Treatment planning and patient management practice questions for the periodontics Qualifying Exam
This domain tests what a periodontist does before and around treatment: sequencing a plan, managing medically complex patients, sedation, informed consent and handling an emergency in the chair.
2027 ABP blueprint domain: Treatment Planning and Patient Management
11%of our mock exams
~22of 200 full-length mock questions
100questions on this domain in the bank
What the blueprint covers
The 2027 Qualifying Exam blueprint lists these objectives for this domain:
Problem-focused and comprehensive, sequential treatment plans, with consultations and referrals
Ethical and professional dilemmas, and the elements of informed consent
Stress reduction: inhalation, enteral and parenteral sedation, and iatrosedation
Behavior change for tobacco and vaping, oral hygiene, drug use and nutrition, and TMD and myofascial pain
Medically compromised and special-needs patients
Implant and prosthetic planning in analog and digital workflows
Recognizing and managing medical emergencies
High-yield areas
AHA 2021 infective endocarditis prophylaxis and the ADA guidance on prosthetic joints
Anticoagulants and antiplatelets, including DOACs, before periodontal surgery
Moderate sedation definitions, monitoring and reversal
Patients on antiresorptives, after head and neck radiation, and with poorly controlled diabetes
Syncope, hypoglycemia, anaphylaxis, chest pain and local anesthetic toxicity
How to study it
Practice with whole patients: a medical history, a chart and a goal. Decide the order of care and what has to happen before surgery. For emergencies, learn the first two actions for each, cold.
Free practice questions: Treatment planning and patient management
4 questions from the bank, with the full rationale and source. Pick your answer, then open the rationale.
Question 1 of 4 · moderateTreatment Planning and Patient Management
A 64-year-old woman with metastatic breast cancer has received monthly zoledronic acid for 2 years and no radiation to the head and neck. She has had a 1 cm area of exposed bone on the lingual mandibular ridge for 10 weeks. The area is painful, with surrounding erythema and purulent discharge. There is no extraoral fistula, pathologic fracture or oroantral communication, and radiographs show no osteolysis reaching the inferior border. Which AAOMS 2022 stage applies?
Stage 2
Stage 0
Stage 1
Stage 3
At risk
Show answer and rationale
Answer: A. Stage 2
A (correct): Stage 2 is exposed and necrotic bone, or a fistula probing to bone, with evidence of infection or inflammation, typically with pain, erythema and possible purulent drainage. Her findings fit this stage without any Stage 3 features.
B (incorrect): Stage 0 describes patients without exposed bone who have nonspecific symptoms or radiographic changes. She has clinically exposed bone.
C (incorrect): Stage 1 is exposed or probeable necrotic bone in a patient who is asymptomatic and has no evidence of infection. Her pain, erythema and pus exclude it.
D (incorrect): Stage 3 requires Stage 2 findings plus extension beyond the alveolar bone, pathologic fracture, extraoral fistula, oroantral or oronasal communication, or osteolysis to the inferior border or sinus floor. None is present.
E (incorrect): At-risk patients have received antiresorptive or antiangiogenic drugs but show no exposed or necrotic bone. She already has established disease.
Source: Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D. American Association of Oral and Maxillofacial Surgeons' Position Paper on Medication-Related Osteonecrosis of the Jaws: 2022 Update. J Oral Maxillofac Surg. 2022;80(5):920-943. Staging of MRONJ table: At risk, Stage 0, Stage 1, Stage 2 (exposed bone with infection, symptomatic) and Stage 3. https://www.aaoms.org/wp-content/uploads/2024/03/mronj_position_paper.pdf
Question 2 of 4 · easyTreatment Planning and Patient Management
A 49-year-old man with generalized stage III, grade C periodontitis smokes 20 cigarettes per day. He is willing to discuss quitting. Where should a smoking cessation intervention fit in his periodontal treatment plan?
Only after nonsurgical therapy, if residual pockets remain
Only before surgery in the third step
In the first step of therapy, continued throughout supportive care
Only during supportive care, once active therapy is complete
It should be left to his physician and not addressed in the dental plan
Show answer and rationale
Answer: C. In the first step of therapy, continued throughout supportive care
A (incorrect): Waiting until after the second step loses the chance to improve his response to initial therapy. Cessation support belongs at the start.
B (incorrect): Smoking affects every step of therapy, not just surgical healing. Limiting intervention to the surgical phase is too narrow.
C (correct): Smoking cessation interventions are part of risk factor control in the first step and should be repeated during supportive periodontal care. Smoking impairs healing and raises the risk of recurrence, so it should be addressed from the start.
D (incorrect): Supportive care should reinforce cessation, but the intervention should begin in the first step, when it can still improve treatment outcomes. Waiting until active therapy ends delays the benefit.
E (incorrect): Dental professionals are well placed to deliver brief cessation advice and referral. Leaving it out of the periodontal plan neglects a major modifiable risk factor.
Source: Sanz M, Herrera D, Kebschull M, Chapple I, Jepsen S, Berglundh T, Sculean A, Tonetti MS; EFP Workshop Participants and Methodological Consultants. Treatment of stage I-III periodontitis: The EFP S3 level clinical practice guideline. J Clin Periodontol. 2020;47(Suppl 22):4-60. doi:10.1111/jcpe.13290. Recommendations 1.6 and 4.18 (smoking cessation interventions). https://pmc.ncbi.nlm.nih.gov/articles/PMC7891343/
Question 3 of 4 · moderateTreatment Planning and Patient Management
A 30-year-old woman who has been deaf since birth and uses American Sign Language is referred for scaling and root planing. She arrives with a sign language interpreter. A staff member suggests keeping the explanation short, since she may not follow details. Which approach is most appropriate for the treatment discussion and consent?
Speak to her directly, with the interpreter conveying everything
Direct the questions to the interpreter and let the interpreter decide
Decline the interpreter and use only brief written notes
Simplify the explanation and obtain a quick signature
Speak louder and more slowly while wearing a mask
Show answer and rationale
Answer: A. Speak to her directly, with the interpreter conveying everything
A (correct): Clinicians should not assume that a patient with impaired communication has an intellectual disability unless this is documented. Nonverbal communication for patients with hearing impairment can use cues with the help of a caregiver or a sign language interpreter, so she receives the full explanation and gives her own consent.
B (incorrect): The interpreter conveys communication but does not make decisions for her. She is the person consenting to treatment.
C (incorrect): Refusing the interpreter she brought would limit her understanding of a detailed discussion. Written notes can supplement but should not replace her preferred language.
D (incorrect): Shortening the explanation based on an assumption about her understanding is inappropriate. Informed consent requires the same information given to any patient.
E (incorrect): Raising one's voice does not help a patient who is profoundly deaf, and a mask prevents lip reading. Communication should go through her interpreter.
Source: American Academy of Pediatric Dentistry. Management of dental patients with special health care needs. The Reference Manual of Pediatric Dentistry. Chicago, IL: American Academy of Pediatric Dentistry (latest revision 2026). Recommendations, communication: do not assume patients with impaired communication have intellectual disability; nonverbal communication with the help of the caregiver or sign language interpreter. https://www.aapd.org/globalassets/media/policies_guidelines/bp_shcn26.pdf
Question 4 of 4 · easyTreatment Planning and Patient Management
A general dentist refers a 50-year-old man to a periodontist for treatment of stage III periodontitis. After successful therapy, the periodontist's office notices that the patient also needs two crowns and offers to schedule them with the practice's associate restorative dentist. The patient has not expressed any wish to change dentists. What is the periodontist's ethical obligation?
Complete the crowns in-house, since the practice has an associate who can do them
Return the patient to the referring dentist for restorative care and future dental needs
Ask the referring dentist for permission before booking the crowns in-house
Offer the patient a fee discount if he chooses to have the crowns done in-house
Defer the crowns until the patient's next supportive care visit at the periodontal office
Show answer and rationale
Answer: B. Return the patient to the referring dentist for restorative care and future dental needs
A (incorrect): The availability of an associate does not change the duty to return the patient to the referring dentist. Only the patient's expressed preference permits a different arrangement.
B (correct): Specialists who complete their care should return the patient to the referring dentist unless the patient expressly reveals a different preference. Offering in-house restorative care to a referred patient who has expressed no such wish breaches this obligation.
C (incorrect): The obligation is to return the patient, not to negotiate who keeps the restorative work. The deciding factor is the patient's own expressed preference.
D (incorrect): Using price to steer a referred patient away from the referring dentist undermines the referral relationship and the patient's independent choice. The patient should be returned unless he expresses a different preference on his own.
E (incorrect): Delaying needed restorative care does not resolve the obligation. The patient should be returned to the referring dentist for the crowns and continuing care.
Source: American Dental Association. Principles of Ethics and Code of Professional Conduct, with official advisory opinions. Chicago: American Dental Association; 2026. Section 2.B, Consultation and Referral (item 1). https://www.ada.org/about/principles/code-of-ethics
For exam preparation only, not clinical advice.
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