Frequently Asked Questions and Advice From Candidates

ADVICE FROM PREVIOUS CANDIDATES
who have taken the Local Anesthesia Exam

  • RELAX . . . . .STUDY . . . . . .PRACTICE

  • Read the Candidate Guide and Policy Guide before the exam; read them several times. Get a syringe that fits your hand; relax–examiners are actually nice! Think positive. Avoid caffeine the day of the exam. Have your patient come 45-60 minutes ahead of schedule.

  • Make sure the large window is showing.

  • Be a patient for someone else.

  • Bring double of everything.

  • Go camping or on vacation before the exam.

  • Relax: visualize your injections.

  • Ask questions during the tour. Have a back-up patient. Study in advance so you can relax the night before. You have to study for the Written exam.

  • Try to stay calm. Examiners know you are nervous.

  • Study Malamed. Go to the test site/school early to walk around. Practice with three stopping points.

  • Know dosages, medical history contraindications and complications, and anatomy.

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Frequently-Asked Questions
by candidates taking the Local Anesthesia Exam

  • When should I tell my patient to arrive?

    This is up to you and the patient. But as you are directed into the clinic 15-30 minutes before your assigned examination time in order to set up and prepare to perform the injections, it is helpful if the patient is told to be there at least an hour ahead of the scheduled time so that blood pressure and pulse can be taken and recorded and Medical History/Consent form can be completed.

  • When can I take my patient's blood pressure?

    Blood pressure is to be taken within an hour of the assigned clinical examination time. It does not have to be taken in the clinic. It can be taken in the patient waiting area or reception area or wherever your hearing is not impaired. It greatly aids exam flow if you take the BP before coming into the clinic, so that examiners are not kept waiting.

  • When can I apply topical?

    Examiners will check the patient for sores/puncture marks, for maxillary second molars and a premolar in each mandibular quadrant, and review the patient's medical history. After the examiners have accepted the patient, you will be told to go ahead and apply topical to both sites. (This is not an observed/graded procedure.)

  • How much anesthetic can I expel from the cartridge?

    In Orientation, you are told you may expel some solution to make aspiration easier. There is no requirement here. You should use your own discretion, keeping in mind there needs to be enough solution in the cartridge so that examiners can observe rate of deposition. Expressing a stopper width is usually adequate. (It's nice if you don't squirt the examiners or hose the floor in doing this!)

  • What do I do after “dropping a drop”?

    Dropping a drop of anesthetic solution ahead of the needle as it is advanced is not part of PERFORMANCE EXPECTATIONS (see Candidate Guide). If you have been taught this method to possibly increase patient comfort, you must use your own clinical judgment. In this instance, examiners do not tell you when to proceed or how many drops are enough. However, “Amount” is a graded criterion and if too much anesthetic is deposited prior to reaching the target site and aspirating, you will fail the exam. (Page 166 of the Malamed text, Local Anesthesia, 5th ed., states that not more than 1/8 of a cartridge should be deposited as soft tissue is penetrated.)

  • When is it OK to withdraw? What counts as an attempt?

    If bone is prematurely contacted so that the needle does not reach the appropriate depth, you must use your own clinical judgment and either reposition or withdraw the syringe and repenetrate (making an adjustment in the insertion site). You have three attempts to penetrate, before you are stopped and failed. An attempt occurs each time the syringe/needle is withdrawn from tissue and reinserted.

  • Do we need to aspirate on two planes on the PSA injection?

    Malamed is our referenced text, but we do not require rotation and aspiration on two planes. Malamed also states that re-aspiration should be performed several times throughout an injection, and while we do not require that either (so long as the needle position does not change), it is a wise practice.

  • What sterilization procedures should be followed?

    Information on the school/test site's procedures and protocols are mailed to you before the exam. Infection control is also reviewed during the tour following the Written exam. The school guidelines are to be followed exactly. You should be sure to ask questions during the tour if they are unclear on the requirements.

  • May I wrap the syringe thumb ring?

    Yes.

  • What if my patient has only one maxillary second molar?

    The patient will be rejected, which constitutes failure of the exam. The examiners use landmark teeth to evaluate proper technique. “All landmark teeth must be present in the event that an injection needs to be repeated on the other side.” The requirement of maxillary second molars and a premolar in each mandibular quadrant for patient acceptability is not intended to limit the patient pool or in any way disadvantage you. Actually, having the ‘landmark' teeth present should help you perform passing injections.

  • Will I fail the exam if I get a positive aspiration?

    No. You will be instructed to announce whether the aspiration is positive or negative. If it is positive, reposition the needle and perform re-aspiration. In the event of a second positive aspiration at the same injection site, you will be asked to withdraw and the injection will be graded as is. Please refer to your candidate guide for more details.

  • May I use the Minnesota Retractor during my anesthesia board?

    Yes, but do not expect the examiners to hold it for you!

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ADVICE FROM PREVIOUS CANDIDATES
who have taken the Dental Hygiene Exam

In the interest of assisting the upcoming crop of candidates, we have compiled the common refrains heard year after year from candidates.

  • READ, READ, MEMORIZE your candidate guide. This is your bible for the exam. You will be familiar with all paperwork, requirements, and feel more comfortable at this stressful time if you study it thoroughly.

  • Attend the Orientation. This helps reinforce the Candidate Guide and shows you the clinic where you will be taking the exam. Questions are answered and you will feel more sure of yourself.

  • Make sure your patient has excessive SUBgingival calculus. It must be below gingival tissue to be considered sub; it must be heavy. A patient who has regular recall appointments will not qualify. Look for “boulders”!!

  • Make sure you bring a back-up patient. You may need them, or someone else may need them. Make sure all patients are dependable and will show up because they realize the importance of the commitment to you.

  • After you find a board patient, advise them to practice basic oral hygiene (i.e., brush and floss), so that gingival inflammation and bleeding are minimized during the exam. Profuse bleeding impairs instrumentation and visibility and increases risk of tissue damage which is an error you don't want to have. Remember: Calculus does not brush off!

  • Be sure to get a commitment from your patient(s) to be there at least 45 minutes before the exam time. One candidate wrote that her patient was late and it cost her the exam.

  • Bring snacks, fruit, water, a blanket and anything else your patient may appreciate. The day is long, the clinics are cool (but stress and hard work can make the candidates and examiners warm).

  • Bring packets and forms to all orientations and don't lose your badge!

  • Double-check x-rays.

  • Prepare in advance the instruments and forms that your patient will be carrying. You will be glad you got that done because you can feel rushed.

  • Bring extra money to the site in case you need something unexpected.

  • Do as much paperwork as allowed prior to the exam. Organize your paperwork. Make one file for check-in and one for check-out. Be familiar with the forms before orientation. This is one of the biggest stresses for most candidates–GETTING THE PAPERWORK RIGHT. If you study beforehand, it is easy.

  • Sleep well and long the night before. Eat a nutritious breakfast. Relax, take deep breaths often, and do what you have been taught.

  • Time Management is your friend.

WREB is here to help you pass. WREB is not against you. WREB hopes that you successfully complete the exam for licensure. WREB does listen to your questions and comments and works to make the exam fair for everyone involved.

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FREQUENTLY-ASKED QUESTIONS
by candidates taking the Dental Hygiene Exam

  • I plan to submit a quadrant that has more than 12 heavy, subgingival calculus deposits with probing depths of 6 mm or less; but the quadrant also contains a localized area that has a definite 7mm pocket. I don't want to include that as one of the 12 qualifying surfaces. Will I be penalized even though I don't submit the 7mm pocket as one of my surfaces?

    If there is a localized area(s) in the quadrant that has a pocket depth >7mm, the examiners will disqualify that surface as a qualifying surface. If there are 12 qualifying surfaces elsewhere in the quadrant, that shouldn't be a problem. You are not penalized if there are pocket depths >6mm. The criteria for pocket depths only applies to qualifying surfaces.

  • Is there a maximum number of qualifying surfaces on the MAXILLARY anterior teeth?

    No. The limitation is only on the mandibular anterior teeth–a maximum of four qualifying surfaces may be from canine to canine or from canine to central incisor.

  • If I use the same patient for my first submission and also as my alternate submission, and the first submission is rejected, will I be docked 4 points, even though it is the same patient?

    Yes. If your first patient is rejected it is a 4-point penalty.

  • Can I use my anesthesia clinical successful memo I received in March at Phoenix to administer anesthesia to my patient at Portland in June?

    No. The clinical success memo is acceptable documentation only if the anesthesia exam is taken during the week of your dental hygiene exam. If you take the anesthesia exam prior to the week of your dental hygiene exam, WREB will send you a Success Card (must be posted at your operatory), which allows you to administer anesthesia at your exam.

  • Can I allow my educator or dentist to look at my patient to see if he/she is qualified for the board exam?

    This is not recommended. Patient qualification is your responsibility. Other professionals are not calibrated to WREB criteria.

  • Do the radiographs need to be a full mouth (FMX) or just of the quad/teeth we're submitting?

    The films are required for the quadrant/teeth you are submitting and may be diagnostic horizontal or vertical posterior bitewings WITH anterior AND posterior periapicals. You may also submit an FMX.

  • Can I use a 3rd molar as a proximal contact?

    If the 3rd molar is fully-erupted or supra-erupted and does not have tissue covering the occlusal surface and is part of your submission , it may be used as a proximal contact.

  • What do the examiners take into consideration when evaluating the Periodontal Disease Classification?

    The examiners refer to your charting of recession in the assigned quadrant to determine clinical attachment loss (CAL). They also refer to the submitted radiographs to assess interproximal bone loss and furcation involvement. A table and an example are included in the Candidate Guide that lists the criteria that should be considered in determining the Periodontal Disease Classification.

  • Are there particular handles WREB requires for the explorers?

    No. Any handle is acceptable.

  • Can the mirror be double-sided?

    The mirror must be a #4 or #5 front-surface mirror. It could be double-sided.

  • Can the probe be a double-ended with a shepherd's hook or does it have to be single-ended?

    The probe must be a UNC 12, not a right-angled instrument. Whatever is on the other end is immaterial.

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ADVICE FROM PREVIOUS CANDIDATES
who have taken the Hygiene Restorative Exam

  • When ordering preps, have the model number and brand of your dentoform as well as the tooth numbers ready.

  • Doing two preps gave me more confidence that I could demonstrate my skills.

  • Get a good night's sleep before the exam. It helps to be rested.

  • The tour is helpful.

  • Remember to bring a box for your dentoform.

  • Bring your own triturator; it makes a difference.

  • Take a much extended restorative course; not one that only lasts several hours.

  • Practice carvings and also having to remove a carving.

  • Know what to do if your marginal ridge breaks.

  • Practice.

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Frequently-Asked Questions
by candidates taking the Hygiene Restorative Exam

  • What happens if I break a prep during the examination?

    Inform the Chief Examiner immediately. The Chief will confer with the examining team and a new prep will be assigned.

  • If I've previously taken this exam and have virgin dentoform teeth with red lines across them, can I use those teeth again?

    Yes. Use fingernail polish remover and remove the red lines.

  • Can I bring my own triturator?

    Yes.

  • Can I leave the clinic if I am finished before the one and one-half hour deadline?

    Yes, but you will not be allowed to re-enter until cleanup time is announced.

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TEST TAKING TIPS

A Board member from New Mexico has written the following to help you through your exam day. These suggestions will help you whether you are taking dental hygiene, anesthesia, restorative or all three!

  1. Be prepared. Make sure that you have familiarized yourself with the exact location of the school as well as the best route to take to get there. You may want to arrive 30 minutes early to find parking and to find the examination room. You may also want to dress in layers so that your clothing can be adjusted, as necessary, to the environment. A cold or warm room could prove to be a distraction while taking the examination. You do not need any added distractions. Anticipate both scenarios and wear layers.

  2. Prepare your body as well as your mind. During the week of the examination, be sure to get plenty of rest, especially the night before. Last-minute “cramming” is usually not going to help at this point and may produce unnecessary stress. It is advisable to eat well the day of the exam, starting with a balanced breakfast and avoiding stimulants. Coffee or caffeinated sodas may make you feel energized for the moment, but the ultimate effect will be a sluggish performance when you least desire it.

    Odds are you will grow increasingly nervous as the exam date draws near. This reaction is perfectly normal. Realizing that your preparation to take the exam is adequate and reassuring yourself of this fact is a comfort. Many experts believe that a little anxiety may actually improve performance in some individuals. So think of this extra nervous energy as an ally and use it to your advantage. If at any time during the exam an overwhelmed feeling or loss of concentration occurs because of increased nervousness, try closing your eyes and taking some slow deep breaths. Too much stress can create a condition of anoxia in vital organs of the body. Breathing correctly will not only help you to relax, but it will also help deliver oxygen to the brain, where it is needed the most. Above all, be confident in your level of preparation to take this examination.

  3. Review the packet and Candidate Guide(s) sent to you by WREB prior to the exam. Make sure you have filled out all the forms that need to be turned in at the exam and bring the entire packet with you to the school. Read the Candidate Guide and Policy Guide thoroughly as both clearly explain what is expected of you.

  4. Pace yourself. If taking the anesthesia written exam, understand that there is one hour and there are 55 questions. In the written exam, you will be given a 10-minute warning. The dental hygiene clinical exam is 2 hours and 30 minutes to do specific tasks. Either way, if you budget your time you can work more efficiently through whatever series of tasks or questions are required in the time allotted. Avoid wasting time by looking frequently at the clock.

  1. Bring a photo I.D.
  2. Be sure to have the required instruments for the examiner to use.
  3. Remember NOT to administer local anesthesia until after the Chief's approval.
  4. You may want to consider re-anesthetizing your patient right before checkout.
  5. Use page 27 of your Candidate Guide in your operatory as a checklist.
  6. Bring a blanket and a snack for your patient.
  7. You may want to bring an FMX just in case your first submission is not accepted.

As students, you have taken a number of examinations. This is one more. It may seem more fraught with consequences, but it is nothing more than proof positive that you have been a good student and are ready to move out into the world of dental hygiene.

WREB wishes all of you the best as you prepare for your chosen profession.

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