coated with emulsion on both sides.
8. The bisecting technique is the technique of choice for intraoral radiography.
9. Dental radiography supplements visual and physical examination to provide a quality evaluation of a patient.
10. Digital imaging systems can reduce radiation dosage more than film-based radiography.
11. A radiograph is an image produced by exposure to x-rays.
12. Computed tomography eliminates the use of radiation to produce an image.
13. Digital imaging replaces the conventional dental x-ray machine.
14. The paralleling technique is based on the rule of isometry.
15. The PID is used to direct the useful beam of radiation.
16. X-radiation was discovered when Roentgen was working with a Crookes tube.
17. Roentgen named his discovery the roentgen ray.
18. The x-radiation output of the Crookes tube (named after the English chemist William Crookes) could be predetermined and accurately controlled.
19. Early scientists and researchers working in the field of radiography were not aware that continued exposure produced accumulations of radiation effects in the body.
20. In the early 1900s, it was common practice for the radiographer to help the patient hold the film in place while making the exposure.

Short Answer

1. Who first determined that x-rays would play a role in dentistry?
2. Who is considered to be the first advocate for the science of radiation protection?
3. Who developed the hot cathode ray tube?
4. Which radiograph displays the entire dentition and surrounding structures?
5. What is the technique of choice for intraoral radiography?
6. In dental digital imaging systems, what replaces film?
7. What medical imaging modality records a selected plane of tissues?
8. What is the name of the device that functions to direct the x-ray beam toward the patient?
9. What is the purpose of studying the history of radiography and dental radiography?
10. What are the two techniques for exposing intraoral dental radiographs?

Chapter 2

Multiple Choice

1. Each of the following is a form of energy EXCEPT one. Which one is the EXCEPTION?
2. Heat
3. Water
4. Light
5. X-radiation
6. What is the maximum number of electron shells (energy levels) an atom can have?
7. 1
8. 3
9. 5
10. 7
11. Each of the following is a form of ionizing radiation EXCEPT one. Which one is the EXCEPTION?
12. Cosmic rays
13. X-rays
14. Radio waves
15. Gamma rays
16. Each of the following statements about electromagnetic radiations is true EXCEPT one. Which one is the EXCEPTION?
17. They have a negative electrical charge.
18. They have no mass.
19. They pass through space as particles and in a wave-like motion.
20. They have no weight.
21. Which of the following statements about x-rays is NOT true?
22. They travel at the speed of light.
23. They are invisible.
24. They have no mass.
25. They travel in convergent lines.
26. Which one of these is NOT a Système International (SI) unit of measurement?
27. Sievert
28. Roentgen
29. Coulombs per kilogram
30. Gray
31. The Système International unit for measuring absorbed dose is the
32. Gray
33. Sievert
34. Rad
35. Rem
36. The greatest exposure to ionizing radiation to the population comes from
37. Medical x-rays
38. Occupational exposure
39. Dental x-rays
40. Background radiation
41. The speed of a wave is its
42. Wavelength
43. Velocity
44. Frequency
45. Photon
46. The majority of x-rays produced by dental x-ray machines are formed by:
47. Characteristic radiation
48. Radionuclide decay
49. Bremsstrahlung radiation
50. Coherent scattering
51. Radiation is best described as a:
52. substance that occupies space.
53. resistor of heat.
54. type of electricity.
55. movement of energy.
56. The smallest particle of a substance that still retains the properties of that substance is a/an:
57. atom.
58. electron.
59. neutron.
60. molecule.
61. The emission and movement of electromagnetic or particulate energy through space is known as:
62. ionization.
63. radiation.
64. radioactivity.
65. the formation of ion pairs.
66. The measure of the number of waves that pass a given point per unit of time is known as the:
67. angstrom unit.
68. wavelength.
69. frequency.
70. velocity.
71. When x-rays pass through matter, which interaction results in x-rays being scattered in all directions?
72. The coherent effect
73. The photoelectric effect
74. The Compton effect
75. The amount of energy deposited in the teeth or soft tissue by any type of radiation is called the:
76. exposure amount.
77. absorbed dose.
78. dose equivalent.
79. background radiation.
80. The units used to measure the dose equivalent of radiation is the:
81. Gray (Gy).
82. Sieverts (Sv).
83. Coulombs per kilogram (C/kg).
84. Roentgens (R).
85. The sievert and rem are units of measurement for:
86. the radiation exposure in the air.
87. the amount of energy absorbed by tissues.
88. the comparison of biological effects.
89. All of the above.
90. A weighting (qualifying) factor is used to determine which of the following?
91. coulombs per kilogram
92. sievert
93. roentgen
94. gray
95. The wavelength determines the energy and penetrating power of the radiation.

The longer the wavelength, the higher the energy of the radiation.

1. The first statement is true. The second statement is false.
2. The first statement is false. The second statement is true.
3. Both statements are true.
4. Both statements are false.

True/False

1. Matter is defined as the ability to do work and overcome resistance.
2. An atom is the smallest part of an element that still retains properties of that element.
3. Electrons have a positive charge.
4. The inner-most electron shell in an atom is the K shell.
5. Dental x-rays do not involve the use of radioactivity.
6. X-rays travel at the speed of sound.
7. Wavelength and frequency are directly related.
8. X-rays make the materials they pass through radioactive.
9. The photoelectric effect is an all-or-nothing energy loss.
10. The Compton effect causes x-rays to be scattered in all directions.
11. The number of electrons in the nucleus of an element determines its <KT>atomic number.
12. Background radiation includes cosmic rays from outer space, naturally occurring radiation from the earth, and radiation from radioactive materials.
13. Kinetic energy is the internal energy within the atom that holds its components together.
14. The total number of protons in the nucleus of an atom determines the atomic number.
15. Energy that travels in a different direction than that of the original x-ray is collectively called “secondary radiation.”
16. The majority of x-rays produced by dental x-ray machines are formed by general (bremsstrahlung) radiation.
17. The electromagnetic spectrum arranges energy types by decay rates.
18. X-rays of high energy and extremely short wavelengths are classified as hard radiation.
19. Ionizing radiation is energy that is capable of producing ions.
20. Electromagnetic radiation is propelled through space as both a particle and a wave.

Short Answer

1. What is defined as anything that occupies space and has mass?
2. What are the positively charged particles in the nucleus of an atom called?
3. What is the term for atoms that have gained or lost electrons and electrical neutrality?
4. What is the name of the process in which unstable elements undergo spontaneous decay in order to become stable?
5. What is the term for bundles of energy that travel through space at the speed of light?
6. What is the speed of a wave called?
7. When radiation has great penetrating power it is called what?
8. Should you wait 30 seconds after making an exposure before entering the room?
9. People living on the Colorado plateau receive a higher dose of what type of radiation than people living in Philadelphia?
10. One gray equals how many rads?

Chapter 3

Multiple Choice

1. Dental x-ray machines contain each of the following components EXCEPT one. Which one is the EXCEPTION?
2. Control panel
3. Extension arm
4. Radioactive material
5. Tube head
6. Which regulating device on the control panel measures the amount of current passing through the wires of the circuit?
7. The timer
8. The line switch
9. The kVp selector
10. The mA selector
11. Each of the following conditions must exist for x-rays to be produced EXCEPT one. Which one is the EXCEPTION?
12. A target capable of stopping the electrons
13. An air-filled glass tube
14. High voltage to impart speed to the electrons
15. A source of free electrons
16. Which of the following is NOT a function of the tube head?
17. It allows all radiation to exit.
18. It provides grounding for the electrical components.
19. It protects the x-ray tube from accidental damage.
20. It prevents overheating of the x-ray tube.
21. The anode is composed of the focusing cup and the filament, and must be charged negative during x-ray production.
22. The first part of the statement is correct, the second part of the statement is NOT correct.
23. The first part of the statement is NOT correct, the second part of the statement is correct.
24. Both parts of the statement are correct.
25. Both parts of the statement are NOT correct.
26. How many electrical circuits are used in a dental x-ray machine?
27. One
28. Two
29. Three
30. Four
31. Sixty (60) impulses is equivalent to:
32. 1/6 second.
33. 1/10 second.
34. ½ second.
35. 1 second.
36. The intensity of the x-ray beam is affected by each of the following EXCEPT one. Which one is the EXCEPTION?
37. Target size
38. Kilovoltage
39. Exposure time
40. Milliamperage
41. A 1/10-second exposure equals how many impulses?
42. 4
43. 6
44. 10
45. 60
46. Which of these statements is FALSE?
47. The positive anode and negative cathode are sealed within the x-ray tube.
48. The control panel may be integrated with the x-ray machine tube head support.
49. The exposure button should be on the end of a 3-foot timer cord.
50. The x-ray tube contains a target capable of stopping the electrons.
51. The duration of an x-ray exposure is determined by which control?
52. The timer
53. The line switch
54. The kVp selector
55. The mA selector
56. The filament and target are made out of tungsten because it:
57. produces fewer electrons.
58. prevents electrons from being liberated.
59. withstands high temperatures.
60. ensures that x-rays are projected in one direction.
61. Which transformer corrects minor fluctuations in the current flowing through the wires?
62. The step-up transformer
63. The step-down transformer
64. The autotransformer
65. X-rays originate at the:
66. cathode.
67. port.
68. focusing cup.
69. focal spot.
70. Amperage measures the electric potential or force that moves electrons along a conductor.

Increasing the force with which the electrons move increases the penetrating potential of the x-ray beam.

1. The first statement is true. The second statement is false.
2. The first statement is false. The second statement is true.
3. Both statements are true.
4. Both statements are false.
5. Which of the following best describes how x-rays are actually produced in the dental x-ray tube?
6. Radioactive particulate matter undergoes controlled disintegration.
7. Electrical current passes through an oil mixture, creating minute explosions.
8. Low milliamperage current is transformed to high kilovoltage current.
9. High-speed electrons collide with target material electrons.
10. What percent of the kinetic energy inside the x-ray tube is actually converted to x-radiation?
11. 99 percent
12. 50 percent
13. 25 percent
14. 1 percent
15. Increasing which of the following would best increase the number of electrons flowing through the

dental x-ray electrical circuit?

1. Impulses
2. Kilovoltage
3. Milliamperage
4. PID length
5. Which of the following removes the soft x-rays for the <</KT>x-ray beam as it exits the port?
6. The positioning indicating device (PID)
7. The collimator
8. The filter
9. The transformer
10. How does the radiographer know when the x-ray exposure cycle is complete?
11. When the deadman switch cannot be depressed
12. When the audible beep stops
13. When the timer dial completes the rotation
14. When the indicator light illuminates

True/False

1. Electricity is defined as electrons in motion.
2. The metal housing of the tube head increases the safety of the x-ray machine.
3. Direct current flows in pulses and changes direction.
4. Voltage is the measurement of the number of electrons moving through a wire conductor.
5. If the tube head is properly sealed, the port is the only place through which x-rays can escape.
6. The x-ray beam formed at the focal spot is monochromatic.
7. The intensity of the beam refers to the quantity and quality of the x-rays.
8. The filament is on the negative side of the vacuum tube in the dental x-ray machine.
9. Dental x-ray machines may have controls for manual adjustment of kVp and mA, or these controls may be preset by the manufacturer.
10. In the ON position, the line switch on the control panel energizes the low- and high-voltage circuits.
11. Increasing the amperage will result in a production of more x-rays.
12. That part of the cathode designed to direct the free electrons toward the tungsten target of the anode is called the “focal spot.”
13. The tungsten anode is embedded in a core of copper to conduct heat away to a radiator.
14. A small area on the tungsten target of the anode toward which the electron beam is directed is called the “focal spot.”
15. The step-down transformer corrects fluctuations in the current flowing through the x-ray machine.
16. The anode is the negative electrode (terminal) in the x-ray tube.
17. The collimator is a lead diaphragm that restricts the dimensions of the useful beam.
18. Thermionic emission refers to the release of electrons from the target material during the process of incandescence.
19. Primary beam refers to a high-energy, short wavelength x-ray beam.
20. An x-ray beam composed of many different wavelengths is called “polychromatic.”

Short Answer

1. What does adjusting the kilovolt peak (kVp) do?
2. What is the name of the device that allows the amount of current passing through the wires of the circuit to be changed?
3. Why are the extension arm and yoke of the x-ray machine insulated?
4. What is the term for the measurement of the number of electrons moving through a wire conductor?
5. Inside the dental x-ray machine, what does the speed of the electrons determine?
6. Who is responsible for the radiation dose incurred by the patient during x-ray exposure?
7. What does kVp measure?
8. What is the purpose of a “deadman” exposure switch?
9. What is the term for the process by which electrons are created at the filament wire of the cathode?
10. In the cathode, the wire filament is recessed into what?

Chapter 4

Multiple Choice

1. Which of these statements is FALSE?
2. Structures should be magnified to enhance interpretation.
3. An area of interest must be recorded completely with sufficient surrounding structures for a frame of reference.
4. A radiograph should be of proper density, contrast, and definition.
5. An image should be free of errors.
6. Each of the following is a term used to describe visual image characteristics EXCEPT one. Which one is the EXCEPTION?
7. Sharpness
8. Contrast
9. Milliamperage
10. Density
11. Which of these statements regarding radiographic contrast is FALSE?
12. There are few shades of gray in a radiograph with short-scale contrast.
13. Short-scale contrast describes a radiograph in which the density differences between adjacent areas are large.
14. There are many shades of gray in a radiograph with long-scale contrast.
15. Long-scale contrast describes a radiograph in which the density differences between adjacent areas are large.
16. The degree of overall blackness of a radiographic image is termed:
17. sharpness.
18. density.
19. resolution.
20. contrast.
21. The difference in densities between adjacent areas on the radiograph is termed:
22. sharpness.
23. density.
24. resolution.
25. contrast.
26. Which of these is NOT a shadow-casting principle?
27. A large focal spot
28. Long target–image receptor distance
29. Short object–image receptor distance
30. Parallel object–image receptor relationship
31. Which of the following statements about dental radiographic exposure variables is true?
32. Increasing the mA darkens the radiograph.
33. Decreasing exposure time darkens the radiograph.
34. Exposure time is difficult to change on most machines.
35. Milliamperage affects radiographic contrast.
36. An original radiograph is exposed at 8 mA for 1.0 seconds. If the mA is increased to 10, which of the following exposure times would be correct to maintain radiographic density?
37. 0.4
38. 0.6
39. 0.8
40. 1.0
41. Which of these statements is FALSE?
42. Increasing the target–image receptor distance reduces penumbra.
43. Radiation intensity is directly proportional to the square of the distance from the source.
44. A long PID increases image sharpness.
45. A recessed tube increases the target–image receptor distance.
46. Which of the following is recommended for increasing radiographic contrast while maintaining radiographic density?
47. Increase kVp and increase exposure time.
48. Decrease kVp and decrease exposure time.
49. Increase kVp and decrease exposure time.
50. Decrease kVp and increase exposure time.
51. Radiolucent images appear dark or black because:
52. hard radiation was allowed to reach the image receptor.
53. dense structures stopped x-rays from reaching the image receptor.
54. soft radiation was stopped before reaching the image receptor.
55. less dense structures permitted more x-rays to reach the image receptor.
56. Each of the following appear radiopaque EXCEPT one. Which one is the EXCEPTION?
57. Bone
58. Dentin
59. Pulp
60. Enamel
61. Which kVp setting produces long-scale image contrast?
62. 65 kVp
63. 75 kVp
64. 85 kVp
65. 95 kVp
66. Each of the following results in image unsharpness EXCEPT one. Which one is the EXCEPTION?
67. Patient movement during exposure
68. Image receptor positioned close to the teeth
69. A short PID
70. The use of intensifying screens
71. A radiographic film with a small crystal size
72. creates sharpness.
73. causes magnification.
74. decreases exposure time.
75. increases contrast.
76. Image magnification can be decreased by:
77. increasing the target-object distance.
78. increasing the object–image receptor distance.
79. decreasing the target-surface distance.
80. increasing the focal spot size.
81. When changing the PID length from 8 inches (20.5 cm) to 16 inches (41 cm), what corresponding change must be made to maintain image density?
82. Decrease exposure time.
83. Increase exposure time.
84. Decrease kilovoltage.
85. Increase kilovoltage.
86. The inverse square law states that the intensity of the radiation:
87. increases as the distance from its source increases because the beam of radiation converges.
88. decreases as the distance away from its source increases because the beam of radiation diverges.
89. increases as the distance away from its source increases because the beam of radiation diverges.
90. decreases as the distance away from its source increases because the beam of radiation converges.
91. Which of the following refers to a radiographic image that is black and white with many shades of gray in between?
92. Low contrast
93. High contrast
94. Low density
95. High density
96. Which of the following indicates a radiographic image that is black and white with few shades of gray in between?
97. Short resolution
98. Long resolution
99. Short scale
100. Long scale

True/False

1. White areas on a radiographic image are termed radiolucent.
2. Radiographic density (film darkening) is decreased when the milliamperage or exposure time is increased.
3. The term “short-scale contrast” describes a radiograph in which density differences between adjacent areas are small.
4. Increasing the kVP results in a more penetrating x-ray beam.
5. Sharpness/definition refers to the detail and clarity of the structures on a radiograph.
6. A small focal spot reduces penumbra.
7. Grids absorb scattered x-rays.
8. Theoretically, the ideal focal spot would be a point source.
9. The target–image receptor distance should be short to create radiographs with the best definition.
10. The film should be in close physical contact with the intensifying screens.
11. A radiographic image with many shades of gray is said to have low contrast.
12. That portion of the radiographic image that appears light is called “radiolucent.”
13. Penumbra is a device used in extraoral radiography to prevent scatter radiation from fogging the image receptor.
14. Some clinicians prefer a radiographic image that is of low contrast, and others prefer a radiographic image that is of high contrast.
15. Radiographic image unsharpness is generally caused by movement of the patient, image receptor, or tube head during exposure.
16. Digital imaging sharpness can be affected by pixel size and distribution.
17. Thicker intensifying screens increase the sharpness of extraoral radiographs.
18. The target-object distance is the distance between the focal spot on the target and the skin surface of the patient.
19. 1 Only one film should be placed in contact with the intensifying screens used for extraoral radiography.
20. Slight movement of the tube head during exposure of a radiograph effectively increases the size of the focal spot on the target within the tube head.

Short Answer

1. What types of tissues or structures appear radiolucent on radiographs?
2. What types of tissues or structures appear radiopaque on radiographs?
3. What is radiographic density?
4. What is short-scale contrast?
5. What is the relationship between kVp and contrast?
6. Why should the x-ray film be placed parallel to the long axis of the tooth?
7. The quality of the beam of radiation is determined by which exposure factor?
8. What is radiographic contrast?
9. What is long-scale contrast?
10. What is penumbra?

Chapter 5

Multiple Choice

1. Which of the following statements regarding the biological effect mechanisms of the direct theory is FALSE?
2. Most dental x-ray photons pass through the cell, causing no damage.
3. X-ray photons may collide with important cell chemicals and break them apart.
4. Ionization can cause critical damage to large molecules.
5. Irradiated cells cannot be repaired.
6. Which of the following statements regarding the biological effect mechanisms of the indirect effect is FALSE?
7. Ionization dissociates water into hydrogen and hydroxyl radicals.
8. Ions have a strong tendency to seek out new combinations.
9. New chemicals, such as hydrogen peroxide, can form from hydrogen and hydroxyl radicals.
10. Radiation must be massive to destroy entire body tissues that result in death.
11. Which of the following is most sensitive to damage from radiation?
12. Bone cells
13. Epithelial cells
14. White blood cells
15. Muscle cells
16. Which of the following statements about radiation repair is FALSE?
17. Somatic cells cannot repair radiation damage.
18. Scientists believe that some radiation effects are cumulative.
19. Ions have a strong tendency to recombine immediately to form water again.
20. The quantity, duration, and body area irradiated determine the amount of damage inflicted by the radiation.
21. Which of the following statements regarding the theory established by a threshold dose-response curve is true?
22. There is a dose below which no biological response would be expected.
23. It predicts the effects of very low levels of radiation exposure.
24. It indicates that any amount of radiation has the potential to cause a biological response.
25. It has been adopted by the radiation protection community as the conservative approach to radiation exposure.
26. Each of the following is a potential effect of a low dose of radiation EXCEPT one. Which one is the EXCEPTION?
27. No cell response.
28. Cell repairs itself and functions at pre-exposure levels.
29. Cell repairs itself abnormally.
30. Cell becomes radioactive.
31. Which of the following statements regarding radiation injury is FALSE?
32. The smaller the area of tissue exposure, the greater damage to the individual.
33. The greater the dose, the more severe the probable biological event.
34. The rate at which the radiation is absorbed may determine which biological effects occur.
35. A given dose may produce fewer biologic effects if the cells have a chance to recover.
36. Which of the following statements regarding radiation injury is FALSE?
37. The amount of injury to an individual depends on the volume of tissue radiated.
38. The lethal dose (LD 50/30) for humans is 1.5 grays.
39. Younger, more rapidly dividing cells are more likely to incur damage.
40. Individuals vary in radiation sensitivity within the same species.
41. The lethal dose (LD 50/30) of radiation for humans is estimated to be:
42. 4,500 grays.
43. 450 grays.
44. 45 grays.
45. 4.5 grays.
46. Which of these is NOT a symptom of acute radiation syndrome.
47. Constipation
48. Nausea
49. Hemorrhage
50. Hair loss
51. Which of the following is NOT a component of the Law of Bergonié and Tribondeau?
52. Actively dividing cells are less sensitive.
53. Immature cells are more sensitive.
54. More specialized cells are more radioresistant.
55. Cells are most susceptible to injury during cell division.
56. Which of the following groups of cells are correctly ranked in order of radiosensitivity beginning with the most sensitive?
57. Muscle, brain, red blood, white blood
58. Reproductive, bone, nerve, muscle
59. Brain, bone, connective tissue, white blood
60. Red blood, bone, muscle, epithelial
61. Continued exposure to radiation over prolonged periods may result in each of the following EXCEPT one. Which one is the EXCEPTION?
62. It may alter the ability of genetic cells to reproduce normally.
63. It may affect the ability of genetic cells to repair damage.
64. It may produce offspring with increased resistance to radiation exposure.
65. It may result in cumulative chromosome damage.
66. What is the approximate surface (skin) dose of radiation from a full mouth series of 18 F-speed films, exposed at 90 kVp with a 16-inch (41-cm)-length PID?
67. 30 mSv
68. 50 mSv
69. 75 mSv
70. 100 mSv
71. Which of these periods immediately follows radiation exposure?
72. The period of injury
73. The latent period
74. The reparable damage period
75. The recovery period
76. When the severity of change is dependent on the radiation dose, the effect is called a/an:
77. stochastic effect.
78. deterministic effect.
79. acute radiation effect.
80. lethal dose effect.
81. At what dose of whole-body radiation would an observable short-term effect of acute radiation syndrome result?
82. 0.01 Gy
83. 0.25 Gy
84. 0.50 Gy
85. 1.0 Gy
86. Tissues have the capacity to repair radiation damage to a certain degree. However, some damage

cannot be repaired and remains weakened, especially with repeated exposures. This is called:

1. a long-term effect.
2. radioresistant tissue.
3. a cumulative effect.
4. a stochastic effect.
5. What theory of radiation damage to cells results from free radicals combining to form toxins such as hydrogen peroxide?
6. Primary
7. Secondary
8. Indirect
9. Direct
10. A threshold dose-response relationship indicates that any dose, regardless of amount, can be expected

to produce a biologic response.

A linear dose-response relationship indicates that the biologic response is directly proportional to the

dose.

1. The first statement is true. The second statement is false.
2. The first statement is false. The second statement is true.
3. Both statements are true.
4. Both statements are false.

True/False

1. Scientists do not know whether low levels of radiation exposure carry health risks.
2. A less specialized cell is more radioresistant.
3. A nonthreshold dose-response curve indicates that there is a certain level of radiation below which no biological response should be anticipated.
4. The ALARA concept means “As Low As Reasonably Achievable.”
5. The effects of irradiation depend on the type of energy and duration of the exposure.
6. All humans have the same sensitivity to radiation.
7. All cells in the human body have the same sensitivity to radiation.
8. X-rays have been shown to have carcinogenic effects.
9. The structures of the oral and facial regions are relatively radioresistant.
10. The Law of Bergonié and Tribondeau states that cells are most sensitive to radiation injury during mitosis (cell division).
11. The biological effects of very low levels of radiation cannot be predicted.

1 2. Radioresistant refers to those tissues that are protected by the lead apron and thyroid collar during a dental x-ray exposure.

1 3. The latent period refers to the time between exposure to radiation and the ionization of molecules.

1 4. When radiation affects any cells of the body except the reproductive cells, the effect is called indirect.

1. A stochastic effect is when a biological response is based on the probability of occurrence rather than the severity of the change..

1 6. Cancer is a stochastic effect of exposure to radiation.

1 7. Erythema is a stochastic effect of exposure to radiation.

1. Because they do not divide and are very specialized, reproductive cells are radioresistant.

1 9. White blood cells (lymphocytes) and reproductive cells (oocytes) are two exceptions to the Law of Bergonié and Tribondeau, which states cells that do not divide and are very specialized are radioresistant.

1. The average effective dose equivalent from naturally occuring background radiation to the population of the United States is approximately 8 µSv (microsieverts) per day.

Short Answer

1. What is the difference between the effects of irradiation to somatic cells compared to reproductive cells?
2. What do scientists believe about radiation damage to somatic cells from repetitive exposures?
3. Do scientists believe that radiation damage to reproductive cells is cumulative?
4. What is the LD 50/30 for humans?
5. Why are children more susceptible to radiation than adults?
6. When do the effects of irradiation occur?
7. When the dose of radiation is increased, does the severity of a stochastic effect increase?
8. When is the developing fetus most susceptible to the damaging effects of radiation, and why?
9. Can dental x-rays cause cataracts in the lens of the eye?
10. In addition to x-radiation, list other causes of changes to the genetic material of cells.

Chapter 6

Multiple Choice

1. Each of the following statements regarding radiation protection measures for the patient is correct EXCEPT one. Which one is the EXCEPTION?
2. The oral health care team should embrace the ALARA concept.
3. Radiographs must be taken on all new patients.
4. Evidence-based selection criteria should be used when determining which patients need radiographs.
5. The radiographer should possess a working knowledge of appropriate exposure factors.
6. Each of the following statements regarding the technical ability of radiographers is correct EXCEPT one. Which one is the EXCEPTION?
7. They have the ability to communicate clear and concise instructions to the patient.
8. They possess a thorough understanding of how to produce quality images
9. They understand how to perform dental x-ray machine inspections
10. They participate in continuing education
11. The federal performance standard for diagnostic x-ray equipment requires that all x-ray equipment meet each of the following radiation safety requirements EXCEPT one. Which one is the EXCEPTION?
12. Collimators may be round or rectangular.
13. Both inherent and added filtration is usually required.
14. Aluminum filters are required to remove long wavelength x-rays from the beam.
15. A pointed, closed-end PID is acceptable.
16. Which of the following statements regarding x-ray equipment is FALSE?
17. A short (8 in/20.5 cm) PID delivers less radiation to the patient.
18. Total filtration is the sum of inherent and added filtration.
19. A filter placed in the path of the x-ray beam reduces patient radiation exposure.
20. An external collimator can be attached to the PID to achieve rectangular collimation.
21. Which of the following statements about the position indicating device (PID) is correct?
22. The shorter the PID, the less divergent the beam.
23. The longer the PID, the greater the radiation dose to the patient.
24. Pointed, closed-end plastic cone PIDs should no longer be used.
25. A recessed PID creates a shorter target-surface distance.
26. Which of the following statements regarding lead aprons is FALSE?
27. They are fabricated of 0.25-mm lead or lead-equivalent materials.
28. They should be folded and stored when not in use.
29. They provide a protective barrier against scatter radiation.
30. Their use is in keeping with the ALARA concept.
31. Which film speed requires the least amount of radiation exposure to produce a diagnostic-quality image?
32. D
33. E
34. F
35. G

1. Which of the following statements is FALSE?
2. Processing errors increase patient radiation exposure by resulting in retake radiographs.
3. Following the time-temperature method of processing radiographs produces images of ideal quality.
4. Careful attention to chemical replenishment avoids retakes.
5. It is acceptable to increase the dose while underdeveloping the film if time is short.
6. Which of the following statements regarding protection measures for the operator during exposure is FALSE?
7. The ideal angle to stand from the path of the exiting x-ray beam is 180 degrees.
8. A drifting tube head should not be held in place by the radiographer or the patient.
9. The radiographer should stand at least 6 feet from the head of the patient.
10. A structural barrier provides adequate protection during exposure.
11. Which of the following statements regarding radiation monitoring is FALSE?
12. Area monitoring measures output of the x-ray machine.
13. A radiation monitoring service provides a reliable record of occupational radiation exposure.
14. Personnel monitoring devices protect the wearers from scatter radiation.
15. TLDs and OSLs are examples of personnel monitoring devices.
16. Dental radiation exposure to the patient can be reduced by each of the following EXCEPT one. Which one is the EXCEPTION?
17. Using the fastest speed film currently available
18. Prescribing exams based on evidence-based selection criteria
19. Holding the image receptor in the patient’s mouth
20. Restricting the size and shape of the x-ray beam
21. The ALARA concept implies that:
22. any radiation dose that can be reduced without major difficulty, great expense, or inconvenience, should be reduced or eliminated.
23. if a radiation dose cannot be reduced without major difficulty, great expense, or inconvenience, then no radiographs should be exposed.
24. radiation dosages slightly above the acceptable level of risk are acceptable only in emergency treatment situations.
25. fewer radiographs should be taken only if a radiation dose cannot be reduced due to major difficulty, inconvenience, and great expense.
26. The best way to reduce patient radiation exposure is to:
27. expose routine radiographs.
28. determine the risk/benefit ratio prior to exposure.
29. develop office policy for the maximum number of exposures permissible per patient.
30. use evidence-based selection criteria for prescribing radiographs.
31. Guidelines for prescribing radiographs are based on:
32. medical and dental histories.
33. clinical examination.
34. signs and symptoms.
35. All of the above.
36. The function of the collimator in the dental x-ray machine is to:
37. eliminate secondary sources of radiation.
38. reduce the size of the x-ray beam.
39. eliminate primary sources of radiation.
40. allow for faster exposure times.
41. The purpose of aluminum filtration is to:
42. absorb the penetrating short wavelengths that fog films unnecessarily.
43. reduce the radiation to the patient by reducing the volume of tissue exposed.
44. eliminate the sources of scatter or secondary radiation to the patient.
45. absorb the less penetrating long wavelengths to reduce radiation exposure.
46. A less divergent x-ray beam will:
47. increase the radiation dose to the patient.
48. result in lower-quality radiographic images.
49. create a smaller diameter of exposure.
50. require added filtration.
51. Which of the following will reduce radiation to the patient the most?
52. Fast film speeds.
53. Thyroid collars.
54. Image receptor holders.
55. Rectangular PIDs.
56. Each of the following protects the radiographer from radiation EXCEPT one. Which one is the EXCEPTION?
57. Wearing a personnel-monitoring device
58. Increased distance from the source of radiation
59. Standing behind protective shielding during exposure
60. Spending less time near radiation-producing equipment
61. A personnel monitoring device can NOT:
62. record the amount of radiation received.
63. measure the amount of radiation received.
64. protect the operator from receiving radiation.
65. indicate the type of radiation received.

True/False

1. The best way to reduce patient risk from radiation exposure is to keep exposures ALARA.
2. Guidance for deciding when, what type, and how many radiographs to expose on a patient have been developed and should be followed.
3. A rectangular PID requires a larger dose of radiation to produce a diagnostic-quality radiograph than a circular PID.
4. Pure aluminum will not hinder the passage of high-energy x-rays.
5. Fast film requires less radiation for exposure and is essential for reducing radiation to the patient.
6. Increasing the dose of radiation is a recommended method to compensate for weak processing solutions.
7. Thermoluminescent dosimeters (TLDs) contain crystals that absorb energy when exposed to radiation.
8. The maximum permissible dose (MPD) for oral health care professionals is 50 mSv/year.
9. Medical, dental, and therapeutic radiation is included in the MPD.
10. Regulations governing the use of radiation-producing equipment include federal, state, and some local laws.
11. The United States Nuclear Regulatory Commission has developed dose limits for radiographers and patients.
12. The National Committee on Radiation Protection principle to keep exposure down, based on the idea

that all radiation, no matter how small the dose, may cause adverse biological effects, is called “ALARA.”

1. Federal regulations require that the intraoral x-ray beam be collimated to a diameter of 3.75 inches

at the patient’s skin.

1. If the tube head support arm drifts from its appropriate position when taking a radiograph, the radiographer should ask the patient to hold the PID stable during the exposure.
2. If the area of interest is imaged correctly on an adjacent radiograph, it is possible that an undiagnostic radiograph may not need to be retaken.
3. The bisecting technique should be the radiographer’s first choice in exposing periapical radiographs.
4. Based on evidence-based selection criteria for keeping radiation exposure ALARA, an adult recall patient with no risk factors for caries would most likely be assessed for bitewing radiographs annually.
5. Based on evidence-based selection criteria for keeping radiation exposure ALARA, a child recall patient with several risk factors for caries would most likely be assessed for bitewing radiographs every 6 to 12 months.
6. Based on evidence-based selection criteria for keeping radiation exposure ALARA, a high level of caries experience or demineralization increases a patient’s risk for future caries.
7. High-energy x-rays are the most harmful to the patient because they easily penetrate to the deep tissues of the body.

Short Answer

1. Which intraoral technique should be the radiographer’s first choice when exposing periapical radiographs?
2. What undesirable effect does collimation reduce?
3. Absorption of the long wavelength, less penetrating x-rays of the polychromatic beam occurs by passage of the beam through a sheet of aluminum called a .
4. The sum of inherent and added filtration is called .
5. What is the term given to the walls or partitions around the dental x-ray machine that protect the radiographer against scatter radiation?
6. What are the three categories of methods for protecting oral health care personnel from radiation exposure?
7. Some dental x-ray machines appear to have a short PID when in fact the target surface distance is long. Why?
8. Should the patient wear a thyroid collar during panoramic radiography?
9. Currently, what film speed is recommended to reduce radiation exposure?
10. Should image receptor holding devices be recommended to reduce radiation exposure?

Chapter 7

Multiple Choice

1. Which of these is NOT a component of dental x-ray film?
2. Protective layer
3. Base
4. Phosphor crystals
5. Emulsion
6. Which of these is NOT a component of the dental x-ray film packet?
7. Black paper wrapping
8. One or two films
9. Moisture-resistant outer wrapping
10. Aluminum foil
11. Each of the following statements regarding dental x-ray film speed is true EXCEPT one. Which one is the EXCEPTION?
12. E-speed film is the fastest film speed currently available.
13. Film speed is printed on the back side of each individual film packet.
14. Trademark names like “Super” or “Ultra” are not film speeds.
15. Film speeds slower than D are no longer used.
16. Which of the following radiographs gets its name from the Greek word that means around and the Latin word for apex that refers to the root tip?
17. Bitewing
18. Periapical
19. Occlusal
20. Panoramic
21. Which of these intraoral dental films is 2.25 inches × 3 inches?
22. Size #1
23. Size #2
24. Size #3
25. Size #4
26. Each of the following statements regarding duplication of radiographs is correct EXCEPT one. Which one is the EXCEPTION?
27. The emulsion side of duplicating film contains an antihalation coating.
28. The solarized emulsion records the copy of the image.
29. The emulsion side of duplicating film is placed against the original radiograph.
30. The antihalation coating prevents back-scattered light from re-exposing the film.
31. Which of the following statements regarding extraoral film is FALSE?
32. It is used outside the mouth.
33. It comes individually wrapped in protective paper.
34. It is called a “screen film.”
35. It uses intensifying screens.
36. Which of the following statements regarding film storage and protection is FALSE?
37. It is light-sensitive.
38. It has a shelf life.
39. It is affected by high heat and humidity.
40. It should be stored in the darkroom.
41. Extraoral film is used for ALL of the following projections EXCEPTone. Which one is this EXCEPTION?
42. Lateral jaw radiographs
43. Occlusal radiographs
44. Cephalometric radiographs
45. Panoramic radiographs
46. Each of the following statements is true EXCEPT one. Which one is the EXCEPTION?
47. During exposure, the x-rays strike and ionize all silver halide crystals on the film.
48. The invisible image on an x-ray film is called the “latent image.”
49. The function of the gelatin in film emulsion is to keep the silver halide crystals evenly suspended over the base.
50. Silver halide in the emulsion is primarily silver bromide.
51. Dental film has a polyester base for the purpose of:
52. increasing the contrast and image quality.
53. providing support for the emulsion.
54. producing the latent (invisible) image.
55. preventing scatter radiation from exposing the film.
56. Which portion of the dental film retains the latent image?
57. The protective layer
58. The gelatin
59. The silver halide crystals
60. The adhesive
61. Which structure is most likely to absorb or stop more of the x-rays from reaching the film?
62. The enamel
63. The bone
64. The pulp
65. The soft tissue (cheek)
66. Which of these protects the film from white-light exposure?
67. Antihalation coating
68. Solarized emulsion
69. Lead foil
70. Black paper
71. The purpose of the embossed dot on the film packet is to:
72. identify which side of the film contains the emulsion.
73. determine if the film packet contains one or two films.
74. distinguish the patient’s right from left on the developed radiograph.
75. locate the edge of the packet that should be positioned toward the apices.
76. Which of the following indicates the correct placement of an intraoral film?
77. The back side faces the buccal surfaces of the teeth and away from the source of radiation.
78. The back side faces the lingual surfaces of the teeth and is facing the source of radiation.
79. The tube side faces the buccal surfaces of the teeth and faces the source of radiation.
80. The tube side faces the lingual surfaces of the teeth and faces the source of radiation.

1. Each of the following affects film speed EXCEPT one. Which one is the EXCEPTION?
2. Emulsion thickness
3. Crystal size
4. Film packet size
5. Special dyes
6. Graininess of a radiographic image results from:
7. large silver halide crystals.
8. the addition of radiosensitive dyes.
9. a decrease in film speed.
10. film packets that contain two films.
11. Which of the following is NOT an intraoral projection?
12. Periapical
13. Occlusal
14. Panoramic
15. Bitewing
16. Which film size is ideal for positioning a periapical radiograph in the narrow canine region on an adult patient?
17. Size #0
18. Size #1
19. Size #2
20. Size #3

True/False

1. Film used for dental radiography is very similar to photographic film.
2. Intraoral films are designed for use outside the oral cavity.
3. Dental x-ray film is surrounded by a sheet of white paper inside the film packet.
4. Film packets may contain one or two films.
5. The tab for opening the film packet is on the tube side of the packet.
6. During periapical radiograph film packet placement, the embossed dot should be positioned toward the apices of the teeth.
7. Bitewing radiographs image the entire tooth, from crown to root tip.
8. Pedodontic films are usually size #2 films.
9. The radiation exposure needed for extraoral film projections is higher than that needed for intraoral projections.
10. The same film type used for exposing dental radiographs can be used to duplicate them.
11. A fast speed film requires more radiation exposure to record a diagnostic image.
12. The latent image is an image that is slow in its formation, especially when using slow speed film.
13. The purpose of the lead foil in the film packet is to absorb back-scattered x-rays to reduce film fog.
14. Dental film emulsion is about 90 to 99 percent silver bromide and 1 to 10 percent silver iodide.
15. The appearance of clear/white or radiopaque structures on the radiograph is a result of the developer step during film processing.
16. Intraoral film emulsion is composed of a gelatin and silver halide crystals.
17. The white, unprinted side of an intraoral film packet is the back side.
18. A pedodontic film is any film used to radiograph a child’s teeth.
19. Duplicating film gets lighter the longer the exposure to light.
20. Film should be stored in its original packaging in an area shielded from radiation.

Short Answer

1. The invisible image present on a dental x-ray film that does not become visible until after processing is called what?
2. What is placed in the film packet by the manufacturer to absorb scattered radiation?
3. What is the color of the tube side of the film packet?
4. What number is given to occlusal film to indicate its size?
5. What type of film is needed to copy a dental radiograph?
6. Silver halide crystals suspended in gelatin form which part of dental x-ray film?
7. For what is the embossed dot in one corner of intraoral dental x-ray film used?
8. Which side of the film packet faces the source of radiation?
9. The sensitivity of a given type of dental x-ray film is known as its what?
10. Extraoral radiographs require the use of a cassette and what else?

Chapter 8

Multiple Choice

1. Which of these is NOT part of the developer solution?
2. Reducing agent
3. Clearing agent
4. Activator
5. Restrainer
6. Which of the following statements regarding developer chemistry is FALSE?
7. Sodium sulfite slows down the oxidation rate.
8. Sodium carbonate provides the alkaline medium.
9. Potassium bromide restrains development of unexposed silver halide crystals.
10. Potassium alum swells the gelatin.
11. Each of the following statements is true regarding the darkroom EXCEPT one. Which one is the EXCEPTION?
12. It should be located near where radiographs will be exposed.
13. It should be well ventilated.
14. It should have adequate space to store unexposed film.
15. It should be equipped with safelighting.
16. Which of these is NOT a component of fixer?
17. Sodium thiosulfate
18. Preservative
19. Activator
20. Acidifier
21. Each of the following statements regarding darkroom safelighting is true EXCEPT one. Which one is the EXCEPTION?
22. Walls should be painted black.
23. You should allow longer wavelength red-orange light to pass through the safelight filter.
24. Shorter wavelength blue-green light is removed by the safelight filter.
25. Four feet is the minimum distance between the safelight and the countertop.
26. Which of the following statements regarding manual film processing is FALSE?
27. A visual inspection of the image will determine the length of time the film stays in the developer.
28. A film holder clip is used to transport films to and from each of the processing solutions.
29. The optimum temperature for manual processing is 68 degrees F.
30. Cleansing powders should not be used to clean processing tank inserts.
31. Each of the following statements regarding automatic film processing is correct EXCEPT one. Which one is the EXCEPTION?
32. It requires diligent care for optimal performance.
33. Chemical solutions are heated to match the temperature used in manual processing.
34. If processor rollers are not kept clean, films can emerge streaked.
35. It uses a roller transport system to move the film through the processing cycle.
36. Which of the following statements regarding automatic processors is FALSE?
37. Depending on the workload, cleaning must be done approximately every 6 months.
38. The roller assembly should be cleaned in warm running water with special cleansers.
39. Chemistry should be replenished or changed as necessary.
40. Roller transports squeeze excess solution from film surfaces.
41. Which of the following statements regarding rapid processing of dental radiographs is FALSE?
42. It can be accomplished in 30 seconds with special, fast-acting chemicals.
43. It provides archival, permanent quality radiographs.
44. Four cups are set up inside the box containing developer, rinse water, fixer, and wash water.
45. A light-tight countertop box contains two openings that allow light-tight access of the radiographer’s hands.
46. Which of the following statements regarding automatic processing is correct?
47. No water is required.
48. Processing is accomplished under normal white-light conditions.
49. The chemistry in automatic processors is heated to 68 degrees F.
50. Unwrapped film is fed into the film feed slot on the outside of the processor.
51. The purpose of the developing step is to:
52. remove unexposed silver halide crystals from the film emulsion.
53. neutralize the alkalinity prior to the film progressing to the fixer.
54. reduce exposed silver halide crystals to black metallic silver.
55. prevent the rapid buildup of image contrast.
56. Which ingredient slows down the oxidation rate of the developing solution?
57. Sodium sulfite
58. Sodium carbonate
59. Potassium bromide
60. Hydroquinone
61. Potassium alum in the fixer serves to:
62. neutralize the alkali of the developer.
63. act as a preservative.
64. clear remaining crystals.
65. shrink and harden the emulsion.
66. What wattage is ideal for safelighting a darkroom for all film types?
67. 15
68. 25
69. 40
70. 60
71. The advantage of manual processing over automatic processing is that there is:
72. less hazardous waste production.
73. more time required to produce finished radiographs.
74. less malfunction of processing equipment.
75. less water used.
76. At a minimum, how often should manual processing solutions be changed?
77. Every week
78. Every 2 weeks
79. Every 3 weeks
80. Every month
81. The time required for development of radiographic film is determined by the:
82. temperature of the darkroom.
83. temperature of the water.
84. temperature of the developer.
85. temperature of the fixer.

1. The purpose of the washing step in film processing is to:
2. shrink and harden the emulsion.
3. remove any residual chemistry remaining on the emulsion.
4. neutralize alkaline and/or acidic chemistry.
5. reduce the exposed silver halide to metallic silver.
6. During manual time-temperature film processing, after fixing, the films are to be placed in the water wash for:
7. 5 minutes.
8. 10 minutes.
9. 20 minutes.
10. time is dependent upon water temperature.
11. The optimum developing temperature for manual time-temperature film processing is:
12. 58 degrees F.
13. 68 degrees F.
14. 78 degrees F.
15. 88 degrees F.

True/False

1. Developer contains hydroquinone and elon.
2. Replenisher is a superconcentrated solution of developer or fixer.
3. In addition to a safelight, the darkroom should be equipped with a white overhead light.
4. The darkroom door should be locked when processing film.
5. A thermometer is mandatory for archival manual processing.
6. Reduction is the union of developer and oxygen.
7. The life of processing solutions can be extended by replenishment.
8. Processing chemistry can be used indefinitely.
9. A disadvantage of automatic processing is the time it takes to produce a finished radiograph.
10. The ideal time-temperature for manual processing archival radiographs is 85 degrees F.
11. The developer reducing agent that builds up gray tones in the image is hydroquinone.
12. Oxidation is the process during which the chemicals of the developing and fixing solutions combine with oxygen and lose their strength.
13. Developer solution needs replenishment more often than fixer.
14. The preservative sodium sulfite</KT> is found in both the developer and fixer solutions.
15. The dark portion of the radiograph is called “radiolucent.”
16. A darkroom is not necessary if the automatic processor is equipped with a daylight loader.
17. It is safe to read a radiograph under white-light conditions after only 2 or 3 minutes of developing.
18. The fixer is responsible for creating the film’s radiolucent appearance, and the developer is responsible for creating the film’s radiopaque appearance.
19. Developer and fixer chemicals may be obtained in three forms: powder, liquid concentrate, or ready-to-use solutions.
20. The <KT>developing agent</KT> will only have an effect on the exposed silver halide crystals at recommended time-temperature.

Short Answer

1. What is the name of the component of developer that prevents development of unexposed silver halide crystals?
2. Which processing solution prevents further film development?
3. Of what material are manual processing tanks fabricated?
4. A wet reading can safely take place after which step of processing?
5. What is a safelight?
6. How frequently should processing solutions be changed?
7. What is the purpose of rinsing the film after it has been in the developer during manual processing?
8. With what should powdered and liquid concentrate forms of processing solutions be mixed?
9. What is replenisher?
10. How does the temperature of the chemistry used in automatic processors compare to the temperature of the chemistry used for manual processing?

Chapter 9

Multiple Choice

1. Each of the following statements regarding digital radiography is correct EXCEPT one. Which one is the EXCEPTION?
2. In film-based radiography, the radiographer “takes a radiograph,” while in digital imaging, the radiographer “acquires an image.”
3. A digital image has no physical form.
4. Digital radiography systems are limited to intraoral systems.
5. Indirect digital imaging replaces film with a photostimulable plate.
6. Each of the following statements regarding digitization is correct EXCEPT one. Which one is the EXCEPTION?
7. The quality of an indirect digital image has the same quality as a direct digital image.
8. Digitization converts conventional film-based radiographs to digital images.
9. Transparency adapters for digitization of radiographs are available for flatbed scanners.
10. Digitization can be accomplished by taking a digital photograph of a film-based radiograph.
11. Which of these statements is FALSE?
12. The digital image is composed of structurally ordered pixels.
13. Each pixel is a single dot in a digital image.
14. Pixel is short for “pixel element.”
15. Each pixel has a number from 1 to 10.
16. Each of the following statements regarding pixels is correct EXCEPT one. Which one is the EXCEPTION?
17. The more pixels in an image, the higher the resolution and the sharper the image.
18. The number and size of pixels determines the spatial resolution of an image.
19. When the number of pixels is low, the image appears to have jagged edges.
20. A pixel with a stored number of 0 would be pure white.
21. How many shades of gray can the unaided human eye detect?
22. 32
23. 320
24. 3,200
25. 32,000
26. Each of the following is a use of digital radiography EXCEPT one. Which one is the EXCEPTION?
27. To evaluate growth and development.
28. To image soft tissues of the head and neck region.
29. To detect, confirm, and classify oral diseases.
30. To detect and evaluate trauma.
31. Which of the following is NOT a type of digital image receptor?
32. Photostimulable phosphor
33. Scanner
34. Complementary metal oxide semiconductor
35. Charge-coupled device
36. Which of these is used in indirect digital imaging?
37. Photostimuable phosphor
38. Complementary metal oxide semiconductor
39. Charge-coupled device
40. Artificial intelligence
41. Which of these is NOT an advantage of digital imaging over film-based imaging?
42. There is less radiation exposure.
43. It eliminates the need for a darkroom.
44. It is easier to place into position in the oral cavity.
45. Images may be manipulated to enhance interpretation.
46. Each of the following statements regarding photostimulable phosphor plates is correct EXCEPT one. Which one is the EXCEPTION?
47. They use rare earth–coated plates.
48. The plates are disposable.
49. They store x-ray energy until stimulated by a laser beam.
50. They are similar to film-based radiography in that they must be “developed” later.
51. Which of these is NOT a limitation of digital imaging?
52. The need for plastic infection control barriers may hinder placement intraorally.
53. Smaller overall dimensions limit recording area.
54. The initial costs to convert from film-based imaging can be expensive.
55. Images can be manipulated.
56. The more pixels in a digital image, the:
57. lower the resolution and the sharper the image.
58. lower the resolution and the less sharp the image.
59. higher the resolution and the sharper the image.
60. higher the resolution and the less sharp the image.
61. How many gray levels can a computer monitor display?
62. 8
63. 32
64. 256
65. 65,500
66. Which of the following is FALSE regarding a digital sensor?
67. It requires a different technique than a film packet.
68. It replaces an intraoral film packet.
69. It may be wired or wireless.
70. It is available in sizes similar to film packets.
71. Which digital image receptor uses rare earth–coated plates to store the x-ray energy until stimulated by a laser beam?
72. Charge-coupled device
73. Photostimulable phosphor
74. Complementary metal oxide semiconductor
75. How much less radiation exposure is a digital radiograph purported to be over a fast speed film–based radiograph?
76. 0 to 20 percent
77. 0 to 30 percent
78. 0 to 50 percent
79. 0 to 80 percent
80. Which of the following digital imaging technologies converts film-based images to

digitized images?

1. Storage phosphor imaging
2. Charge-coupled device
3. Metal oxide semiconductor
4. Digitization
5. What determines the quality of a digital image?
6. Gray scale
7. Spatial resolution
8. Combination of pixels
9. All of the above
10. Which of the following features of digital imaging software currently available provides the best aid to interpreting digital images?
11. Density/contrast manipulation
12. Colorization
13. Embossing
14. Reversing the gray scale
15. The size and number of pixels that make up a digital image determine the spatial resolution.

Spatial resolution is measured in line pairs.

1. The first statement is true. The second statement is false.
2. The first statement is false. The second statement is true.
3. Both statements are true.
4. Both statements are false.

True/False

1. There are two methods of acquiring a digital image.
2. Digitization converts radiographs obtained with traditional film-based radiography to digital images.
3. Direct digital imaging does not use film.
4. A digital image is the same as an analog image.
5. Each pixel is a single dot in a digital image.
6. Most digital imaging systems cannot be used with conventional x-ray machines.
7. Solid-state digital sensors are available wired of wireless.
8. CMOS and CCD are types of direct digital sensors.
9. Line pairs refers to the total number of shades of gray visible in an image.
10. Digital radiography requires a computer and monitor to capture and view an image.
11. The lower the line pairs per millimeter, the better the spatial resolution.
12. The discernable separation of closely adjacent image details is referred to as contrast.
13. Digitization uses a computer to superimpose two standardized radiographic images, causing the like areas of the image to “cancel” each other out, leaving only the changes visible.
14. Using digital radiographic software to detect caries is an example of artificial intelligence.
15. Film-based radiographs contain analog data.
16. The digital technology used in digital radiographic sensors is similar to that used in digital cameras and computer memory chips.
17. x and y coordinates are used by the computer to reconstruct digital data obtained by the sensor into an image that can be viewed on the computer monitor.
18. If more radiation reaches the digital sensor, the gray value will decrease.
19. CCD and CMOS digital image receptors very closely resemble film and capture x-ray energy in a manner similar to film.
20. Photostimulable phosphor plates are light-sensitive.

Short Answer

1. What is the difference between a digital image and a radiograph?
2. Are digital radiography systems limited to intraoral images?
3. Do digital imaging systems necessarily require a computer and monitor to capture and view an image?
4. By what mechanism are PSP plates reusable?
5. What is the purpose of digital imaging measuring software?
6. What is digital subtraction?
7. How can two images, taken over time, be compared using digital subtraction?
8. Which requires less radiation to produce an image, digital or conventional film-based radiographs?
9. What is the digital equivalent of film fog?
10. What are the advantages of digital radiography?

Chapter 10

Multiple Choice

1. For infection to occur, each of the following conditions must be present EXCEPT one. Which one is the EXCEPTION?
2. An appropriate portal of entry into the host
3. A pathogen
4. An acceptable barrier
5. A susceptible host
6. Which of these statements is FALSE?
7. Microbial aerosols are pathogens present in blood that cause disease in humans.
8. Asepsis means “freedom from infection.”
9. An antiseptic is an agent used on living tissue to kill or reduce numbers of bacteria.
10. Contamination is soiling by contact or mixing.
11. Which of the following statements regarding infection control terminology is correct?
12. A barrier prevents the transmission of infectious microorganisms.
13. Microbial aerosols are disease-causing microorganisms present in human blood.
14. Sepsis is the absence of septic matter.
15. Infection requires an appropriate portal of entry into the host.
16. Each of the following statements regarding personal protective equipment is correct EXCEPT one. Which one is the EXCEPTION?
17. Protective clothing should be laundered weekly.
18. Protection from aerosols may be achieved through the use of a mask.
19. Protective eyewear protects the eye area from aerosols and spatter.
20. Hands should be washed before gloving and after removing gloves.
21. Each of the following types of protective eyewear is acceptable for use by the dental radiographer EXCEPT one. Which one is the EXCEPTION?
22. Glasses with side shields
23. Goggles
24. Contact lenses
25. Full face shields
26. Each of the following statements regarding the use of daylight loader attachments on automatic processors is correct EXCEPT one. Which one is the EXCEPTION?
27. The operator must remove the light-filter cover when placing and removing items.
28. The advantage of these devices is that time-saving shortcuts are acceptable.
29. Clean, dry hands can be slid through light-tight baffles to access the unit.
30. The key to infection control is to never slide anything through the baffles except clean, dry hands.
31. Each of the following statements regarding the use of gloves is correct EXCEPT one. Which one is the EXCEPTION?
32. It is acceptable to wear rings under gloves.
33. Hands must be dried thoroughly before patient treatment gloves are put on.
34. Fingernails should be cut short and well-manicured.
35. Hands should be washed thoroughly before gloving and after removing gloves.
36. Which of the following statements regarding the use of gloves is FALSE?
37. Sterile gloves should be used for surgical procedures.
38. Use of plastic overgloves is acceptable to protect patient treatment gloves.
39. Punctured, torn, or cut gloves should be changed immediately.
40. Gloves should be washed with soap if treatment must be interrupted.
41. Which of the following statements regarding sterilization and disinfection is FALSE?
42. Steilization is accomplished by autoclaving or dry heat processes.
43. Spores are destroyed during disinfection.
44. Disinfecting agents are too toxic to be used on living tissues.
45. Iodophors are hospital-grade disinfectants and tuberculocidals.
46. Which of these statements regarding classification of objects used in radiographic procedures is FALSE?
47. Critical objects must be sterilized after each use.
48. Most quality-made image receptor holders are sterilizable or disposable.
49. Semicritical objects are those used to penetrate soft tissue or bone.
50. No critical instruments are used in dental radiography.
51. Prior to film placement, preprocedural mouthrinses are considered:
52. antiseptics.
53. disinfectants.
54. sterilants.
55. sanitizers.
56. Infection control procedures must be applied to each of the following body fluids EXCEPT one. Which one is the EXCEPTION?
57. Blood
58. Mucus
59. Sweat
60. Saliva
61. During radiographic procedures, when should hands be washed?
62. Before treating the patient
63. After treating the patient
64. Before putting on gloves
65. All of the above
66. Which of the following gloves are recommended for cleaning and disinfecting radiographic operatories and equipment?
67. Heavy-duty utility gloves
68. Plastic overgloves
69. Latex treatment gloves
70. Vinyl treatment gloves
71. Iodophors, phenolics, and chlorine-containing compounds that do not destroy spores are classified as:
72. high-level disinfectants.
73. intermediate-level disinfectants.
74. low-level disinfectants.
75. Lead aprons are classified as __________ objects.
76. critical
77. semicritical
78. noncritical
79. After patient treatment, reusable image receptor holding devices must be:
80. sanitized.
81. disinfected.
82. sterilized.
83. washed.
84. Which of the following will require adhering to infection control protocol for a semicritical object?
85. A lead apron and thyroid collar
86. A control panel and timer selector
87. A film mount and counter top
88. An image receptor holder
89. Which of the following will benefit the most from using film packets with a protective barrier?
90. Manual processing
91. Automatic processing
92. Daylight loaders
93. Rapid (chairside) processing
94. After aseptically removing the barriers, film packets that were packaged inside barrier envelopes may be processed with clean, dry hands because the film packets are not contaminated.
95. The first part of the statement is true. The second part of the statement is false.
96. The first part of the statement is false. The second part of the statement is true.
97. Both parts of the statement are true.
98. Both parts of the statement are false.

True/False

1. A pathosis is a microorganism capable of causing disease.
2. Using standard precautions, infection control protocols are carried out only if the patient is known to be infectious.
3. The lead apron should be sterilized after use.
4. Sterilization refers to total destruction of spores and disease-causing microorganisms.
5. The radiographer should use powdered, nonsterile gloves made of latex or vinyl when placing intraoral radiographs.
6. Sterilization is the use of a chemical or physical procedure to reduce the pathogens to an acceptable level on inanimate objects.
7. Semicritical objects must be sterilized after use.
8. Barrier materials should be placed over surfaces likely to be contaminated during radiographic procedures such as the PID and tube head, control panel, exposure switch, and countertops.
9. Noncritical objects are those that do not come into contact with mucous membranes.
10. The radiographer should be able to aseptically open all film packets in a full mouth series in 2 minutes or less to avoid excessive exposure to safelight.
11. Protective clothing, mask, and eyewear should be in place prior to putting on patient treatment gloves.
12. Darkroom counter surfaces without barrier protection that have been touched by gloved hands must be cleaned.
13. The goal of infection control is the prevention and reduction of disease-causing (pathogenic) microorganisms.
14. Occupational exposure refers to an infection a patient might be exposed to while undergoing oral health care treatment.
15. Radiographers should be vaccinated against certain diseases.
16. Spatter is the suspension of microorganisms that may be capable of causing disease produced during normal breathing and speaking.
17. Universal precautions have replaced standard precautions.
18. Taking a thorough medical history and performing an oral examination will not always identify potential infected patients.
19. The Centers for Disease Control and Prevention (CDC) does not enforce infection control regulations.
20. The lead apron is considered part of personal protective equipment (PPE).

Short Answer

1. What is an antiseptic?
2. How often should protective clothing be changed?
3. Within what time frame should the radiographer be able to aseptically open all film packets of a full mouth series in the darkroom?
4. How should films secured in barrier envelopes be handled?
5. What are infectious diseases?
6. How can the chain of infection be broken?
7. What is asepsis?
8. What is the definition of “disinfect”?
9. Are some patients likely to be reluctant to admit infectious conditions?
10. List personal protective equipment (PPE) required during radiographic procedures.

Chapter 11

Multiple Choice

1. Each of the following statements regarding dental radiographic equipment regulations is correct EXCEPT one. Which one is the EXCEPTION?
2. Most states require registration of dental x-ray machines.
3. Inspection of dental x-ray machines is usually conducted every 2–4 years.
4. Fees are usually collected for inspection of x-ray machines.
5. The dentist can perform inspections of dental x-ray machines.
6. Which of the following statements is correct?
7. The Consumer-Patient Radiation Health and Safety Act was designed to protect patients from unnecessary radiation.
8. The Federal Performance Act of 1974 was designed to protect patients from unnecessary radiation.
9. The Consumer-Patient Radiation Health and Safety Act requires that all x-ray equipment manufactured or sold in the United States meet federal performance standards.
10. There are no federal laws regarding use of dental x-ray equipment.
11. Each of the following statements regarding risk management is correct EXCEPT one. Which one is the EXCEPTION?
12. An attempt should be made to obtain duplicate copies of a new patient’s radiographs.
13. The fastest film speed currently available should be used for all radiographs.
14. Unless required by law, personnel monitoring devices should be discouraged.
15. All intraoral radiograph exposures should use an image receptor holding device.
16. The federal Consumer-Patient Radiation Health and Safety Act:
17. mandated safety requirements for collimation and filtration of equipment.
18. provided guidelines and recommended procedures for infection control.
19. provided and updates evidence-based selection criteria guidelines.
20. established standards for state certification/licensure of radiographic personnel.
21. Each of the following statements regarding informed consent is correct EXCEPT one. Which one is the EXCEPTION?
22. Speak to the patient in lay terms about the risks and benefits of exposing radiographs.
23. Allow the patient to choose who he/she wants to expose the radiographs.
24. Inform the patient about the risks of radiation exposure.
25. Inform the patient of the purpose of exposing the radiographs.
26. Each of the following statements regarding patients who refuse radiographs is correct EXCEPT one. Which one is the EXCEPTION?
27. The dentist must consider whether care can be provided without the radiographs.
28. A patient who does not want radiographs may sign a document releasing the dentist from liability.
29. Patients may believe radiographs are not necessary or that they will add to treatment costs.
30. Patients may be fearful that dental x-ray exposure will be hazardous to their health.
31. Which of these statements is FALSE?
32. Professional rules of conduct are called a “code of ethics.”
33. Professional ethics define a standard by which all members of a profession are obligated to conform.
34. The ethics of a profession help guide the behavior of the health care professional.
35. Ethics are laws and regulations pertaining to the behavior of the health care professional.
36. Which of the following is NOT a goal of the dental radiographer?
37. Keep retake radiographs under three per patient.
38. Perform confidently and with authority.
39. Aim for perfection with each radiograph.
40. Follow strict protocols to protect oneself during exposures.
41. Which of these statements is FALSE?
42. Direct supervision means the dentist is in the office when radiographs are being exposed.
43. Each state’s dental commission controls the scope of practice for dentists, dental assistants, and dental hygienists.
44. State laws governing dental radiographers with on-the-job training vary considerably from state to state.
45. Each state has a mandatory state exam or continuing education requirement for dental radiographers.
46. Which of these statements regarding risk management is FALSE?
47. Obtain a duplicate copy of a new patient’s radiographs if possible.
48. Use the best equipment currently available for exposing radiographs.
49. Take radiographs only if the dentist is present.
50. Establish a written quality assurance system for radiographic equipment.
51. Direct supervision when radiographs are taken means that the dentist:
52. must be present in the office.
53. must be present in an adjacent operatory.
54. need not be present in the office but must be readily available.
55. has authorized the number of films to be taken.
56. Policies and procedures used to reduce the chances a patient will file legal action against the oral health care team is known as:
57. code of ethics.
58. risk management.
59. standards protocol.
60. radiation health and safety.
61. To give informed consent, each of the following must be explained to the patient EXCEPT one. Which one is the EXCEPTION?
62. The purpose of taking radiographs
63. The risks and benefits of taking radiographs
64. The possible risks of refusing radiographs
65. How the radiographs will be taken
66. Legally, radiographs are the property of:
67. the dentist who originally prescribed the radiographs.
68. a new dentist if the patient leaves the original practice.
69. both the original dentist who prescribed the radiographs and a new dentist if the patient leaves the original practice.
70. the patient.
71. Patients may have reasonable access to their radiographs if:
72. changing dentists.
73. having a consult with a specialist.
74. needed for litigation against the dentist.
75. All of the above.
76. Dental radiographs must be retained for 7 years after the:
77. date of exposure.
78. patient is deceased.
79. patient ceases to be a patient.
80. completion of treatment.
81. Who has a legal right to request copies of a patient’s radiographs?
82. Another dentist
83. The patient
84. An insurance company
85. All of the above
86. The statute of limitations for bringing a malpractice suit begins:
87. from the date that treatment was started.
88. from the date that treatment was completed.
89. from the date that the patient discovers an injury.
90. within 5 years from the date that the patient discovered an injury.
91. Certification and/or licensure to expose dental radiographs:
92. is regulated by individual state laws, which may vary.
93. is not required in all states if one has accredited training.
94. may or may not be regulated by the dentist/employer.
95. is required by law in all fifty states and the District of Columbia.
96. The legal right of the patient to refuse radiographs is a form of:
97. the statute of limitations.
98. liability.
99. self-determination.
100. disclosure.

True/False

1. The State Performance Act of 1974 requires all x-ray equipment manufactured or sold in the United States to meet federal performance standards.
2. Radiographers in all states must conform to the Consumer-Patient Radiation Health and Safety Act.
3. Some states require additional credentials beyond passing the National Board Dental Hygiene Examination or Dental Assisting National Board Examination to place and expose dental radiographs.
4. There are variations between states in terms of requirements for a dental hygienist or assistant to place and expose radiographs.
5. There are national guidelines regarding who can place and expose dental radiographs.
6. In malpractice cases, the dentist may be sued for the actions of the radiographer.
7. “Liable” means to be legally obligated to make good any loss or damage that may occur.
8. Original radiographs are the property of the dentist in whose practice they were made.
9. Dental radiographs must be retained by the dentist for 10 years after the patient leaves the practice.
10. Insurance companies and other third-party payers of treatment require original radiographs for pretreatment authorization purposes.
11. Patients have the right to reasonable access to their radiographs.
12. The process of informing the patient about the risks and benefits of a treatment procedure is called “self-determination.”
13. The Consumer-Patient Health and Safety Act provides patients with more control over how their personal health information is used and disclosed.
14. The legal right of an individual to make choices concerning health care treatment is called “self-determination.”
15. As prudent risk management, radiographs should be retained as part of a client’s record for 7 years.
16. Federal laws regulate the manufacture of dental x-ray machines and state regulations control the use of x-ray equipment.
17. Many states consider a certified dental assistant and a registered dental hygienist competent to place and expose dental radiographs.
18. All states have certification requirements for personnel taking dental radiographs.
19. Providing the radiographers with a radiation monitoring device is good risk management.
20. Good patient relations can reduce the risk of possible legal action.

Short Answer

1. Generally, how frequently must x-ray machines be inspected?
2. Policies and procedures to be followed by the radiographer to reduce the likelihood that a patient will file legal action against the oral health care team are collectively called what?
3. What is the discussion with a patient prior to obtaining informed consent to expose dental radiographs called?
4. What is the term for the legal right all patients have regarding choices about the health care they will receive?
5. What is the type of consent a patient gives after being told of the nature and purpose of treatment procedures, the benefits, and the risks?
6. Who owns a patient’s dental radiographs?
7. When does the statute of limitations begin to run for children?
8. Name the action that occurs if diagnosis or treatment is substandard compared to that provided by dentists in a similar locale under similar conditions.
9. What is the term for the period of time during which a patient may bring a malpractice suit against a dental radiographer?
10. Can duplicate radiographs be sent to a specialist consultant or insurance company?

Chapter 12

Multiple Choice

1. Each of the following plays a role in gaining patient confidence and cooperation EXCEPT one. Which one is the EXCEPTION?
2. Appearance
3. Anxiety
4. Attitude
5. Communication
6. Which of these statements regarding patient relations is FALSE?
7. Respectfulness and courtesy are examples of interpersonal skills.
8. The radiographer’s attitude toward his or her own technical ability is conveyed to the patient.
9. If a patient has concerns regarding x-ray exposure, the radiographer should tell the patient not to worry, everything will be okay.
10. If the radiographer feels the procedure is unnecessary or uncomfortable, these feelings will be conveyed to the patient.
11. Which of the following statements regarding interpersonal skills is best?
12. The radiographer should praise the patient for their assistance with the procedure.
13. Acknowledge mistakes with an easygoing “Oops,” indicating that it is not serious.
14. It is natural to show frustration with a patient who is having difficulty managing the procedure.
15. If a patient is feeling discomfort, tell him or her to hang on and be patient.
16. Each of the following statements regarding communication is correct EXCEPT one. Which one is the EXCEPTION?
17. Patient questions must be answered honestly to develop trust.
18. Communication is the process by which information is exchanged between two or more people.
19. Establish how you will communicate with the patient prior to putting on the mask required for radiographic procedures.
20. In an uncomfortable discussion, avoid eye contact with the patient.
21. Each of the following statements regarding effective nonverbal communication is correct EXCEPT one. Which one is the EXCEPTION?
22. Nonverbal communication is not very believable.
23. A nod of the head indicates “yes” or agreement.
24. A smile by the radiographer can help to relax the patient and reduce apprehension.
25. Facial expressions strongly convey the attitude of the radiographer.
26. Which of these statements is FALSE?
27. A panoramic radiograph records all maxillary and mandibular teeth and surrounding bone.
28. Adults generally need x-rays more often than children.
29. X-ray exams should be individualized for each patient.
30. Radiographs may aid in the evaluation of periodontal diseases.
31. Which of the following statements is correct?
32. The measurement term “gray” indicates comparisons between different types of radiation.
33. Exposures are recorded with the term “sievert.”
34. The amount of radiation absorbed by the tissue is referred to as the dose.
35. mSv stands for one-hundredth of a sievert.
36. Which of these statements is FALSE?
37. The radiographer must remain in the room during the exposure to be sure the patient does not move.
38. A lead/lead-equivalent apron and thyroid collar can be used to protect the patient from stray radiation.
39. Scientists know that exposure to large doses of radiation is more likely to cause biological harm.
40. The risk of harmful effects from dental x-ray exams is extremely small.
41. Which of the following statements regarding dental radiography during pregnancy is correct?
42. It causes premature delivery.
43. It overexposes the area of the developing fetus.
44. It has been linked to full-term, low birth-weight infants.
45. It creates birth defects.
46. Each of the following is a precaution that minimizes the amount of radiation a patient receives EXCEPT one. Which one is the EXCEPTION?
47. Take only necessary radiographs.
48. Use the slowest film speed currently available.
49. Use collimating equipment that restricts the beam size and shape.
50. Cover all patients with a lead/lead-equivalent apron and thyroid shield.
51. Which of the following statements would be acceptable communication with a patient?
52. “We need to retake your radiographs because the films got stuck in the processor again.”
53. “This tube head always drifts.”
54. “This x-ray machine is making a strange noise. Let’s see if it will affect your radiographs.”
55. “Your radiographs are too dark but we corrected the problem. Let’s take them again.”
56. If you are uncertain of the correct pronunciation of the patient’s name:
57. ask the patient to pronounce his or her name for you.
58. pronounce the name phonetically and let the patient correct you.
59. ask the receptionist for the correct pronunciation.
60. address the patient using his or her first name.
61. Which attitude is more likely to gain the patient’s trust with respect to the radiographer’s ability?
62. “I know this is an uncomfortable procedure, so I’ll be as quick as possible.”
63. “This is an easy procedure, but I need you to help by slowly closing.”
64. “I always gag on the back ones, so I understand your apprehension.”
65. “A small mouth makes it difficult, but this will only be for a few seconds.”
66. Which communication to a patient is contraindicated during radiographic procedures?
67. “Open wider, please.”
68. “I need you to slowly close.”
69. This won’t hurt a bit.”
70. “Breathe through your nose.”
71. Effective verbal communication begins with:
72. facing the patient directly, maintaining eye contact, and giving specific directions.
73. speaking lower than the patient’s educational level to ensure that directions are understood.
74. giving instructions quickly to minimize the length of time the patient must bite down.
75. repeating requests several times to greater facilitate comprehension.
76. Which word is least likely to be understood by the average patient?
77. Dental film
78. X-ray film
79. Radiograph
80. Periapical
81. Which of the following are considered forms of nonverbal communication?
82. Facial expressions
83. Body movements
84. Listening
85. All of the above
86. Which of the following best responds to this patient question: “How often should children have dental x-rays?”
87. Every 6 months
88. Once a year
89. Whenever the child needs them
90. After the first permanent molars erupt
91. Which of the following best responds to this patient question: “Why do you use a lead apron when exposing my radiographs?”
92. “In case you are pregnant.”
93. “To protect you from possible scatter radiation.”
94. “To assist with holding you still in the chair.”
95. “Because it’s required by law.”
96. A position assumed by the body in connection with a feeling or mood is called:
97. attitude.
98. empathy.
99. communication.
100. chairside manner.

True/False

1. Attitude is defined as the position assumed by the body in connection with a feeling or mood.
2. Attitudes toward an employer and co-workers play a role in determining the degree of successful patient management.
3. Apathy is the ability to share in another’s emotions or feelings.
4. If placement of an intraoral image receptor is uncomfortable for the patient, the radiographic procedure should be postponed.
5. When placing the image receptor intraorally, the radiographer should ask the patient, “Does that feel okay?”
6. Prior to leaving the operatory to make an exposure, the radiographer should ask the patient, “Can you hold still, please?”
7. Sentence structure is important for the short, precise directions used in dental radiography.
8. Nonverbal communication includes gestures, facial expressions, body movement, and listening.
9. Educating patients about the importance of dental radiographs in comprehensive oral health care depends on the radiographer’s ability to communicate.
10. A patient can refuse dental radiographs and still be treated.
11. An educated patient is more inclined to understand and accept dental treatment plans and embrace suggestions for oral health promotion and disease prevention.
12. Patients who have had radiation therapy for cancer of tissues located in the head or neck region should avoid dental radiographs.
13. When verbal and nonverbal communication is not in synch, it is the verbal communication that is more believable.
14. Show-tell-do is a method of communication reserved for the child patient.
15. The best answer to the patient question, “Why do I need x-rays?” is because the dentist requested them.
16. Respectfulness and courtesy are examples of interpersonal skills.
17. If the radiographer feels the procedure is unnecessary or uncomfortable, these feelings

will be conveyed to the patient.

1. Dismissing the patient’s fears and reassuring him or her that everything will be okay prior to the procedure improves chairside manner.
2. The radiographer’s attitude toward his or her own technical ability will also be conveyed to the patient.
3. The radiographer should respond to a patient’s fear of radiation by stating that excess radiation exposure from dental radiographs is not a concern of the practice.

Short Answer

1. How should the radiographer greet the patient?
2. What is the term used to describe the conduct of the radiographer while taking radiographs on the patient?
3. What is the name of the process by which information is exchanged between two or more people?
4. Is it acceptable for the radiographer to use such slang terms as “zap” or “shoot” to describe radiographic procedures?
5. Should dental x-rays be taken every 6 months?
6. Does patient refusal to submit to dental radiographs preclude care being rendered by the dentist?
7. Can intraoral and panoramic radiographs be prescribed for the same patient?
8. Are large amounts of radiation harmful?
9. Are the radiation doses for modern dental diagnostic procedures large?
10. Should patients who have had radiation therapy for cancer of the head or neck avoid dental x-rays?

Chapter 13

Multiple Choice

1. Which of the following is NOT an intraoral radiograph?
2. Occlusal
3. Bitewing
4. Panoramic
5. Periapical
6. Which of the following is NOT a shadow-casting principle?
7. Use the largest possible source of radiation (focal spot).
8. The tooth should be as far as possible from the source of radiation.
9. The tooth and image receptor should be as close together as possible.
10. The tooth and image receptor should be parallel to each other.
11. Each of the following statements regarding the fundamentals of periapical radiographs is correct EXCEPT one. Which one is the EXCEPTION?
12. Periapical radiographs may be taken using the paralleling or bisecting technique.
13. Placement of the image receptor-holding device must be evaluated to avoid angulation errors.
14. The patient’s finger can be used to hold a large image receptor in position in the oral cavity.
15. The size of image receptor chosen depends on the shape and size of the dental arches.
16. Each of the following is standard placement for a full mouth series of periapical radiographs using a size #2 image receptor on an adult patient EXCEPT one. Which one is the EXCEPTION?
17. Four incisor periapical radiograph
18. Four canine periapical radiographs
19. Four premolar periapical radiographs
20. Four molar periapical radiographs
21. Which of the following statements is FALSE?
22. A minimum of 10 periapical radiographs is required for a full mouth survey on an adult patient.
23. The long dimension of the image receptor is positioned horizontally in the posterior regions.
24. A size #1 image receptor is the best fit for the canine region.
25. Six size #2 image receptors may be used to record the maxillary and mandibular anterior region.
26. Which of the following statements regarding orientation of a film packet is FALSE?
27. The white, unprinted side of the film packet must face the source of radiation.
28. The identification dot should be positioned toward the apices of the teeth when placing periapical radiographs.
29. The identification dot is used during interpretation of the radiograph to distinguish between the patient’s left and right sides.
30. The film may be positioned with the long dimension vertically or horizontally when placing posterior bitewing radiographs.
31. Which of these statements is FALSE?
32. Incorrect vertical angulation results in overlapped contact points.
33. Negative angulation is generally used for exposure of the mandibular arch.
34. Positive angulation is generally used for exposure of the maxillary arch.
35. An image receptor will aid the radiographer in determining the correct angulations.
36. Which of these statements is FALSE?
37. Negative angulation directs the central ray upward toward the ceiling.
38. Accurate vertical angulation is more important to the paralleling than the bisecting technique.
39. 0˚ vertical angulation directs the PID parallel to the floor.
40. Vertical angulation refers to directing the PID up and down.
41. Each of the following statements regarding the point of entry is correct EXCEPT one. Which one is the EXCEPTION?
42. Incorrect point of entry results in cone cut error.
43. Care must be taken to center the image receptor within the beam of radiation.
44. The open end of the PID should be placed two inches from the patient’s skin.
45. An image receptor holder with an external aiming device aids in locating the point of entry.
46. Which of the following statements is FALSE?
47. Determining horizontal angulation is the same for both the bisecting and the paralleling techniques.
48. Vertical angulation is accomplished by directing the central ray parallel to the image receptor.
49. Angulation is changed by rotating the tube head horizontally and vertically.
50. To change horizontal angulation, the tube head is swiveled from side to side.

1. Which of the following statements is correct?
2. Vertical angulation is usually described in millimeters.
3. Vertical angulation of the tube head and PID begins at 90 degrees.
4. To change vertical angulation, the tube head is swiveled from side to side.
5. When the open end of the PID is tilted toward the floor, the vertical angle is positive.
6. Which of these statements is FALSE?
7. Bitewing radiographs record the apices of teeth and surrounding bone.
8. Bitewing radiographs record the coronal portions of teeth and alveolar crests of both arches.
9. Periapical radiographs may be taken using the bisecting or paralleling technique.
10. Occlusal radiographs record the maxillary or mandibular arch (or a portion thereof) on a single image receptor.
11. Which of these statements is FALSE?
12. The two basic techniques employed in intraoral radiography are bisecting and paralleling.
13. The paralleling technique arose through application of the rule of isometry.
14. Both the paralleling and the bisecting techniques can be modified to meet special conditions.
15. The paralleling technique is newer than the bisecting technique.
16. The paralleling technique is also called the:
17. right-angle technique.
18. extension-cone technique.
19. long-cone technique.
20. All of the above.
21. Which one of the following is NOT a principle of shadow casting?
22. Long axes of the teeth and image receptor should be parallel to each other.
23. Long axes of the teeth and image receptor should be as close to each other as possible.
24. Source of radiation should be as small as possible.
25. Teeth should be as close as possible to the radiation source.

16, If vertical angulation of the tube head is set at zero, the PID will be:

1. parallel to the floor.
2. perpendicular to the floor.
3. in positive angulation.
4. in negative angulation.
5. Conditions that would indicate the need for a periapical radiograph include each of the following EXCEPT one. Which one is the EXEPTION?
6. Abscess
7. Cleft palate
8. Large caries
9. Root fracture
10. Periapical radiographs can be taken with each of the following image receptor sizes EXCEPT one. Which one is the EXCEPTION?
11. 0
12. 1
13. 2
14. 3
15. A minimum of how many periapical radiographs should make up a full mouth survey for most adult patients?
16. 10
17. 12
18. 14
19. 16
20. The identification dot on an intraoral radiograph film is used to:
21. provide a comparative reference to pathology.
22. identify buccal and lingual surfaces of the teeth.
23. distinguish occlusal or incisal edges from apices.
24. distinguish between the patient’s right and left sides.

True/False

1. Radiographs are shadow images on an image receptor.

2.The open end of the PID should almost touch the face with its midpoint centered over the point of entry before exposure.

1. All vertical angle deviations from zero in which the tip of the PID is tilted toward the floor are called “negative angulations.”

4.The purpose of the periapical examination is to record the crowns and alveolar bone crests of the teeth in both arches on one radiograph.

1. The word “periapical” is derived from the Greek word peri (meaning around) and the Latin word apex (meaning highest point).
2. Periapical radiographs can image only one tooth on each radiograph.
3. An image receptor holding device should be used to position intraoral radiographs.
4. While the use of a size #2 image receptor for anterior periapical radiographs is acceptable, the narrower size #1 image receptor may fit this area better.
5. Periapical image receptors for exposure of posterior areas are placed with the long dimension vertically.
6. Periapical image receptors for exposure of anterior areas are placed with the long dimension vertically.
7. The identification dot should be placed toward the apices of the teeth when exposing periapical radiographs.
8. Placing the dot in the slot of the film holder positions the identification dot toward the apices of teeth.
9. The correct horizontal and vertical angulations are critical to producing quality periapical radiographs.
10. The periapical examination is sometimes referred to as an <BOLD>interproximal radiograph.
11. The technique used to image <KT>bitewing radiographs is unique to the bitewing exam.
12. The bitewing technique could be considered a modification of the bisecting technique used for exposing periapical radiographs.
13. The bisecting technique originated from the rule of isometry.
14. Neither the paralleling nor the bisecting technique completely meets all five requirements for accurate shadow casting in all regions of the oral cavity on all patient types.
15. The size #3 film or phosphor plate is used exclusively for occlusal radiographs of adult patients, and the size #4 film or phosphor plate is used exclusively for horizontal bitewing radiographs of adult patients.
16. The bitewing survey may consist of two to eight radiographs.

Short Answer

1. Which of the two techniques for obtaining intraoral radiographs is considered the technique of choice?
2. Have film holders always been used in dental radiography?
3. What is the spot on the surface of the patient’s face toward which the central ray is directed called?
4. Aligning the PID in the vertical and horizontal dimensions is called what?
5. What are the units used to describe angulation?
6. What device is used to facilitate positioning the image receptor, film or digital sensor parallel to the teeth?
7. Why is the paralleling technique the technique of choice over the bisecting technique for intraoral radiographs?
8. What will assist the radiographer with directing the x-ray beam at the correct angle?
9. Why is it important to not position the embossed dot on the film near the apices of the teeth?
10. Where should the open end of the PID be placed relative to the patient for radiographic exposures?

Chapter 14

Multiple Choice

1. Which of the following statements is FALSE?
2. A sterile cotton roll may be placed on the opposite side of the bite block for stabilization of the image receptor holder.
3. The external indicator ring attachment must be as close to the patient’s skin as possible without touching.
4. The patient must bite down on the bite block firmly enough to hold the image receptor in place.
5. The bite block back plate must be at a 105-degree angle for use with the paralleling technique
6. Excessive vertical angulation when using the paralleling technique results in:
7. cutting off incisal/occlusal edges.
8. cutting off the apices.
9. foreshortened images of the teeth.

d, elongated images of the teeth.

1. Which image receptor placement is most likely to be more comfortable and allow the patient to become accustomed to the procedure?
2. Maxillary anteriors
3. Maxillary posteriors
4. Mandibular posteriors
5. Posterior bitewings
6. When using the paralleling technique, the patient must bite down on the image receptor holder bite block as far away from the teeth as possible with the exception of which area?
7. Maxillary anteriors
8. Mandibular canines
9. Maxillary premolars
10. Mandibular molars
11. Which of the following is a basic principle of the paralleling technique?
12. The image receptor is placed perpendicular to the long axes of the teeth.
13. The central ray of the x-ray beam is directed parallel to both the teeth and the recording plane of the image receptor.
14. The image receptor is placed parallel to the long axes of the teeth.
15. The central ray of the x-ray beam is directed perpendicular to an imaginary bisector.

6 . The principles of the paralleling technique include each of the following EXCEPT one. Which one is the EXCEPTION?

1. The image receptor is placed parallel to the long axis of the tooth of interest.
2. The central ray of the x-ray beam is directed perpendicular to the tooth and to the image receptor.
3. The central ray of the x-ray beam is directed at a plane halfway between the long axis of the tooth and the long axis of the image receptor.
4. Parallel placement of the image receptor is accomplished using an image receptor holder.
5. Which of these statements is FALSE?
6. The paralleling technique does not meet all five shadow-casting principles in all regions of the oral cavity on all patients.
7. With the paralleling technique, it is not possible to direct the central rays of the x-ray beam to both the tooth and the image receptor simultaneously.
8. The paralleling technique is the technique of choice for obtaining periapical radiographs.
9. With the paralleling technique, the object and image receptor are positioned parallel to each other.
10. Each of the following statements regarding the principles of the paralleling technique is correct EXCEPT one. Which one is the EXCEPTION?
11. Parallel placement of the image receptor is accomplished using an image receptor holder.
12. The central ray of the x-ray beam is directed perpendicular to both the teeth and the image receptor.
13. The patient is directed to hold the image receptor in the mouth with a finger or thumb.
14. The image receptor is placed parallel to the long axes of the teeth of interest.
15. Comparing the paralleling technique with the bisecting technique, which of the following statements is correct?
16. The paralleling technique is easy to achieve on all patients.
17. Proficiency should be achieved in both techniques.
18. The bisecting technique is more likely to be uncomfortable for the patient.
19. Once the full mouth series procedure is started, the radiographer must continue with the bisecting or the paralleling technique and not mix the two.
20. The paralleling technique must achieve parallelism by placing the image receptor:
21. away from the crowns of the teeth.
22. away from the root tips of the teeth.
23. closer to the crowns of the teeth.
24. closer to the root tips of the teeth.
25. To compensate for the increased object–image receptor distance needed to achieve parallelism:
26. the target–image receptor distance should be decreased.
27. the target–image receptor distance should also be increased.
28. the object–image receptor distance should also be increased.
29. the object–image receptor distance should be decreased.
30. What is the ideal target–image receptor distance used with the paralleling technique?
31. 8 inches (20.5 cm)
32. 12 inches (30 cm)
33. 16 inches (41 cm)
34. Which of the following is NOT an advantage of the paralleling technique?
35. It is ideal for positioning radiographs for children.
36. It minimizes superimposition of adjacent structures.
37. It produces images with minimal dimensional distortion.
38. With appropriate image receptor-holding devices, it takes less time than trying to locate the position of an imaginary bisector.
39. Which of the following is NOT a disadvantage of the paralleling technique?
40. The best images are obtained with the more difficult to position long 16-inch PID.
41. Image receptor positioning is difficult for patients with small mouths.
42. There is a limited number of image receptor holders that accommodate the paralleling technique.
43. It is more likely to excite an exaggerated gag reflex to achieve parallel position in the posterior region.
44. Anterior periapical radiographs should be positioned in the oral cavity with the long dimension ___________, and posterior periapical radiographs should be positioned in the oral cavity with the long dimension __________.
45. vertical, horizontal
46. horizontal, vertical
47. horizontal, horizontal
48. vertical, vertical
49. Which teeth should be imaged on an adult molar periapical radiograph?
50. Distal half of canine, first premolar, second premolar, and first molar
51. Distal half of first premolar, second premolar, first molar, and second molar
52. Distal half of second premolar, first molar, second molar, and third molar
53. Distal half of first molar, second molar, and third molar
54. What is the ideal design of a paralleling image receptor holder?
55. A short bite block and an L-shaped backing
56. A long bite block and an L-shaped backing
57. A short bite block and a 105-degree backing
58. A long bite block and a 105-degree backing
59. Which of these image receptor holders is NOT designed for use with the paralleling technique?
60. XCP
61. XCP-DS
62. Snap-A-Ray<SUP></SUP>
63. RAPD<SUP></SUP>
64. The patient must bite down on the bite block as far away from the teeth as possible, using the full extent of the bite block to maintain a parallel relationship between the image receptor and the teeth in all regions of the oral cavity EXCEPT the:
65. maxillary incisors and canines.
66. mandibular incisors and canines.
67. maxillary premolars and the maxillary molars.
68. mandibular premolars and the mandibular molars.
69. Centering the image receptor to line up behind the central and lateral incisors to include recording the mesial halves of the canines if using a size #2 image receptor describes the placement of the image receptor for which periapical radiograph?
70. Central incisor
71. Canine
72. Premolar
73. Molar

True/False

1. With the paralleling technique, the central ray is directed perpendicular to the long axes of the teeth and the plane of the image receptor.
2. When using the paralleling technique, insufficient vertical angulation will result in loss of the image of the crowns.
3. The paralleling technique is preferred over the bisecting technique.
4. The paralleling technique does not meet the shadow-casting principle that requires placement of the image receptor close to the teeth of interest.
5. To compensate for the increased object–image receptor distance needed to achieve parallelism, the target–surface receptor distance should be increased.
6. The use of the paralleling technique is ideal with adult patients with a small mouth or shallow palatal vault.
7. An advantage of the paralleling technique is that it produces accurate radiographic images with a minimal amount of superimposition of adjacent structures.
8. Image receptor holders designed for use with the paralleling technique usually have a short bite block.<KT>
9. The Dentsply Rinn XCP image receptor holder is designed for use with the paralleling technique.
10. An image receptor holder with an external aiming device can make radiographic errors less likely.

11.When using an image receptor holder with an external aiming device, the patient’s head does not need to be precisely positioned.

1. An image receptor holder with an external aiming device is more comfortable for the patient.
2. In the paralleling technique, the distance between the tooth and the image receptor is usually closer than ideal.
3. If an image receptor holder has an external aiming device, then the patient must be seated upright with the head straight.
4. Because of the supporting structures on the maxillary arch, to accomplish a parallel relationship between the image receptor and the long axes of teeth, the image receptor must be placed closer to the teeth.
5. Image receptors with an external aiming device eliminate radiographic technique errors.
6. The Dentsply Rinn Stabe and the Flow Dental SUPA image receptor holders designed for the paralleling technique do not have an external aiming device.
7. A patient may bite down on a sterilized cotton roll that is placed on the same side of the bite block as the teeth to provide stablization and add to patient comfort.
8. If using an image receptor holder with an external aiming device, the <KT>indicator ring attachment must be slid all the way down the metal arm of the device to be as close to the patient’s skin as possible without touching the patient prior to the exposure.
9. Correct horizontal angulation is determined by positioning the image receptor parallel to the embrasure of two predetermined teeth.

Short Answer

1. What is the preferred target-surface distance when using the paralleling technique?
2. With the paralleling technique, where is the central ray directed?
3. What are three image receptor holders designed for use with the paralleling technique?
4. What are two image receptor holders that with slight modifications can be used for either the paralleling or the bisecting technique?
5. Name an image receptor holder designed for the paralleling technique that does not have an external aiming device.
6. What is the most likely reason that overlapping occurs even if the image receptor is correctly positioned parallel to the teeth of interest and the central ray is accurately directed through the appropriate embrasure?
7. How is correct vertical angulation achieved when using the paralleling technique?
8. How is correct horizontal angulation achieved when using the paralleling technique?
9. How is the correct point of entry achieved when using the paralleling technique?
10. Incorrectly aligning the point of entry will result in what type of error?

Chapter 15

Multiple Choice

1. Which of the following statements regarding image receptor holders is FALSE?
2. Short bite blocks should be used for the bisecting technique.
3. External aiming devices help locate correct angles and points of entry.
4. External aiming devices eliminate the need to position the patient’s head precisely.
5. Bite blocks with an L-shaped back plate should be used with the bisecting technique.
6. Which of the following statements regarding patient preparation for dental radiography is NOT correct?
7. The patient should be protected with a lead/lead-equivalent apron and thyroid collar.
8. The patient’s occipital protuberance should be against the headrest during exposure.
9. The patient’s eyeglasses may be left in place to protect the eyes.
10. Objects in the mouth such as dentures, partials, and retainers should be removed prior to exposure.
11. The presence of each of the following conditions may indicate using the bisecting technique instead of the paralleling technique EXCEPT one. Which one is the EXCEPTION?
12. A class II malocclusion
13. An edentulous region
14. A large palatal or mandibular tori
15. A very low or shallow palatal vault
16. To determine the vertical angulation when using the bisecting technique, the central rays of the x-ray beam should be directed:
17. perpendicular to the image receptor.
18. parallel to the image receptor.
19. perpendicular to the imaginary bisector.
20. parallel to the imaginary bisector.
21. Which of the following is true of the bisecting technique?
22. It is easy to standardize subsequent films.
23. There is increased patient comfort during image receptor placement.
24. There is decreased radiation exposure for the patient.
25. It is less likely to cause image distortion.
26. Which of the following will correct an elongated image?
27. Increasing the vertical angulation
28. Decreasing the vertical angulation
29. Directing the central ray perpendicular to the plane of the image receptor
30. Directing the central ray perpendicular to the long axis of the tooth
31. Which of the following will correct a foreshortened image?
32. Increasing the vertical angulation
33. Decreasing the vertical angulation
34. Directing the central ray perpendicular to the plane of the image receptor
35. Directing the central ray perpendicular to the long axis of the tooth
36. Which of the following will correct an overlapping error?
37. Increasing the vertical angulation
38. Decreasing the vertical angulation
39. Directing the central ray perpendicular to the plane of the image receptor
40. Directing the central ray perpendicular to the long axis of the tooth
41. The recommended vertical angulation for exposing a maxillary canine periapical radiograph

using the bisecting technique is:

1. +20 degrees
2. +30 degrees
3. +40 degrees
4. +45 degrees
5. The recommended vertical angulation for exposing a mandibular canine periapical radiograph

using the bisecting technique is:

1. -10 degrees
2. -15 degrees
3. -20 degrees
4. -5 degrees
5. The recommended vertical angulation for exposing a maxillary premolar periapical radiograph

using the bisecting technique is:

1. +20 degrees
2. +30 degrees
3. +40 degrees
4. +45 degrees
5. The recommended vertical angulation for exposing a mandibular premolar periapical radiograph

using the bisecting technique is:

1. -10 degrees
2. -15 degrees
3. -20 degrees
4. -5 degrees
5. The recommended vertical angulation for exposing a maxillary molar periapical radiograph

using the bisecting technique is:

1. +20 degrees
2. +30 degrees
3. +40 degrees
4. +45 degrees
5. The recommended vertical angulation for exposing a mandibular molar periapical radiograph

using the bisecting technique is:

1. -10 degrees
2. -15 degrees
3. -20 degrees
4. -5 degrees
5. The recommended vertical angulation for exposing a maxillary incisor periapical radiograph

using the bisecting technique is:

1. +20 degrees
2. +30 degrees
3. +40 degrees
4. +45 degrees
5. The recommended vertical angulation for exposing a mandibular incisor periapical radiograph

using the bisecting technique is:

1. -10 degrees
2. -15 degrees
3. -20 degrees
4. -5 degrees

1. Which of the following best describes the correct vertical direction of the central ray when using the bisecting technique?
2. 90 degrees to the long axes of the teeth
3. 90 degrees to the plane of the image receptor
4. 90 degrees to the long axes of the teeth and the plane of the image receptor
5. 90 degrees to the imaginary bisector
6. The bisecting technique is useful in patients who cannot tolerate parallel placement of the image receptor.

The bisecting technique produces images with reduced image distortion.

a.. The first statement is true. The second statement is false.

1. The first statement is false. The second statement is true.
2. Both statements are true.
3. Both statements are false.
4. Which of these is NOT a disadvantage of the bisecting technique?
5. It produces images with dimension distortion.
6. Image receptor positioning is difficult for patients with small mouths.
7. Adjacent structures are often superimposed.
8. Estimating the location of the imaginary bisecting may be difficult.
9. Which of these image receptor holders is designed for use with the bisecting technique?
10. XCP
11. XCP-DS
12. Snap-A-Ray<SUP></SUP>
13. RAPD<SUP></SUP>

True/False

1. The bisecting technique is applied when the image receptor cannot be placed parallel to the long axes of the teeth.
2. Using the bisecting technique, the image receptor is placed parallel to the long axes of the teeth.
3. Specific vertical angulations required when using the bisecting technique differ from those used with the paralleling technique.
4. Changes in vertical angulation are indicated when the patient’s palatal vault is high or low.
5. Excessive vertical angulation when using the bisecting technique will elongate the image.
6. Because it satisfies fewer shadow-casting principles, the bisecting technique is less likely to produce superior diagnostic-quality radiographs.
7. Careful attention to the steps of the bisecting technique can produce acceptable radiographs.
8. The two planes that can be visualized by the radiographer are the estimated long axis of the tooth and the plane of the image receptor.
9. An isometric triangle is a triangle with sides that are inversely related to the base.
10. A longer 12-inch or 16-inch PID is better suited to the bisecting technique.
11. When using the bisecting technique, because the long axis of the tooth and the plane of the image receptor are not parallel, a shorter target–image receptor distance will increase magnification and distortion.
12. It is possible to place the image receptor close to the mandibular molars and still achieve a parallel relationship between the image receptor and the long axes of the teeth.
13. It is possible to place the image receptor close to the maxillary anterior teeth and still achieve a parallel relationship between the image receptor and the long axes of the teeth.

1 4. Even when the positioning and angulation steps are accurate and precise, the bisecting technique will produce some dimension distortion.

1. When using the bisecting technique, the patient should bite down on the image receptor bite block as close to the teeth as necessary.
2. The patient must be seated correctly to use predetermined vertical angulations when employing the bisecting technique.
3. The horizontal angulation is determined in the same manner for both the bisecting and the paralleling techniques.
4. The seating position of the patient is not important in using predetermined anatomical landmarks to direct the central ray of the x-ray beam toward the point of entry.
5. The goal of accurate bisecting technique is to direct the central ray of the x-ray beam perpendicular to both the long axes of the teeth and the plane of the image receptor simultaneously.
6. To avoid conecut error when using the bisecting technique, the point of entry should be the occlusal plane of the teeth.

Short Answer

1. To determine accurate and correct angles and points of entry, how should the patient be positioned?
2. How does the central ray of the x-ray beam intersect with the image receptor and the teeth of interest when using the bisecting technique?
3. Why is it important for the radiographer to know how to apply both the paralleling and bisecting techniques?
4. What must the radiographer do prior to confidently using predetermined vertical angulations when applying the bisecting technique?
5. Name an image receptor holder that may be used with both the paralleling and the bisecting techniques.
6. Describe the error that results when excessive vertical angulation is used when taking periapical radiographs using the bisecting technique.
7. 7. Describe the error that results when inadequate vertical angulation is used when taking periapical radiographs using the bisecting technique.
8. Which of the two techniques for obtaining intraoral radiographs may be easier to use for children or adults with shallow palates?
9. What is the preferred target-surface distance when using the bisecting technique?
10. Explain how the bisecting technique relates to the rule of isometry.

Chapter 16

Multiple Choice

1. Bitewing radiographs are especially useful in detecting caries on which of the following tooth surfaces?
2. Mesial
3. Occlusal
4. Facial
5. Lingual
6. Each of the following statements regarding horizontal angulation is correct EXCEPT one. Which one is the EXCEPTION?
7. Contact points should appear open or separate from each other on the radiograph.
8. The central ray should be directed parallel to the curvature of the arch.
9. Overlapped contact points result when incorrect horizontal angulation is used.
10. Horizontal angulation is the positioning of the central ray in a side-to-side plane.
11. Each of the following statements regarding vertical angulation is correct EXCEPT one. Which one is the EXCEPTION?
12. The correct vertical angulation for bitewing radiographs is +10 degrees.
13. Vertical angulation is indicated on a dial on the side of the tube head.
14. Negative angulation directs the central ray downward toward the floor.
15. Vertical angulation is measured in degrees.
16. Which of the following statements regarding bitewing image receptor holders is NOT correct?
17. Disposable bitewing holder tabs and loops are available.
18. Two stick-on paper bite tabs may be attached to lengthen the bite tab.
19. Bitewing loop holders are limited to use with vertical bitewing radiographs.
20. Stick-on bitewing tabs are available for both film and digital sensors.
21. Which of these statements regarding the anterior bitewing exam is FALSE?
22. The longer dimension of the image receptor is usually placed vertical.
23. For ease of placement and to avoid bending, the use of a size #1 image receptor is recommended.
24. Use of a longer bite tab allows for placement of the image receptor farther lingually in the mouth.
25. Vertical angulation used for anterior bitewings is increased over that used for posterior bitewings.
26. Each of the following statements regarding preparations for bitewing exams is correct EXCEPT one. Which one is the EXCEPTION?
27. The dental x-ray machine should be turned on and the exposure setting selected prior to placing the image receptor intraorally.
28. The radiographic procedure should be explained to the patient prior to beginning the exposures.
29. The patient’s head should be positioned with the mean tangent parallel to the floor.
30. The patient should be asked to remove eyeglasses and all intraoral appliances prior to placement of the image receptor.
31. Which of the following statements regarding managing bitewing exposures is correct?
32. The patient should be instructed to close so that the teeth occlude normally.
33. The bite tab should be held firmly against the lingual surface of the mandibular teeth while the patient closes.
34. The film packet should be inserted vertically into the patient’s mouth.
35. The bite tab should be held firmly to permit the film to drift bucally.
36. Which of the following is most likely to result in a retake of a bitewing radiograph?
37. The patient maintained a steady pressure on the bite tab.
38. The patient swallowed during the exposure.
39. There are no large tori or severely malpositioned teeth.
40. The top edge of the image receptor did not contact the lingual gingiva.
41. Each of the following statements regarding successful patient preparation for bitewing radiographs is correct EXCEPT one. Which one is the EXCEPTION?
42. Position the image receptor close to the lingual surfaces of the teeth.
43. Base image receptor size on the size of the arches.
44. Check for anatomical obstructions before positioning the image receptor.
45. Caution the patient not to swallow or let the teeth separate during the exposure.
46. Which of the following statements is FALSE?
47. Malaligned teeth may necessitate the exposure of additional bitewing radiographs.
48. Bitewing radiographs are not required if a full mouth series of periapical radiographs is available.
49. When patients present with edentulous areas, bitewing radiographs may not be needed.
50. Children with mixed dentitions may not need bitewings if a visual inspection of the proximal surfaces is possible.
51. The disadvantage of using the largest size image receptor possible to expose a bitewing radiograph is that:
52. unnecessary structures will be imaged.
53. exposure times must be increased.
54. anatomical limitations may hinder ideal placement.
55. it is contraindicated for patients with periodontal disease.
56. Which of the following image receptor sizes would necessitate that only two bitewing radiographs be exposed?
57. Size #0
58. Size #1
59. Size #2
60. Size #3
61. For an adult horizontal premolar bitewing, position the image receptor so that the anterior edge lines up:
62. behind the distal half of the canine.
63. between the first and second premolars.
64. behind the distal half of the first premolar.
65. in front of the mesial half of the second premolar.
66. For an adult horizontal or vertical molar bitewing, align the film packet so that the anterior edge lines up:
67. behind the distal half of the first premolar.
68. behind the distal half of the second premolar.
69. in front of the mesial half of the first premolar.
70. in front of the mesial half of the second premolar.
71. What is the result if a bitewing radiograph is exposed using a negative 10-degree vertical angulation?
72. More maxillary teeth and alveolar bone will be recorded.
73. More mandibular teeth and alveolar bone will be recorded.
74. The image of the arches will appear tilted across the horizontal plane.
75. The image of the arches will appear tilted across the vertical plane.
76. Using an image receptor holder with an external aiming device will most likely eliminate what error?
77. Overlapping
78. Unequal distribution of arches recorded
79. Cone cutting
80. Incorrect placement of the image receptor
81. Recording an unequal distribution of the arches is caused by incorrect:
82. vertical angulation.
83. horizontal angulation.
84. centering of the x-ray beam.
85. aligning of the anterior edge of the image receptor with the teeth of interest.
86. Conecut error results from incorrect:
87. vertical angulation.
88. horizontal angulation.
89. centering the x-ray beam.
90. aligning the anterior edge of the image receptor with the teeth of interest.
91. Which of the following is the cause of overlap error, when the overlapping appears to be more severe in the distal or posterior region of the image?
92. The horizontal angulation was directed obliquely from the mesial
93. The horizontal angulation was directed obliquely from the distal
94. The horizontal angulation was directed obliquely from the occlusal
95. The horizontal angulation was directed obliquely from the apical

20.Which of the following is the cause of overlap error, when the overlapping appears to be more severe in the mesial or anterior region of the image?

1. The horizontal angulation was directed obliquely from the mesial
2. The horizontal angulation was directed obliquely from the distal
3. The horizontal angulation was directed obliquely from the occlusal
4. The horizontal angulation was directed obliquely from the apical

True/False

1. For bitewing radiographs, the image receptor is placed near and almost parallel to the teeth of both arches while the patient holds the mouth in an open position.
2. The name bitewing is descriptive.
3. The true value of bitewing radiographs is that proximal surface caries may be identified.
4. Bitewings are limited in their ability to image the entire tooth.
5. If the image receptor holder is not positioned precisely, the resultant image may be undiagnostic.
6. Traditionally, the image receptor for a bitewing radiograph has been placed with the longer dimension vertically in the posterior region.
7. Anterior bitewings should be exposed using a vertical angulation of +20 degrees.
8. When exposing a set of four posterior bitewing radiographs, it is recommended that the molar bitewing be exposed first, followed by the premolar bitewing on the same side, before switching sides.
9. Sometimes there is a need to expose more than four bitewing radiographs on an individual patient.
10. Because the proximal surfaces of the molars are in a buccolingual relationship to the patient’s sagittal plane, conventional image receptor placement parallel to the buccal surfaces of the molars often results in overlapping of the contact area and closure of the embrasure spaces.
11. There are four radiographs in a posterior bitewing survey.
12. The term used to describe the contact point between teeth in the same arch is “proximal surface.”
13. Overlap refers to an elongated or foreshortened image on a bitewing radiograph.
14. A periodontally involved patient would benefit more from vertical bitewing radiographs than traditionally placed bitewing radiographs.
15. Periapical radiographs image the alveolar bone crest better than bitewing radiographs.
16. If periapical radiographs are available, there is no need to expose additional bitewing radiographs.
17. The smallest available image receptor should be used to take bitewings on the child patient.
18. The size #3 image receptor has two advantages over a size #2 image receptor when exposing a bitewing radiograph.
19. When a class II occlusal relationship presents, the anterior edge of the image receptor should be positioned behind the distal half of the maxillary canine for a premolar bitewing.
20. To avoid overlap error, t</OLINK>he central ray of the x-ray beam should be directed perpendicular to the mean tangent.

Short Answer

1. Where should the anterior edge of the image receptor be placed to record a premolar bitewing radiograph?
2. What is the name of the location the central ray is directed toward on the patient’s face?
3. What type of error results when the image receptor is not centered within the x-ray beam?
4. Where should the open end of the PID be placed in relation to the patient’s face?
5. What is the orientation of a traditionally placed bitewing radiograph in the posterior regions?
6. For bitewing radiographs, the radiographer should strive to ensure placement of the image receptor so that more of which arch, maxillary or mandibular, will be imaged?
7. What is the main purpose of the bitewing radiograph?
8. What size image receptor is used for bitewing radiographs on a child with primary teeth?
9. Which two angulations are critical to producing quality bitewing radiographs?
10. What is the name of the portion of the image receptor holder that helps the radiographer determine the point of entry?

Chapter 17

Multiple Choice

1. Each of the following statements regarding occlusal radiographs is correct EXCEPT one. Which one is the EXCEPTION?
2. They do not require the use of an image receptor holder.
3. They images both of the arches on a single film.
4. They may be either topographical or cross-sectional.
5. They are placed in the mouth between the occlusal surfaces of the maxillary and mandibular teeth.
6. Which of the following statements is correct?
7. Topographical occlusal radiographs yield a greater amount of information in the alveolar crest and apical areas than periapical radiographs.
8. Topographical occlusal radiographs may be exposed only on the maxillary arch.
9. Cross-sectional occlusal radiographs work best to image the maxilla.
10. Topographical occlusal radiographs cannot be used on children.
11. Each of the following is a use of an occlusal radiograph EXCEPT one. Which one is the EXCEPTION?
12. Detecting incipient, interproximal caries
13. Locating soft tissue calcifications
14. Assisting in the evaluation of fractures
15. Revealing retained roots of extracted teeth
16. Each of the following statements regarding orientation of the occlusal radiographic image receptor is correct EXCEPT one. Which one is the EXCEPTION?
17. If using film, the white side must face the arch of interest.
18. The image receptor must be placed in the mouth with the long dimension horizontal.
19. The image receptor should protrude from the mouth about ¼ inch.
20. If using film, the embossed dot should be positioned toward the anterior.
21. Which of these statements is FALSE?
22. Cross-sectional occlusal radiographs of the mandible are taken with the occlusal plane perpendicular to the floor.
23. Topographical occlusal radiographs of the mandible may be taken with the head positioned the same as for maxillary topographical occlusal radiographs.
24. An image receptor holder is not required for stabilization of the image receptor.
25. Mandibular topographical radiographs are taken with the midsaggital plane parallel to the floor.
26. Which of the following statements is correct?
27. Occlusal radiographs have some amount of dimensional distortion.
28. The occlusal technique is similar to the paralleling technique.
29. Occlusal films should be inserted completely into the oral cavity.
30. An image receptor holder will allow for correct positioning of occlusal radiographs.
31. Assuming that the patient’s head is in the correct position, which of the following is the correct vertical angulation setting for a maxillary anterior topographical occlusal radiograph?
32. +65 degrees
33. +45 degrees
34. -55 degrees
35. -45 degrees
36. Each of the following should be done prior to placing the image receptor intraorally EXCEPT one. Which one is the EXCEPTION?
37. Turning on the dental x-ray machine
38. Placing the tube head in the approximate position for the exposure
39. Selecting the appropriate exposure setting
40. Assembling a sterile image receptor holder
41. The topographical occlusal radiographic technique is similar to what technique?
42. Paralleling
43. Bisecting
44. Bitewing
45. Panoramic
46. Which of the following statements regarding managing occlusal radiograph exposures is FALSE?
47. Exposure factors are the same as those used for periapical and bitewing radiographs in the same region.
48. The open end of the PID should be positioned as close to the patient’s skin as possible, without touching.
49. A modification of the paralleling technique is used to determine the vertical angulation.
50. A shorter PID minimizes distortion.
51. What size image receptor is used for occlusal radiographs on most adult patients?
52. 1
53. 2
54. 3
55. 4
56. The embossed identification dot on occlusal film should be positioned toward the:
57. anterior.
58. posterior.
59. mesial.
60. distal.
61. The patient’s head should be reclined and the chin tipped upward for which occlusal projection?
62. Maxillary anterior topographical
63. Maxillary posterior topographical
64. Mandibular posterior topographical
65. Mandibular cross-sectional
66. A vertical, zero-degree angulation is used for exposure of which occlusal radiograph?
67. Maxillary posterior topographical
68. Mandibular anterior topographical
69. Mandibular posterior topographical
70. Mandibular cross-sectional
71. The thyroid collar may be in the path of the primary beam during which occlusal technique?
72. Maxillary posterior topographical
73. Mandibular anterior topographical
74. Mandibular posterior topographical
75. Mandibular cross-sectional
76. Through a point on the middle of the chin toward the center of the image receptor describes the recommended point of entry of the central ray of the x-ray beam for which of the following occlusal radiographs?
77. Maxillary anterior topographical
78. Maxillary posterior topographical
79. Mandibular anterior topographical
80. Mandibular posterior topographical
81. A vertical +65-degree angulation is used for which occlusal radiograph?
82. Maxillary anterior topographical
83. Maxillary posterior topographical
84. Mandibular posterior topographical
85. Mandibular cross-sectional
86. Through a point on the ala-tragus line below the outer cantus of the eye toward the center of the image receptor describes the recommended point of entry of the central ray of the x-ray beam for which of the following occlusal radiographs?
87. Maxillary anterior topographical
88. Maxillary posterior topographical
89. Mandibular anterior topographical
90. Mandibular posterior topographical
91. Which of the following occlusal radiographs yields more information about the location of tori and impacted or malpositioned teeth and calcifications of soft tissues?
92. Maxillary anterior topographical
93. Maxillary posterior topographical
94. Mandibular posterior topographical
95. Mandibular cross-sectional
96. Assuming that the patient’s head is in the correct position, which of the following is the correct vertical angulation setting for a maxillary posterior topographical occlusal radiograph?
97. +65 degrees
98. +45 degrees
99. -55 degrees
100. -45 degrees

True/False

1. The cross-sectional technique produces an occlusal radiograph that resembles a large periapical radiograph.
2. When imaging the mandibular arch, the printed side of the occlusal film packet will face the mandible.
3. When imaging the maxillary arch, the white, unprinted side of the occlusal film packet will face the maxilla.
4. The identification dot on an occlusal film should be placed toward the posterior to the oral cavity.
5. The vertical angulation used for topographical occlusal radiographs follows the rules of the bisecting technique used for periapical radiographs.
6. Topographical occlusal radiographs of the mandible may be taken with the head positioned the same as for maxillary topographical occlusal radiographs.
7. Specialized image receptor holders should be used for occlusal radiographs.
8. A 16-inch (41-cm) PID should be used for the occlusal radiographic exam.
9. If the patient is seated in the correct position, the vertical angulation for a mandibular cross-sectional occlusal radiograph will most likely be set at 0 degrees.
10. The occlusal examination may be made alone or to supplement periapical or bitewing radiographs.
11. A cross-sectional occlusal radiograph will significantly distort the image of the teeth, producing an image of the teeth that appear circular or elliptical.
12. Topographical radiographs of the mandible are ideal at detecting the presence of salivary stones (sialoliths) in the ducts of the sublingual and submandibular glands.
13. Occlusal radiographs can be placed and exposed in five regions of the oral cavity.
14. An occlusal radiograph must be taken with the size #4 image receptor.
15. If the image receptor is not placed in the mouth with at least 1/4 inch (1/2 cm) protruding outside, the result will be cone cutting.
16. The horizontal angulation for topographical occlusal radiographs is determined by directing the central rays at the image receptor perpendicularly through the teeth embrasures (spaces).
17. If the patient is seated in the correct position, the recommended vertical angulation setting for a posterior mandibular topographical is 0 degrees.
18. Correct points of entry position are determined by directing the central rays of the x-ray beam at the center of the image receptor.
19. If the patient’s head is in correct position, predetermined vertical angulations and points of entry may be used.
20. Determining the vertical angulation for exposure of a cross-sectional occlusal radiograph is assisted by positioning the open end of the PID parallel to the external aiming device of the image receptor holder.

Short Answer

1. What is the purpose of the occlusal radiographic exam?
2. How is the image receptor positioned to expose an occlusal radiograph?
3. When placing an occlusal film packet intraorally, where should the embossed identification dot be positioned?
4. What type of image receptor holder is used for occlusal radiography?
5. Do occlusal radiographs display dimensional distortion?
6. Is a short or a long PID recommended for use in occlusal radiography?
7. List reasons for assessing a patient for occlusal radiographs.
8. Can a thyroid collar be used during the occlusal radiographic exam?
9. What are the recommended exposure settings for occlusal radiographs?
10. Is it acceptable to recline the chair or tip the headrest back to facilitate obtaining an occlusal radiograph?

Chapter 18

Multiple Choice

1. Each of the following statements regarding retake radiographs is correct EXCEPT one. Which one is the EXCEPTION?
2. All errors create a need to re-expose the patient.
3. If one radiograph in a set of bitewings is overlapped, it should be determined whether adjacent radiographs image the area adequately.
4. Determining when a retake is necessary will keep radiation exposure to a minimum.
5. All errors reduce the quality of the radiograph.
6. Each of the following would result in a retake radiograph EXCEPT one. Which one is the EXCEPTION?
7. Not imaging the correct tooth
8. Imaging 2 millimeters of supporting bone beyond tooth apices
9. Cone cutting the area of interest
10. Imaging a herringbone or tire track pattern.
11. Which of the following statements regarding positioning of the image receptor is correct?
12. Absence of apical structures results when the image receptor is not placed low enough in the oral cavity.
13. Inadequate horizontal angulation will result in less of the crown recorded.
14. Excessive vertical angulation will result in overlap error.
15. Not placing the image receptor parallel with the occlusal plane results in cone cutting.
16. An image receptor placed too far back in the mouth will result in not imaging the:
17. maxillary structures.
18. mandibular structures.
19. anterior structures.
20. posterior structures.
21. A slanted or tilted occlusal plane results from which of the following?
22. Not using a cotton roll to stabilize the image receptor holder
23. Not positioning the edge of the image receptor parallel to the occlusal plane
24. Orienting the image receptor vertically when it should have been oriented horizontally
25. Placing the image receptor in the mouth backward
26. Elongation error results from which of the following?
27. Excessive vertical angulation using the bisecting technique
28. Excessive vertical angulation using the paralleling technique
29. Inadequate vertical angulation using the bisecting technique
30. Inadequate vertical angulation using the paralleling technique
31. Which of the following identifies the cause and corrective action for an image with overlapping of the proximal contacts in which the overlap appears more severe in the posterior region than the anterior region?
32. Mesiodistal projection of the central ray caused the error. Shift the tube toward the anterior to correct this error.
33. Mesiodistal projection of the central ray caused the error. Shift the tube toward the posterior to correct this error.
34. Distomesial projection of the central ray caused the error. Shift the tube toward the anterior to correct this error.
35. Distomesial projection of the central ray caused the error. Shift the tube toward the posterior to correct this error.
36. Light (thin) images may result from each of the following EXCEPT one. Which one is the EXCEPTION?
37. Placing the image receptor (film) in the mouth backward
38. Not depressing the exposure button for the duration of the cycle
39. Using an mA setting that was too high
40. Developing in weak processing solutions
41. What term is used to describe images other than anatomy or pathology that do not contribute to a diagnosis of the patient’s condition?
42. Artifacts
43. Cone cuts
44. Double images
45. Pressure marks
46. Overdevelopment results in which of the following?
47. Green areas
48. Dark images
49. White or clear spots
50. Cracked emulsions
51. Failing to record the apical region of the teeth on a periapical radiograph most likely results from an error made in which of the following steps?
52. Placement of the image receptor
53. Horizontal angulation
54. Vertical angulation
55. Centering the x-ray beam
56. Failing to record the incisal or occlusal edges of the teeth on a periapical radiograph most likely results from an error made in which of the following steps?
57. Placement of the image receptor
58. Horizontal angulation
59. Vertical angulation
60. Centering the x-ray beam
61. Cone cutting of the radiographic image most likely results from an error made in which of the following steps?
62. Placement of the image receptor
63. Horizontal angulation
64. Vertical angulation
65. Centering the x-ray beam
66. Overlapping of adjacent teeth on the radiographic image most likely results from an error made in which of the following steps?
67. Placement of the image receptor
68. Horizontal angulation
69. Vertical angulation
70. Centering the x-ray beam
71. When using the paralleling technique, excessive vertical angulation will result in:
72. elongation of the teeth.
73. foreshortening of the teeth.
74. cutting off the apices of teeth.
75. cutting off the occlusal/incisal edges of the teeth.
76. When using film, the corrective action for a radiograph that displays a “tire track” pattern is to:
77. thoroughly clean the rollers of the automatic processor.
78. position film intraorally with the tube side toward the source of radiation.
79. carefully separate the lead foil from the film packet before processing.
80. lower the temperature of the processing chemicals.
81. If using film, a blank image indicates that:
82. there was an overexposure to radiation.
83. there was no exposure to radiation.
84. a full denture blocked the film from radiation.
85. the film was accidentally exposed to white light.
86. If a film is accidentally placed in the fixer before placing it in the developer, the resultant image will:
87. be light.
88. be dark.
89. be blank.
90. have a herringbone pattern.
91. Residual glove powder on the fingers or hands that touches the film results in:
92. white marks.
93. pressure marks.
94. black smudges.
95. film fogging.
96. Improper or insufficient washing of radiographic films will result in:
97. brown films.
98. green films.
99. black films.
100. white/clear films.

True/False

1. Misuse of a cotton roll to stabilize the image receptor may result in root tips being cut off from the image.
2. The image receptor should be placed with the long dimension horizontal for exposure of anterior periapical radiographs.
3. A herringbone or tire track pattern appears on the image if the film packet was placed in the oral cavity reversed.
4. Elongation error causes the images to appear stretched out.
5. Assembling an image receptor holder with external aiming device incorrectly may lead to conecut error.
6. A dark image occurs when the developing solution is diluted.
7. A black film indicates accidental exposure to white light.
8. Formation of a partial image on the radiograph occurs if the developing solution is too weak.
9. White spots on the film are caused by premature contact with the developer solution.
10. Dark spots on the film are caused by premature contact with the developer.
11. A light radiograph can result from either underexposure or underdeveloping.
12. A dark radiograph can result from either overexposure or overdeveloping.
13. A scratched safelight filter or incorrect bulb wattage can result in film fog.
14. A white line will appear on a processed film at the point where a film packet was bent or subjected to excessive pressure.
15. A distomesial projection of the x-ray beam results in more severe overlapping in the posterior region of the radiograph.
16. Exposing film to excessive heat and humidity can compromise radiographic quality.

1 7. Electronic noise is the digital equivalent of film fog.

1. To avoid radiographic error while opening a film packet in the darkroom, the film should be removed from the outer packaging rapidly.
2. If the darkroom door is accidentally opened during unwrapping of the film packets, the resultant image will appear clear, or blank of any image.
3. Bending a phosphor plate will result in a black crimp line.

Short Answer

1. What causes an iridescent stain on the radiograph?
2. What causes discrete black lines to appear on the radiograph?
3. What causes the black paper in the film packet to become stuck to the film?
4. What produces thin black lines or smudges often in a pattern on the radiograph?
5. What is film fog?
6. Film not protected from stray radiation is susceptible to what?
7. Film fog may result from what?
8. What conditions permit white-light film fog?
9. Does radiographic film have an expiration date?
10. Can fluorescent watch faces and dials fog film?

Chapter 19

Multiple Choice

1. Each of the following statements is correct EXCEPT one. Which one is the EXCEPTION?
2. Quality assurance is defined as a series of tests to assure that the radiographic system is functioning properly and that the radiographs produced are of an acceptable level of quality.
3. The radiographer should strive to produce high-quality radiographs while minimizing radiation exposure.
4. Quality assurance includes both quality control techniques and quality administration procedures.
5. One objective of quality control is to identify problems before image quality is compromised.
6. Each of the following is an objective of quality control EXCEPT one. Which one is the EXCEPTION?
7. Maintain a high standard of image quality.
8. Identify problems as soon as image quality is compromised.
9. Keep patient and occupational exposures to a minimum.
10. Reduce the occurrence of retake radiographs.
11. Which of the following statements regarding dental x-ray machine output consistency testing is
    correct?
12. It should be performed by a qualified expert only.
13. Multiple images that are identical in density and contrast indicate a failed test.
14. Each test film should be processed immediately after exposure.
15. It uses a step wedge.
16. Each of the following statements regarding the coin test is correct EXCEPT one. Which one is the EXCEPTION?
17. A true test of the safelight uses a film pre-exposed to a small amount of radiation.
18. When the period of exposure to the safelight is up, the film is processed as usual.
19. A coin is placed on top of the unwrapped film for 10 minutes.
20. A coin test uses a coin and a lightly exposed film to determine safelight adequacy.
21. Each of the following statements regarding testing for darkroom light leaks is correct EXCEPT one. Which one is the EXCEPTION?
22. All lights, including the safelight, should be turned off.
23. White-light leaks may be marked with tape or chalk so that they can subsequently be sealed.
24. White-light leaks are visible as soon as the lights in the darkroom are turned off.
25. Possible sources of light leaks include around the entry door and around pipes leading into the darkroom.
26. Each of the following statements regarding quality assurance of the automatic processor is correct EXCEPT one. Which one is the EXCEPTION?
27. Solution levels must be replenished and changed on a regular basis.
28. Maintenance procedures and tests need to be performed annually under normal conditions.
29. A failed test should prompt the operator to check the solutions, the water supply, and the film dryer.
30. The water supply must be turned on and the dryer operating correctly to produce a clear, dry film.
31. Which of the following statements regarding processing solutions is correct?
32. A dental radiographic normalizing and monitoring device can be used to monitor the developer.
33. When the developer solution oxidizes and deteriorates, the radiographic images darken.
34. The fixer is the most critical of processing solutions and demands careful attention.
35. Use of the step wedge to monitor the developer should occur at the end of each day.
36. Which of these statements is FALSE?
37. The coin test monitors darkroom safelighting.
38. Processing solutions must be replenished to keep optimal.
39. The fresh film test can be used to monitor the quality of each box of film.
40. Intensifying screens should be cleaned daily with solutions recommended by the manufacturer.
41. Each of the following applies to all oral health care team members EXCEPT one. Which one is the EXCEPTION?
42. They should be provided with training opportunities to assure competency.
43. They are responsible for participating in state inspections.
44. They can be given authority to carry out specific aspects of the quality control program.
45. They must be informed of how and why quality control tests are to be performed.
46. Which of these statements regarding the competency operators is FALSE?
47. They must be able to carry out an effective quality assurance program.
48. They must be competent in exposing, processing, and mounting dental radiographs.
49. They must know when to prescribe dental radiographs.
50. They must be able to identify errors that occur on dental radiographs.
51. Each of the following is a quality control measure EXCEPT one. Which one is the EXCEPTION?
52. Dental x-ray machine output test
53. Safelight evaluation
54. Patient compliance determination
55. Test for darkroom light leaks
56. A step wedge is a device of layered metal steps of varying thickness used to:
57. determine film freshness.
58. determine safety of the safe light.
59. evaluate tube head stability.
60. test the strength of processing chemicals.
61. A qualified health physicist should examine the equipment for which of the following failed tests?
62. Radiation output consistency
63. Darkroom safelight adequacy
64. Fresh film test
65. Reference film test
66. Each of the following conditions is necessary for safelighting EXCEPT one. Which one is the EXCEPTION?
67. Adequate bulb wattage
68. Appropriate filter color
69. Safe distance from working area
70. Black darkroom walls
71. Which of the following indicates a passed coin test?
72. No image of a coin
73. A faint image of the coin
74. An undistorted image of the coin
75. A dark image of the coin
76. In automatic processing, the most likely cause of damp films is that:
77. the water level too high.
78. the dryer was not operating correctly.
79. distilled water was not used.
80. the rinse spray was too forceful.
81. Monitoring the strength of the manual processing solutions should be performed:
82. daily.
83. weekly.
84. monthly.
85. quarterly.
86. The expiration date manufacturers place on radiograph film boxes indicates that films:
87. should not be used for patient exposures after this date.
88. may be safely used for one additional month after this date.
89. may be safely used for a 6-month period after this date.
90. may be used safely after performing a quality control test.
91. Radiographic competencies of the dental assistant and dental hygienist include each of the following EXCEPT one. Which one is the EXCEPTION?
92. The ability to recognize quality radiographs
93. The ability to identify the cause of poor-quality radiographs
94. The ability to complete necessary state documentation of safe operating equipment
95. The ability to apply appropriate corrective actions to failed quality control tests

1. Continuing education courses contribute to radiographic competence.

Competent radiographers are key to quality assurance programs and reducing patient radiation exposure by avoiding retakes.

1. The first statement is true. The second statement is false.
2. The first statement is false. The second statement is true.
3. Both statements are true.
4. Both statements are false.

True/False

1. In most locations, a qualified health physicist must perform x-ray machine testing according to state and local regulations.
2. The dental radiographer can play a role in monitoring the x-ray machine.
3. When not in use, the x-ray unit support arm should be placed in the open position.
4. The dental x-ray machine should be tested for tube head stability periodically.
5. The darkroom should be evaluated to be sure it is free from chemical fumes.
6. Quality control is the planning, implementation, and evaluation of procedures used to produce high-quality radiographs with maximum diagnostic information while minimizing radiation exposure.
7. Quality assurance is a series of tests to assure that the radiographic system is functioning properly and that the radiographs produced are of an acceptable level of quality.
8. After exposing the first film out of a newly opened box, the film should be processed and examined to determine if it is fresh.
9. A monitoring and maintenance schedule listing all the quality control tests and the name of the person responsible for each test should be generated and posted.
10. Extraoral film cassettes do not require quality control tests.
11. A device consisting of increasing increments of an absorbing material is called a “reference film.”
12. Establishing a quality control program for radiographic procedures helps to increase the quality of radiographs produced and decrease the incidence of retake radiographs.
13. There are quality control tests for all radiographic equipment and procedures including the personnel who work with the systems.
14. Assessing the radiographic equipment and systems in use, and developing a written plan for quality control are the first steps in establishing a quality administration program.
15. Dental x-ray machine tube head stability should be tested annually.
16. Quality control testing of the automatic processing system should be performed monthly.
17. Dental x-ray machine output analysis should be performed annually.
18. Only the dentist has the authority to carry out quality control tests on radiographic systems used in the practice.
19. Keeping a log of retakes can help identify the radiographer who needs continuing education.
20. Operator competency can reduce patient radiation exposure.

Short Answer

1. Periodic inspection of viewboxes, cassettes, and intensifying screens and tests to evaluate safelighting of the darkroom are part of a series of tests called what?
2. What is the name of the device made of layered metal steps of varying thickness used to determine film density and contrast?
3. When not in use, should the PID be pointing up?
4. In the coin test, how long is a coin placed on top of the unwrapped film?
5. How long after closing the darkroom door and turning off the lights would light leaks become visible?
6. What does the outline of a coin on the processed film used in the coin test indicate?
7. What is the key to peak performance of an automatic processor?
8. Which processing solution is most critical and demands careful attention?
9. What is quality assurance in dental radiography?
10. What is a reference film?

Chapter 20

Multiple Choice

1. Alkaline means having a pH:
2. of 7.
3. less than 7.
4. greater than 7.
5. Acidic means having a pH:
6. of 7.
7. less than 7.
8. greater than 7.
9. A chemical that is capable of being broken down into harmless products by living organisms such as those found in a wastewater treatment facility is considered:
10. environmentally friendly.
11. user friendly.
12. biodegradable.
13. neutral.
14. Which of the following is NOT considered a hazardous waste?
15. Lead foils from film packets
16. Used processing chemicals
17. Broken digital sensors
18. Discarded film mounts
19. Waste materials that present a threat to community health or the environment are called:
20. hazardous.
21. biodegradable.
22. recycled.
23. microbial.
24. The interaction of fixer with the silver ions in the emulsion of film produces:
25. sodium carbonate solution.
26. a hydroquinone-elon combination.
27. silver halide molecules.
28. silver thiosulphate complex.
29. Which of these is the name of the synthetic rubber used in utility gloves that protect the radiographer when handling chemicals?
30. Vinyl
31. Neoprene
32. Nitrile
33. Latex
34. What gloves best protect the radiographer during processing chemical replenishment?
35. Plastic overgloves
36. Nitrile utility gloves
37. Vinyl treatment gloves
38. Powdered latex gloves
39. Which of these is NOT considered PPE?
40. Mask
41. Gloves
42. Eyewear
43. Radiation monitoring device
44. What agency sets and enforces regulations that protect the radiographer from infection in the oral health care setting?
45. The Environmental Protection Agency (EPA)
46. The Occupational Safety and Health Administration (OSHA)
47. The Centers for Disease Control (CDC)
48. The Material Safety Data Sheets (MSDS)
49. MSDS list each of the following EXCEPT one. Which one is the EXCEPTION?
50. The amount of product the practice can legally store
51. Chemical ingredients and common name
52. Potential hazards of working with the product
53. Requirements for safe handling and storage
54. Who is responsible for reviewing the MSDS?
55. The dentist
56. The dental assistant
57. The dental hygienist
58. All of the above
59. Which of these statements is FALSE?
60. All containers holding developer and fixer must be labeled.
61. Developer and fixer manufacturers are required to provide labels for their product.
62. Chemical labels must be at least 3 inches by 5 inches in size.
63. Towels used to wipe a spill must be placed in a labeled container for disposal.
64. Which of these does NOT need an OSHA Hazard Communication Standard label?
65. Lead foil
66. Developer
67. Fixer
68. Disinfectant
69. Which of the following is FALSE?
70. Under normal conditions, fixer should not cause respiratory difficulty.
71. If heated sufficiently, developer releases a gas that may cause respiratory difficulty.
72. Prolonged contact with aerosols from processing chemistry may irritate individuals with asthma.
73. If processing chemical mist or vapors are inhaled, proceed immediately to the eyewash station.
74. A chemical manufacturer may not have to reveal ingredients of a product unless:
75. another manufacturer used the same ingredient in their product.
76. a medical emergency arises when a radiographer is using the chemical.
77. the chemical is known to produce a hazardous waste.
78. OSHA mandates that all chemicals be revealed on the MSDS.
79. Each of the following statements concerning the need for proper disposal of old radiographs is correct EXCEPT one. Which one is the EXCEPTION?
80. The amount of silver remaining in the film will depend on the density.
81. Unprocessed films will have more silver ions than processed films.
82. The lighter the radiograph, the larger the amount of silver remaining on the film.
83. Radiographs contain silver that should be recovered or recycled prior to disposal into the waste stream.
84. Switching from film-based radiography to a digital imaging system will eliminate the need for managing each of the following EXCEPT one. Which one is the EXCEPTION?
85. Disinfectant
86. Developer
87. Fixer
88. Lead foils
89. Accidentally mixing developer with fixer, even in minute droplets, will result in:
90. the release of an irritating sulphur dioxide gas.
91. contamination of the processing chemicals.
92. lower-quality radiographs.
93. All of the above.
94. All intra- and extraoral film should be stored in:
95. a lead-lined storage box.
96. a disinfected drawer in the operatory.
97. the original packaging until ready for use.
98. the darkroom.

True/False

1. Fixer is caustic.
2. Developer is considered to be more acidic than fixer.
3. Sodium thiosulphate found in used fixer of dental radiographic processors is actually a very stable compound.
4. The individual dental practice is a small generator of hazardous wastes.
5. The EPA sets and enforces regulations that protect the radiographer from infection in the oral health care setting.
6. The EPA requires that manufacturers of developer and fixer supply MSDS to the oral health care practices that purchase these products.
7. Dentists are required by OSHA to obtain and keep on file an MSDS for every chemical product used in the practice.
8. A manufacturer of a developer chemical may not have to disclose a trade secret ingredient, except in an emergency.
9. The radiographer should not handle the lead foils from film packets unless the hands are protected with gloves.
10. Unused radiographic films should be stored in lead-lined boxes especially made for this purpose.
11. An emergency eyewash station must be within 25 feet of where processing chemicals are handled.
12. The radiographer must be able to access an emergency eyewash station within 10 seconds of the area where automatic rollers are cleaned.
13. The water flow of a properly functioning emergency eyewash station must be at least 1 gallon per minute.
14. Contact lenses should be removed prior to using the emergency eyewash station.
15. If splashed into the eyes, developer would be more easily washed away in the emergency eyewash station than fixer.
16. Developer and fixer should be stored in their original containers.
17. Procedures for safe handling of developer differ from those recommendations for handling fixer.
18. If disinfectant should contact the skin, the recommended treatment is to flush immediately with copious amounts of water.
19. Cleaning products, like those used to clean automatic processing rollers, do not require MSDS.
20. Switching from film-based radiography to digital imaging systems will eliminate the need for protocol for disposing of hazardous wastes.

Short Answer

1. Identify those materials and chemicals used for dental radiography that are considered hazardous wastes.
2. Name two agencies responsible for recommendations and regulations regarding safe handling of chemicals and other potentially harmful materials, and for the management of hazardous wastes used in dental radiography.
3. What information is listed on a product’s MSDS?
4. What does the OSHA Hazard Communication Standard state is the purpose of a product label?
5. What chemicals used in radiographic procedures are required to have MSDS and product labels obtained from the manufacturer?
6. List personal protective equipment (PPE) required for safe handling of processing chemicals.
7. List the requirements of an emergency eyewash station.
8. Describe at least 10 general recommendations for safe handling of hazardous chemicals used in dental radiography.
9. Describe the appropriate use of an emergency eyewash station.
10. What happens if fixer chemicals are accidentally mixed with developer?

Chapter 21

Multiple Choice

1. Each of the following statements regarding film mounting is correct EXCEPT one. Which one is the EXCEPTION?
2. Mounted films are easy to store.
3. Mounting decreases the chance of error caused by confusing the patient’s right and left sides.
4. Lingually mounted radiographs allow for easy transfer of findings to the patient’s record.
5. Patient communication is enhanced when films are mounted.
6. Which of these statements is FALSE?
7. The lingual method of film mounting is recommended by the American Dental Association and the American Academy of Oral and Maxillofacial Radiology.
8. With the labial method of film mounting, the radiographs are mounted so that the embossed dot is convex.
9. With the lingual method of film mounting, the radiographs are mounted so that the embossed dot is concave.
10. With the labial method of film mounting, the viewer’s right is the patient’s left.
11. Which of the following statements regarding film mounting methods is correct?
12. With the labial method, the embossed dot is concave.
13. With the lingual method, the embossed dot is convex.
14. With the lingual method, the viewer is reading the radiographs as if facing the patient.
15. With the labial method, the viewer is reading the radiographs as if facing the patient.
16. Which of the following statements regarding film mounting is correct?
17. Anterior periapical radiographs are placed in the oral cavity with the long dimension of the film packet positioned horizontally.
18. Size #1 film is usually used to radiograph the anterior regions.
19. Size #4 film is usually used to radiograph the posterior regions.
20. Posterior periapical radiographs are placed in the oral cavity with the long dimension of the film packet positioned vertically.
21. From the following, select the correct generalization that aids in mounting radiographs.
22. Most roots curve toward the mesial.
23. Premolars have the longest roots when compared to adjacent teeth.
24. Maxillary anterior teeth are larger than mandibular anterior teeth.
25. Maxillary molars have two roots.
26. From the following, select the correct generalization that aids in mounting radiographs.
27. Posterior films are oriented to give a slight “smile” appearance.
28. The presence of a third root on mandibular molars makes it difficult to view bone in the furcation area.
29. Roots and crowns of mandibular anterior teeth are larger and longer than those of the maxilla.
30. Large, radiolucent areas denoting the nasal fossa or sinus indicate that the image is of the mandibular arch.
31. Which of the following would indicate that a film was mounted incorrectly?
32. The radiographs appear in anatomical order.
33. The identification dots are not all oriented in the same way.
34. The roots are pointing up for the maxilla and down for the mandible.
35. The radiographs are firmly secured in the mount.
36. Which of these statements is FALSE?
37. Dental radiographs may be viewed by the dentist, dental hygienist, or dental assistant.
38. Diagnosis is defined as identification and determination of the nature of an abnormal condition or disease.
39. Dental radiographs may be interpreted by all members of the oral health care team.
40. Diagnosis is the responsibility of the dental assistant and dental hygienist.
41. Which of these statements regarding viewing equipment is FALSE?
42. A magnifying glass may be used to aid the viewer.
43. Clear plastic film mounts help reduce glare and enhance the detail of the images.
44. Subdued room lighting is best for viewing radiographs.
45. Viewbox lighting must be of uniform intensity and evenly diffused.
46. Which of these statements is FALSE?
47. Once exposed and processed, heat can no longer affect dental film.
48. Misplaced radiographs can result in risk-management problems.
49. Radiographs should be retained indefinitely.
50. Radiographs should be handled with care to avoid smudging or scratching.
51. To mount radiographs, the radiographer must possess knowledge of:
52. film brands and sizes.
53. pathology and diagnosis.
54. normal anatomy.
55. All of the above.
56. Each of the following is an advantage of film mounting EXCEPT one. Which one is the EXCEPTION?
57. Aids viewing and interpretion
58. Prevents unnecessary retakes
59. Facilitates storage of radiographs
60. Provides meaningful patient education
61. If a film packet is placed in the patient’s mouth correctly, which side will face the source of radiation?
62. The white, unprinted side with the embossed dot concave
63. The white, unprinted side with the embossed dot convex
64. The colored, printed side with the embossed dot concave
65. The colored, printed side with the embossed dot convex
66. With the lingual method of film mounting, the embossed dot will be ____________, and the viewer will interpret the radiographs as if ___________________________.
67. convex, facing the patient
68. concave, facing the patient
69. convex, standing behind the patient
70. concave, standing behind the patient
71. With the labial method of film mounting, the embossed dot will be ____________, and the viewer will interpret the radiographs as if ___________________________.
72. convex, facing the patient
73. concave, facing the patient
74. convex, standing behind the patient

d.concave, standing behind the patient

1. Which of these mandibular teeth generally have the longest roots?
2. Central incisors
3. Lateral incisors
4. Canines
5. Premolars
6. Dental assistants and hygienists may:
7. make a final diagnosis from dental radiographs alone.
8. make a final diagnosis from dental radiographs and the clinical examination.
9. interpret dental radiographs and use them to help educate the patient regarding oral conditions.
10. place and expose dental radiographs but not read them.
11. Black opaque or cardboard film mounts are preferred because they:
12. are less expensive and more readily available from the manufacturer.
13. are more common and therefore easily shared with other practices.
14. make placing films in the windows easier.
15. block extraneous light to aid in interpretion.
16. Which statement(s) regarding film mounting is (are) true?
17. It allows the radiographs to be viewed in a systematic order.
18. It helps to prevent lost films.
19. It provides a means for labeling the films with pertinent data.
20. All of the above.
21. After orienting the embossed dots all the same way, the next suggested step when systematically mounting dental radiographs is to:
22. separate anterior periapical radiographs from posterior periapical radiographs.
23. separate maxillary periapical radiographs from mandibular periapical radiographs.
24. separate bitewing radiographs from periapical radiographs.
25. label the film mount with the patient’s name and date.

True/False

1. All radiographs, whether intraoral or extraoral, should be mounted.
2. A single intraoral radiograph should be placed in a coin envelope and attached to the patient’s chart.
3. Clear plastic mounts are preferred over black plastic or gray cardboard mounts.
4. Mandibular premolar and molar radiographs should be oriented so that a slight “smile” appearance is viewed.
5. Radiographs may be best interpreted by holding the film up to the overhead room light.
6. Some viewboxes are equipped with a magnifying glass.
7. Patient radiographs should be retained indefinitely.
8. The identification dot on intraoral radiographs is used to distinguish the patient’s left and right sides.
9. The lingual method of film mounting is the preferred method.
10. Mandibular molars generally have two divergent roots that are distinctly observed radiographically.
11. A practice may contact a manufacturer of film mounts to order a custom-designed mount for that practice.
12. When a film packet is positioned correctly in the oral cavity, the embossed identification dot will automatically be oriented so that the convexity or concavity may be used to identify the patient’s left and right sides.
13. A radiograph may only be viewed correctly from the side with the embossed dot convex.
14. Clues that assist the radiographer in the mounting process include using the size and orientation of the film packet.
15. Roots and crowns of the mandibular anterior teeth are larger and longer than those of the mandibular teeth.
16. The incisive foramen, the median palatine suture, and the genial tubercles are all anatomical landmarks that can be found on radiographs of the maxillary anterior region.
17. The oblique ridge, mylohyoid ridge, and submandibular fossa are all anatomical landmarks that can be found on radiographs of the mandibular posterior region.
18. To optimize viewing of digital radiographs, the computer monitor should be located in an area of bright light.
19. The interpretation of radiographs is improved if the radiographer develops a systematic method to reading the images.
20. The lingual method of mounting radiographs positions the embossed dot convex.

Short Answer

1. The placement of radiographs in a film holder is called ________________.
2. What part of an intraoral film distinguishes the patient’s right and left sides?
3. How long should dental radiographs be retained?
4. What type of film mount is preferable?
5. Which is the preferred method of mounting films?
6. Which method of film mounting is no longer recommended?
7. Maxillary molars generally have how many roots?
8. What is radiographic interpretation?
9. Who is responsible for interpreting a patient’s radiographs?
10. What pieces of equipment are necessary for optimum film viewing?

Chapter 22

Multiple Choice

1. Which of the following statements regarding normal anatomic landmarks is correct?
2. The maxillae are two bones, a left maxilla and a right maxilla.
3. There are right and left mandibular bones.
4. There are two frontal bones, a right and a left.
5. The sphenoid bone is also called the “malar bone” or “cheekbone.”
6. Which of these is NOT a normal radiographic landmark often imaged on intraoral radiographs?
7. The maxillary sinus
8. The mandibular canal
9. The nasal septum
10. The occipital bone
11. Which of the following bone types will appear the most radiopaque?
12. Cancellous
13. Spongy
14. Cortical
15. Trabecular
16. Which of the following describes the radiographic appearance of the lamina dura?
17. A thin radiolucent border that outlines the root of the tooth
18. A thin radiopaque border that outlines the root of the tooth
19. A radiolucent honeycomb layer adjacent to the root of the tooth
20. A radiopaque honeycomb layer adjacent to the root of the tooth
21. Which of the following structures of the tooth appears the most radiopaque?
22. Cementum
23. Enamel
24. Dentin
25. Pulp
26. Which of the following is the correct term for a tooth that fails to erupt?
27. Supernumerary tooth
28. Impacted tooth
29. Primary tooth
30. Permanent tooth
31. Each of the following appear radiopaque EXCEPT one. Which one is the EXCEPTION?
32. Foramen
33. Process
34. Ridge
35. Spine
36. Which of these statements is FALSE?
37. The incisive foramen appears as a round or pear-shaped radiolucency between the apices of the maxillary central incisors.
38. The nasal fossa appears as two paired radiolucencies separated by the radiopaque nasal septum.
39. The lateral fossa appears as a radiolucency between the maxillary canine and first premolar.
40. The median palatine suture appears as a thin radiolucent line between the maxillary central incisors.
41. Which of the following provides the best organizational framework of steps to aid in learning how to interpret normal radiographic anatomy?
42. First, determine if the structure in question is anterior or posterior; second, determine if radiopaque or radiolucent; third determine if maxilla or mandible.
43. First, determine if the structure in question is maxilla or mandible; second, determine if anterior or posterior; third, determine if radiopaque or radiolucent.
44. First, determine if the structure in question is radiopaque or radiolucent; second, determine if maxilla or mandible; third determine if anterior or posterior.
45. First, determine if the structure in question is anterior or posterior; second, determine if maxilla or mandible; third determine if radiopaque or radiolucent.
46. Which of the following soft tissues may be imaged on an intraoral dental radiograph?
47. Eyelid
48. Ear lobe
49. Tip of the nose
50. Cheek
51. Each of the following is a structure of the mandible EXCEPT one. Which one is the EXCEPTION?
52. The ramus
53. The condyle
54. The coronoid process
55. The hamulus
56. Certain anatomical landmarks may or may not be imaged on dental radiographs depending on:
57. placement of the image receptor.
58. patient positioning.
59. the angle of the x-ray beam.
60. All of the above.
61. What is the compact or dense bone observed on dental radiographs called?
62. Cortical
63. Cancellous
64. Trabecular
65. Honeycomb
66. What is the thin radiopaque border that outlines the root of the tooth called?
67. The trabeculae
68. The periodontal ligament space
69. The alveolar process
70. The lamina dura
71. Which of the following lists the structures in order of decreasing radiopacity?
72. Pulp, dentin, cementum, enamel
73. Enamel, dentin, cementum, pulp
74. Pulp, cementum, dentin, enamel
75. Enamel, cementum, dentin, pulp
76. The coronoid process is most likely to be recorded on an intraoral radiograph of the:
77. maxillary anterior region.
78. maxillary posterior region.
79. mandibular anterior region.
80. mandibular posterior region.
81. The oblique ridge is most likely to be recorded on an intraoral radiograph of the:
82. maxillary anterior region.
83. maxillary posterior region.
84. mandibular anterior region.
85. mandibular posterior region.
86. The incisive foramen is most likely to be recorded on an intraoral radiograph of the:
87. maxillary anterior region.
88. maxillary posterior region.
89. mandibular anterior region.
90. mandibular posterior region.
91. The genial tubercles are most likely to be recorded on an intraoral radiograph of the:
92. maxillary anterior region.
93. maxillary posterior region.
94. mandibular anterior region.
95. mandibular posterior region.
96. The zygomatic process is most likely to be recorded on an intraoral radiograph of the:
97. maxillary anterior region.
98. maxillary posterior region.
99. mandibular anterior region.
100. mandibular posterior region.

True/False

1. Bones are solid only on the outside and honeycombed within.
2. Small, interconnected trabeculae form a multitude of various-sized compartments that account for the honeycomb appearance of cancellous bone radiographically.
3. Cancellous bone appears extremely radiopaque.
4. Cortical bone varies in radiopacity according to the size and number of trabeculae.
5. The periodontal ligament space appears as a thin radiolucent line between the lamina dura and the root of the tooth.
6. Nutrient canals are thin radiolucent lines of uniform width that sometimes exhibit radiopaque borders.
7. Radiographs taken on a 5-year-old child will most likely image 20 primary teeth.
8. The nasal septum appears as a radiopaque “V”-shaped projection from the floor of the nasal fossa in the midline.
9. An important radiographic landmark is the inverted “Y,” which is seen between the right and left nasal fossae.
10. A thin radiopaque line delineates the midline of the palate and the junction of the right and left maxilla.

11.The lingual foramen is a very small opening located in the center of the genial tubercles on the lingual side of the mandible.

1. While the maxillary sinus appears radiolucent on a radiograph, the maxillary sinus walls appear radiopaque.
2. A line of union of adjacent cranial or facial bones that appears radiolucent on radiographs is called a “suture.”
3. The <KT>alveolar process</KT> is that portion of the maxilla or mandible that surrounds and supports the teeth.
4. Structures that are dense and absorb or resist the passage of x-rays will appear dark or black on the radiograph.
5. Examples of anatomic landmarks that appear radiolucent include ridges, spines, and tubercles.
6. Examples of anatomic landmarks that appear radiopaque include foramina, canals, and sutures.
7. Examples of anatomic landmarks that may appear on a maxillary anterior radiograph include the nasal septum, anterior nasal spine, and soft tissue shadow of the nose.
8. Examples of anatomic landmarks that may appear on a mandibular anterior radiograph include the genial tubercles, lingual foramen, and mental ridge.
9. Examples of anatomic landmarks that may appear on a mandibular posterior radiograph include the oblique ridge, mylohyoid ridge, and mental foramen.

Short Answer

1. How does cortical bone appear on a radiograph?
2. What are the four small radiopaque bony crests imaged at the midline of the mandible called?
3. What is the very small, circular radiolucency often observed in the middle of the radiopaque genial tubercles called?
4. What is the radiopaque ridge that extends forward and downward on the lateral surface of the mandible called?
5. What is a bony growth extending out from the lingual surface of the mandible called?
6. What term is applied to a large, irregularly shaped radiolucency below the mylohyoid ridge and roots of the mandibular molars?
7. What is the round radiolucency often observed near the apices of the mandibular premolars called?
8. What is the vertical radiopaque line separating the paired radiolucencies of the nasal cavity called?
9. What is the thin radiolucent line that delineates the midline of the palate and the junction of the right and left maxilla called?
10. How does the lateral fossa appear on a dental radiograph?

Chapter 23

Multiple Choice

1. Each of the following must be added to radiographic findings for accurate diagnosis EXCEPT one. Which one is the EXCEPTION?
2. Medical and dental history
3. Clinical observations
4. Signs and symptoms
5. Past radiation exposure
6. Which of the following restorative materials appears the most radiolucent?
7. Silicate
8. Gutta-percha
9. Stainless steel crown
10. Implant
11. Which of the following restorative materials may appear radiopaque or radiolucent?
12. Amalgam
13. Sealants
14. Composite
15. Gold
16. Base material (calcium hydroxide pastes) and cements exhibit approximately the same degree of radiopacity as:
17. enamel.
18. dentin.
19. bone.
20. amalgam.
21. Radiographs are helpful in revealing each of the following EXCEPT one. Which one is the EXCEPTION?
22. Amalgam particles in soft tissue
23. Bluish-colored gingiva
24. Base material
25. Overhanging restorations
26. Which of these statements regarding the radiographic appearance of dental materials is FALSE?
27. A full metal crown may be distinguished from amalgam by its smooth margins.
28. A stainless steel crown has a see-through appearance.
29. A porcelain jacket appears more radiopaque than a full metal crown.
30. Porcelain appears about the same density as dentin.
31. Which of these statements is FALSE?
32. Post and core restorations resemble implants radiographically.
33. Retention pins have a shape that is easy to identify on the radiograph.
34. Retention pins are located in the dentin only.
35. Post and core restorations are always observed in conjunction with endodontic filling material.
36. Which of the following restorative crown types appears the least radiopaque?
37. Porcelain fused to metal
38. Full metal
39. Stainless steel
40. Porcelain
41. Which of these dental anomalies will NOT be recorded on a dental radiograph?
42. Dilaceration
43. Mesiodens
44. Gingival recession
45. Dens in dente
46. Which of these will appear radiopaque?
47. An abscess
48. A cyst
49. A granuloma
50. Osteosclerosis
51. On a radiograph, an amalgam tattoo may appear as a(n):
52. radiolucency.
53. radiopacity.
54. bluish-colored irregularity.
55. overhang.
56. Which of these sequences of interpreting radiographic images is recommended?
57. Examine the teeth, determine the location of the suspected caries and periodontal disease, check the condition of restorations, and identify landmarks.
58. Identify landmarks, examine the teeth, check the condition of restorations, and determine the location of the suspected caries and periodontal disease.
59. Determine the location of the suspected caries and periodontal disease, examine the teeth, identify landmarks, and check the condition of restorations.
60. Check the condition of restorations, determine the location of the suspected caries and periodontal disease, identify landmarks, and examine the teeth.
61. Each of the following should be determined from the radiographic image EXCEPT one. Which one is the EXCEPTION?
62. The identity of the anatomical landmark
63. The normal size and shape of the anatomical landmark
64. Whether the anatomical landmark is in the appropriate region
65. Whether pathosis if the anatomical landmark is absent
66. Which of these restorative materials will appear the most radiopaque on a dental radiograph?
67. Post and core
68. Composite
69. Porcelain
70. Gutta-percha
71. Which of these restorative materials will appear the most radiopaque on a dental radiograph?
72. Cement
73. A temporary filling
74. Gold
75. Base material
76. Each of the following dental materials might not be imaged on a dental radiograph or may be only slightly visible EXCEPT one. Which one is the EXCEPTION?
77. Acrylic resins
78. Sealants
79. Silver points
80. Base materials
81. Each of the following is true regarding the radiographic appearance of composite restorations EXCEPT one. Which one is the EXCEPTION?
82. They may appear either radiopaque or radiolucent.
83. They may appear with irregular or diffuse margins.
84. They may mimic caries.
85. They may appear about the same density as cementum.
86. Which of the following dental materials will most likely have a see-through appearance radiographically?
87. A stainless steel crown
88. Gutta-purcha
89. A temporary filling
90. Acrylic resin
91. Each of the following dental materials may be observed within the pulp chamber and/or root canals of the tooth EXCEPT one. Which one is the EXCEPTION?
92. Post and core
93. A silver point
94. Gutta-percha
95. An implant
96. Which of the following terms means “the absence of teeth”?
97. Supernumerary
98. Anodontia
99. Anomaly
100. Mesiodens

True/False

1. Hypercementosis appears radiopaque and is caused by excessive cementum formation.
2. Hypercementosis is distinguished from other radiopacities in bone by the absence of the periodontal ligament space.
3. A taurodont tooth is a single tooth bud that divides and forms two teeth.
4. A condition where the cementum of adjacent teeth is joined together is called “condensing osteitis.”
5. A cyst is an epithelium-lined sac containing fluid or other fibrous or solid material that appears radiolucent.
6. An acute abscess may be barely discernable radiographically.
7. A granuloma is a mass of granulation tissue.
8. Unless a cyst is completely removed at the time of tooth extraction, it will remain and is then called a “radicular cyst.”
9. The dentigerous cyst is an odontogenic cyst that develops at the apex of a nonvital tooth.
10. Internal root resorption is most often characterized by root-end resorption where the roots of the teeth appear shorter than normal.
11. When a developmental anomaly occurs in which the enamel invaginates within the body of the tooth, it is called “mesiodens.”
12. Dilaceration occurs as an unnatural or sharp bend in the tooth root.
13. A torus is a bony growth projecting outward from the surface of a bone.
14. Fusion occurs when a single tooth bud divides and forms two teeth.
15. The term “idiopathic resorption” can apply to either external or internal resorption.
16. Resorption that follows a path from inside out, or a widening of the root canal of the tooth, is external resorption.
17. A nonodontogenic cyst arises from epithelial cells associated with the development of a tooth.
18. An odontoma often appears as a mixed radiopaque and radiolucent mass of enamel and dentin.
19. Radiographs can be used to determine an overhang.
20. The endodontic filling materials gutta-percha and silver points cannot be distinguished radiographically.

Short Answer

1. What is the name of the process characterized by root-end resorption in which the roots of the teeth appear shorter than normal?
2. What type of resorption appears as a radiolucent widening of the root canal?
3. What is the term used for calcifications that may occur in the dental pulp of some teeth?
4. What is the term used for a region of abnormally dense bone, which, as a result of infection, has not developed?
5. What is the most common odontogenic tumor?
6. What is the term applied to tumors that do little or no harm?
7. What is the most commonly encountered form of benign tumor in the arches?
8. What type of malignant tumor arises from an epithelial origin?
9. Thin radiolucent lines that demarcate a region of bone or tooth separation are called what?
10. What type of temporary restoration has a “see-through” appearance on the radiograph?

Chapter 24

Multiple Choice

1. Which of the following statements is FALSE?
2. The detection of caries is one of the most common reasons for exposing dental radiographs.
3. The carious process is one of remineralization of tooth structure.
4. Caries appears radiolucent on the radiograph.
5. The presence of caries allows more x-rays to pass through the tooth and darken the image receptor.
6. Which of the following statements regarding radiographic detection of caries is FALSE?
7. Radiographs aid significantly in the detection of proximal decay.
8. Bitewing radiographs are the radiographs of choice for the evaluation of caries.
9. Incorrect vertical angulation overlaps the contacts between teeth to render the radiograph useless for caries detection.
10. Radiographs have limited usefulness in detection of early occlusal caries.
11. Which of the following statements regarding radiographic detection of caries is correct?
12. Decalcification must reach 80–90 percent loss of hard structure to be imaged radiographically.
13. The depth of the caries appears more advanced radiographically than clinically.
14. The periapical radiograph is the radiograph of choice to image caries.
15. Some practitioners prefer to use a low kVp to best image caries.
16. For caries to be imaged on a radiograph, approximately what percentage of calcium and phosphorus of the tooth structure must be lost?
17. 20–30 percent
18. 30–40 percent
19. 40–50 percent
20. 50–60 percent
21. Which of the following statements regarding caries depth is correct?
22. Incipient caries penetrates less than halfway through the enamel.
23. Moderate caries penetrates through the enamel and the DEJ.
24. Advanced caries penetrates all the way through the enamel, the dentin , and to the pulp.
25. Severe caries penetrates more than halfway through the enamel but not the DEJ.
26. Each of the following is a possible location of caries EXCEPT one. Which one is the EXCEPTION?
27. Root
28. Proximal
29. Alveolar
30. Occlusal
31. Each of the following statements regarding the radiographic appearance of caries is correct EXCEPT one. Which one is the EXCEPTION?
32. Buccal/lingual caries appears as a round radiolucency in the middle of the tooth.
33. Cemental caries appears as an ill-defined, radiolucent, saucer-shaped area below the CEJ.
34. Occlusal caries appears in the pit and fissures of the tooth surface.
35. Proximal caries begins as a radiolucent notch on the enamel at the contact point between adjacent teeth.
36. Which of the following is the correct classification for proximal caries of enamel and dentin definitely at or through the dentinoenamel junction (DEJ) but less than halfway through the dentin toward the pulp?
37. C-1
38. C-2
39. C-3
40. C-4
41. Which of the following statements regarding the radiographic appearance of occlusal caries is correct?
42. Occlusal carious lesions are located on the incisal edges of the anterior teeth.
43. Incipient occlusal caries is well-visualized on the radiograph.
44. Radiolucencies in dentin below occlusal enamel indicate occlusal caries.
45. The irregularity of cusps and occlusal pits and fissures usually indicate the presence of caries.
46. Which of these statements is FALSE?
47. Cemental caries may be called “root caries.”
48. Root caries may be misinterpreted as cervical burnout.
49. Arrested caries are caries that are no longer active.
50. Rampant caries refers to decay that occurs under a restoration or around margins.
51. Which kVp setting produces the highest contrast between sound enamel and demineralization?
52. 70
53. 80
54. 85
55. 90
56. The caries process demineralizes tooth structures, allowing _____ x-rays to pass through the tooth and _______ the image receptor.
57. more, lighten
58. more, darken
59. less, lighten
60. less, darken
61. Incipient caries is seen radiographically as a radiolucency that has:
62. penetrated less than halfway through the enamel.
63. penetrated over halfway through the enamel but did not reach the DEJ.
64. penetrated at or through the DEJ but less than halfway through the dentin toward the pulp.
65. penetrated over halfway through the dentin toward the pulp.
66. Advanced caries is seen radiographically as a radiolucency that:
67. penetrated less than halfway through the enamel.
68. penetrated over halfway through the enamel but did not reach the DEJ.
69. penetrated at or through the DEJ but less than halfway through the dentin toward the pulp.
70. penetrated over halfway through the dentin toward the pulp.
71. Moderate caries is seen radiographically as a radiolucency that has:
72. penetrated less than halfway through the enamel.
73. penetrated over halfway through the enamel but did not reach the DEJ.
74. penetrated at or through the DEJ but less than halfway through the dentin toward the pulp.
75. penetrated over halfway through the dentin toward the pulp.
76. Severe caries is seen radiographically as a radiolucency that has:
77. penetrated less than halfway through the enamel.
78. penetrated over halfway through the enamel but did not reach the DEJ.
79. penetrated at or through the DEJ but less than halfway through the dentin toward the pulp.
80. penetrated over halfway through the dentin toward the pulp.
81. When interpreting dental radiographs for caries, which section of the tooth surface should be examined for evidence of proximal caries?
82. Just above and just below the enamel on the occlusal surface
83. Just apical to the occlusal surface at the contact point of adjacent teeth
84. At and just apical to the contact point of adjacent teeth
85. At and just apical to the gingival margin between adjacent teeth
86. As a carious lesion progresses, it takes on a triangular shape with the apex pointing toward the __________________ and the base toward the ___________________.
87. cementoenamel junction, outer surface of the tooth
88. dentinoenamel junction, outer surface of the tooth
89. outer surface of the tooth, cementoenamel junction
90. outer surface of the tooth, dentinoenamel junction
91. Which of the following is least likely to be imaged on a radiograph?
92. Incipient occlusal caries
93. Moderate proximal surface caries
94. Advanced proximal surface caries
95. Severe root caries
96. Which of the following conditions resembles caries on a radiograph?
97. Nonmetallic restorations
98. Cervical burnout
99. Mach band effect
100. All of the above

True/False

1. Early occlusal, buccal, lingual, and cemental caries are not likely to be recorded on radiographs.
2. Proximal caries occur on the buccal and lingual surfaces of the teeth.
3. Occlusal caries occur on the smooth surfaces of the posterior teeth.
4. An optical illusion caused by the overlapping of teeth that mimics decay is called the “Mach band effect.”
5. Buccal and lingual caries are best detected radiographically.
6. The borders of buccal and lingual caries are usually ill-defined radiographically.
7. The depth of buccal or lingual caries can be determined by observing the radiographs.
8. Root caries develops between the enamel border and free gingival margin on the cemental surface of the tooth.
9. Recurrent caries appears as a radiolucency adjacent to the restoration.
10. Nonmetallic radiolucent restorations may mimic decay radiographically.
11. The high contrast between normal enamel and overlapped enamel can produce an optical illusion called “cervical burnout.”
12. Arrested caries refers to caries that are no longer active.
13. Caries is a disease of the calcified tissues of the teeth.
14. Arrested caries refers to caries that occurs under a restoration or around its margins.
15. Caries is a pathological process consisting of localized destruction of dental hard tissues by organic acids produced by microorganisms.
16. Radiographs reveal carious lesions that may go undetected clinically, especially caries in the pits and fissures (occlusal surfaces) of the posterior teeth.
17. For dental caries to be recorded on a radiograph, there has to be a decrease in calcium and phosphorus of approximately 40–50 percent.
18. A caries grading system establishes a baseline from which to track the progression and/or remineralization of the carious lesions at future appointments.
19. The shape of proximal caries begins as a radiolucent double triangle through the enamel and dentin.
20. It is the superimposition of the buccal and lingual cusps of the posterior teeth that hinders recording incipient occlusal caries on a radiograph.

Short Answer

1. Radiographs are often prescribed to detect caries on which surfaces of the teeth?
2. What is the name of the optical illusion that describes the increased darkness near the neck of the teeth proximally on radiographs?
3. What is the name for severe, unchecked caries that affect multiple teeth?
4. What term is applied to caries that are no longer active?
5. What term is applied to an optical illusion in which radiolucent lines are caused by overlapping images of the teeth?
6. What is the term applied to the pathologic process in which acids produced by microorganisms cause local destruction of dental hard tissues?
7. How do caries appear radiographically compared to radiopaque enamel?
8. How are caries differentiated from nonmetallic radiolucent restorations radiographically?
9. According to the grading system suggested by Haugejorden and Slack (1977), what is the most extensive class of proximal decay?
10. What is the radiographic appearance of moderate occlusal decay at the DEJ?

Chapter 25

Multiple Choice

1. Each of the following can be determined from radiographs EXCEPT one. Which one is the EXCEPTION?
2. Total loss of periodontal attachment
3. Amount of bone remaining rather than bone loss
4. Crestal alveolar irregularities
5. Interdental septal changes
6. Which of the following statements is correct?
7. Localized bone loss occurs throughout both arches simultaneously.
8. Horizontal bone loss is also known as angular bone loss.
9. Horizontal bone loss occurs in a plane perpendicular to the CEJ of adjacent teeth.
10. Vertical bone loss is also known as angular bone loss.
11. Periodontal bone changes that may be recorded by radiographs include each of the following EXCEPT one. Which one is the EXCEPTION?
12. Amount of bone loss
13. Distribution of bone loss
14. Severity of bone loss
15. Pattern of bone loss
16. Which of the following local contributing factors for periodontal disease will not be detected by radiographs?
17. Widening of the PDL
18. Recession
19. Amalgam overhang
20. Calculus
21. The effects of occlusal trauma may be evident on a radiograph as
22. a widening of the PDL space.
23. an excessive buildup of calculus.
24. dilacerations of the teeth roots.
25. furcation involvement.
26. Each of the following is a use of radiographs in the assessment of periodontal disease prognosis EXCEPT one. Which one is the EXCEPTION?
27. Evaluating root-to-crown ratio
28. Detecting furcation involvement
29. Determining active versus inactive disease
30. Revealing root shape and length
31. Each of the following is a limitation of radiographs in the assessment of periodontal disease EXCEPT one. Which one is the EXCEPTION?
32. Two-dimensional images do not reveal infrabony changes.
33. The destruction of periodontium is not as severe clinically.
34. Changes in soft tissues will not be imaged.
35. Active versus inactive disease is not distinguished.
36. Which of the following would be the least valuable radiographic assessment for the patient with periodontal disease?
37. A vertical bitewing series
38. Periapical radiographs exposed using the paralleling technique
39. A horizontal bitewing series
40. Periapical radiographs exposed using the bisecting technique
41. Radiographs may provide information regarding which of the following periodontal conditions?
42. Gingival inflammation
43. Local contributing factors
44. The presence of active disease
45. The depth of the pockets
46. Each of the following periodontal case types will reveal bony changes radiographically EXCEPT one. Which one is the EXCEPTION?
47. I
48. II
49. III
50. IV
51. Which of the following statements is FALSE?
52. Radiographs reveal the pattern of bone loss.
53. Radiographs indicate the amount of bone loss.
54. Radiographs cannot detect early signs of periodontal diseases.
55. Radiographs reveal crestal bone irregularities.
56. To accurately record the alveolar crestal bone, which of the following is necessary?
57. Precise parallelism with vertical and horizontal angulations
58. Placement of the image receptor parallel to the long axis of the tooth
59. Central rays of the x-ray beam directed perpendicular to the tooth and image receptor
60. All of the above
61. Which of the following is considered a local contributing factor for periodontal disease?
62. Calculus
63. Amalgam overhang
64. A poorly contoured crown margin
65. All of the above
66. Radiolucencies appearing in the furcations of multirooted teeth with less than 50 percent bone loss indicate which periodontal case type?
67. I
68. II
69. III
70. IV
71. Widening of the periodontal ligament space at the crest of the interproximal bone is called:
72. triangulation.
73. furcation involvement.
74. horizontal bone loss.
75. a local contributing factor.
76. Bone loss between the roots of molar teeth is called:
77. triangulation.
78. furcation involvement.
79. horizontal bone loss.
80. a local contributing factor.
81. Which of the following describes the radiographic appearance of calculus?
82. A pointed projection extending from the side of the tooth
83. Ring-like and encircling the neck of the tooth
84. A fuzzy speck barely visible against the side of the tooth
85. All of the above
86. Radiographs add each of the following to an assessment of periodontal disease EXCEPT one. Which one is the EXCEPTION?
87. Root morphology and lengths
88. The amount of supporting bone between the teeth
89. The length of a clinical crown
90. The presence of dilacerate roots
91. Which of the following statements is FALSE?
92. Radiographs assist with determining active versus arrested disease.
93. Radiographs provide information on the tooth root-to-crown ratio.
94. Radiographs provide documentation of the progression of periodontal disease.
95. Radiographs can assist the practitioner with predicting outcomes of treatment.
96. Which of the following is NOT a limitation of radiographs in the evaluation of periodontal disease?
97. They record an exaggerated assessment of actual clinical involvement of the disease.
98. They provide a two-dimensional representation of three-dimensional structures.
99. Changes in soft tissue are not recorded.
100. They cannot distinguish between treated versus untreated disease.

True/False

1. Radiographs may assist in making the diagnosis of gingivitis.
2. Radiographs may be used to evaluate crestal bone and interdental septal changes.
3. In horizontal bone loss, the buccal and lingual plates and interdental bone have all been resorbed to relatively the same degree.
4. Radiographs may assist in determining the distribution of periodontitis.
5. Radiographs can reveal furcation involvement in the posterior teeth.
6. Occlusal trauma can cause periodontal disease.
7. Radiographs can serve as a baseline and as a means for determining treatment success or failure.
8. Radiographs are two-dimensional images of three-dimensional objects.
9. Changes in soft tissue can be demonstrated radiographically.
10. Radiographs can distinguish treated versus untreated disease.
11. Periodontal diseases affect both soft tissues (gingiva) and bone around the teeth.
12. Radiographs document the amount of bone remaining rather than the amount lost.
13. Vertical bone loss is the same diagnosis as </KT><KT>angular bone loss.
14. Localized bone loss is the same diagnosis as generalized bone loss.
15. An amalgam overhang is a local contributing factor for periodontal disease.
16. To image periodontal conditions, horizontal bitewing radiographs are preferred over vertical bitewing radiographs.
17. Some practitioners prefer to expose radiographs used for the purpose of recording information regarding the periodontium at a lower kVp setting because of the high contrast it will produce.
18. When taking multiple radiographs of the same region, varying the horizontal angulation slightly will compromise diagnosis.
19. Evidence of bone loss up to 30 percent and crestal bone density that appears as a fuzzy cupping-out of the alveolar crest are radiographic signs of case type II periodontal disease.
20. To be useful in the evaluation of periodontal disease, periapicals should be exposed using the paralleling technique.