all the BIG exams in dental school and how to pass them

by ann

IT’S FINALLY HAPPENED. I AM FINALLY DONE WITH BOARDS.

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I am licensed to drill, my friends. I can finally say to you that I have taken all the board exams in dental school and passed them. Now let me tell you what I did.

Let’s break this down:

[D2]
Take the NBDE Part I.

[D4]
Take the NBDE Part II.

Decide if you want to take the Northeastern Regional Board (NERB) or the Western Regional Board (WREB).

The NERB is now known as the CDCA so I’ll be using both terms interchangeably.
The CDCA consists of three parts:
1. The ADEX multiple choice exam
2. The clinical manikin exam consisting of  endodontics and prosthodontics
3. The clinical live patient exam consisting of two operative procedures (class II amalgam/composite + class III composite) and perio

The WREB consists of:
1. A free response treatment planning exam for three cases, including one pediatric case
2. A clinical section consisting of operative, endo and perio

I am taking the NERB. The WREB seems to be a much more relaxed exam. The most significant reason licensure-wise to taking the WREB is if you plan on practicing in California- among  a few other states-where it only takes the WREB.

Other notable differences:

  • For the NERB, you must do a class II amalgam/composite AND a class III composite.
    For the WREB, you can do a class II amalgam, class II composite OR a class III composite. The class III composite is not required.
  • For the NERB, you must access, instrument and obturate a plastic central incisor and access a plastic molar.
    For the WREB, you must access, instrument and obturate a single rooted extracted natural tooth and access, instrument and obturate one canal of a multi-rooted natural tooth.
  • For the NERB, you must prep a central incisor for an all-ceramic crown and a three unit bridge in which a premolar is prepped for a PFM and the molar is prepped for an all metal crown.
    The WREB does not have a prosth section.

HOW I PASSED
For NBDE I

  • What I did: NBDE I Mastery App
  • What others did: Dental Decks, First Aid
  • Note: Some people took it over winter break. I waited until after finals and it was horrendous. I would have rather sucked it up, studied during the break and taken it either at the end of break/in the first few weeks back.
  • UPDATE: I almost forgot. These videos online for dental anatomy were a godsend. BUT review third molar anatomy as well because that is also on the exam.

For NBDE II// ADEX
The NBDE II and ADEX exams contain similar information so I would advise taking the exams in a row and knocking it out while the material is fresh on your mind.

  • What I would recommend: I used a ton of materials for NBDE II and ADEX. I read through Mosby’s (esp for Practice Management) and First Aid. I also used the Tufts Pharmacology Study Guide, which can be found online and provides a good overall review. The Pearls in the back of the ADEX/CDCA Boards Busters is especially helpful too.
  • What others used: Boards Busters, Dental Decks, NBDE II Mastery App

For NERB// ENDO + PROSTH
The only thing you can do to prepare for this exam is to practice. Prior to the day of the exam, I would write out all the materials you need so that you can get it all at once and not have to continually run up to the dispensary and wait in line. Also, if there are certain disposables that you like to use, prepare a week or so prior to the exam and BRING YOUR OWN. On my exam day, certain dispensaries didn’t carry some materials (i.e., 10 K-file, Enhance burs, etc.)

  • (ENDO) Be careful when heating your instruments. Although this is supposed to simulate a real endodontic procedure, these teeth are plastic and can burn.
  • (PERIO) Be careful of nicking the adjacent teeth. Use Interguards as a preventative measure.
  • (PERIO) Watch out for undercuts.

For NERB// OP + PERIO

Most common failures are due to:

  • patient issues
  • improper paperwork
  • open contacts/margins

Tips + tricks:

  • Patient management is number one. Without a patient, you’ve failed.
    • Be upfront with your patient about the amount of time this will take. The average amount of time is 3 hours from patient approval to final check BUT this varies depending on wait time. My first patient arrived at 6:45 AM and didn’t leave until 11:30 AM.
    • Compensate your patients to ensure their arrival and emphasize it. What is a few hundred dollars (going rate per patient is $50-100) versus the price-and stress- of taking it again?
    • Thank your patients. You literally could not do it without them.
    • Note on patient selection: Choose patients that are timely, mild-mannered and ROOTING FOR YOU. If your patient has a history of being late, of being anxious during injections, of complaining while waiting for faculty to come by, THEN DO NOT USE THEM FOR BOARDS. My own patient had a great Class 2 lesion, confirmed on Wednesday, did not pick up her phone the two times I called her on Thursday OR the morning of my exam (Friday). This was no Cinderella story and my Prince Class 2 did not arrive to save me in the nick of time. THANKFULLY, a classmate found me a lesion. Otherwise, I would have had to re-take my Class 2 in April.
  • READ THE MANUAL. It is tedious and repetitive but very, very informative.
  • When in doubt about your next step, ask your CFE. Really, before you take any important steps (i.e. prepping or restoring), confirm with a CFE that you may do so. They aren’t your enemies! All the ones I interacted with were encouraging and helpful.
  • Find an assistant for the big day. An assistant makes the process more efficient and, more importantly, keeps you calm.
  • TRIPLE check you are prepping the right tooth. That sounds obvious until you’re in the thick of it.
  • Know beforehand if you are doing conventional or slot prep BUT be prepared to switch from slot to conventional.
  • When prepping, if you are concerned about nicking the adjacent tooth, use Interguards.
  • It is better to ask for a modification than not. You can fail due to a prep that is too conservative or has remaining caries.
  • For the same reason, when in doubt, go bigger.
  • You aren’t graded on your rubber dam placement but make it look nice. You could be asked to replace it before it can be evaluated. THAT WASTES TIME.
  • Also remember to include a periodontal probe when sending your patient to the evaluation station. It isn’t asked for in the manual but was asked for on the day on the exam.
  • Know how to handle a pulp exposure. (Direct pulp cap- Place dycal/vitrebond.)
  • Wedge the HELL out of your tooth. Perhaps try one of the wedging techniques like double wedging or wedge-wedging.
  • Check your contacts tactically (with floss) and visually. You don’t want to think you got contact but actually got caught on an overhang.

UPDATE:
Below I have included pictures of the checklists that I wrote in my manual for my setup and for when sending the patient to the evaluation station. Prior to the exam, I prepared baggies containing the disposables I needed for each of the procedures. My numbers for the disposables were high but better to be more prepared if you’re farther from the dispensary!

PERIO SET-UP CHECKLIST

20160313- CDCA Checklists (1 of 5)

PERIO EVALUATION STATION CHECKLIST

20160313- CDCA Checklists (4 of 5)

OPERATIVE SET-UP CHECKLIST (with checkboxes for Class II and Class III)

20160313- CDCA Checklists (3 of 5)

OPERATIVE EVALUATION STATION CHECKLIST

20160313- CDCA Checklists (5 of 5)

Take a deep breath because these exams are milestones to getting that dental degree! Good luck!

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