Oral Pathology Practice Questions
Oral pathology is one of the most visual branches on dental board exams, and one of the most heavily tested. These questions cover odontogenic cysts and tumours, fibro-osseous and non-odontogenic lesions of the jaws, oral mucosal pathology, salivary gland pathology, developmental anomalies, head and neck oncology, and oral manifestations of systemic disease. On the AFK, INBDE, ORE and ADC, expect to match a radiographic appearance or clinical description to the most likely diagnosis, and to know which lesions recur, which undergo malignant change, and which demand urgent referral.
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Questions
Question 1 of 10
Non-Odontogenic Tumors & Fibro-Osseous Lesions of the Jaws
Because central giant cell granuloma is histologically indistinguishable from the brown tumor of hyperparathyroidism, which workup step is essential before treatment?
The answer is B.
Central giant cell granuloma and the brown tumor of hyperparathyroidism share an identical histologic appearance of multinucleated giant cells within a fibrocellular stroma, so serum calcium, phosphate, and parathyroid hormone testing is essential to rule out an underlying parathyroid disorder before local treatment.
Question 2 of 10
Odontogenic Cysts
Which histologic finding is most characteristic of the calcifying odontogenic cyst (Gorlin cyst)?
The answer is C.
The calcifying odontogenic cyst is defined histologically by the presence of ghost cells, which are epithelial cells that have lost their nuclei but retain a faint cellular outline, and these ghost cells frequently mineralize, producing scattered calcified foci within the cystic lining.
Question 3 of 10
Head & Neck Oncology (Dental-Relevant Scope)
Which combination of factors represents the most well-established risk factors for oral squamous cell carcinoma?
The answer is A.
Tobacco use in any form, heavy alcohol consumption, and infection with high-risk strains of human papillomavirus are the most well-established and heavily studied risk factors for oral squamous cell carcinoma, with tobacco and alcohol showing a synergistic rather than simply additive effect on risk.
Question 4 of 10
Developmental & Genetic Jaw/Tooth Anomalies (Pathology Scope)
Radiographically, teeth affected by dentinogenesis imperfecta most typically show which finding over time?
The answer is D.
Dentinogenesis imperfecta is characterized radiographically by progressive obliteration of the pulp chambers and root canals as abnormal dentin continues to be deposited, in contrast to the enamel-only defect seen in amelogenesis imperfecta, where pulp chamber morphology remains largely normal.
Question 5 of 10
Odontogenic Tumors
The peripheral ameloblastoma differs from the intraosseous forms of ameloblastoma mainly in which way?
The answer is D.
Peripheral ameloblastoma is a soft-tissue variant that arises from gingival epithelium or dental lamina rests confined to the gingiva or alveolar mucosa without primary bony invasion, so it generally behaves less aggressively and is managed with conservative local excision.
Question 6 of 10
Salivary Gland Pathology
Mucoepidermoid carcinoma is clinically significant because it represents which of the following?
The answer is A.
Mucoepidermoid carcinoma is the most common malignant salivary gland tumor, arising from a mixture of mucous-secreting and epidermoid (squamous-like) cells, and it can occur in either major or minor salivary glands with behavior ranging from indolent to aggressive depending on histologic grade.
Question 7 of 10
Oral Mucosal Pathology
A 39-year-old man develops immediate burning pain and a white, sloughing lesion on the gingiva after concentrated phenol accidentally contacts the tissue during a procedure. Adjacent teeth remain non-tender and vital, and radiographs confirm no bony involvement. A white, sloughing, painful patch on the gingiva appearing immediately after contact with a caustic agent is best described as what?
The answer is C.
An immediate white, sloughing, painful lesion arising directly after a caustic chemical contacts the mucosa is a chemical burn, where the agent coagulates and necroses the surface epithelium.
Question 8 of 10
Oral Manifestations of Systemic Disease
Oral involvement in systemic or discoid lupus erythematosus most typically presents as which finding?
The answer is A.
Oral lupus lesions classically present as chronic ulcerations surrounded by irregular white keratotic striae radiating outward from a central erythematous area, most often affecting the buccal mucosa and palate, and this pattern can closely mimic erosive lichen planus on clinical examination.
Question 9 of 10
Head & Neck Oncology (Dental-Relevant Scope)
A painful ulcer on the buccal mucosa adjacent to a fractured restoration is treated by smoothing the sharp edge. Which follow-up finding would require biopsy?
The answer is B.
A traumatic ulcer with its cause removed should heal within 7-14 days; persistence beyond two weeks requires biopsy to exclude malignancy, a foundational rule of oral cancer screening.
Question 10 of 10
Odontogenic Tumors
The solid/multicystic type of ameloblastoma most typically arises in which location?
The answer is B.
The solid/multicystic (conventional) ameloblastoma classically occurs in adults, most frequently in the posterior mandible around the molar-ramus area, and presents as a slow-growing, painless, expansile intraosseous mass that can reach large size before diagnosis.
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