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NDEB Equivalency Process · Last updated November 2026

NDEB Assessment of Fundamental Knowledge (AFK): free practice test

The first of three assessments in the NDEB Equivalency Process for dentists who graduated from a non-accredited dental program. 200 single-answer questions test biomedical science and applied clinical science, from anatomy and pharmacology to restorative dentistry, oral pathology and ethics. It runs twice a year, in February and August, and you can take it a maximum of three times.

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About the AFK exam

The first of three assessments in the NDEB Equivalency Process for dentists who graduated from a non-accredited dental program. 200 single-answer questions test biomedical science and applied clinical science, from anatomy and pharmacology to restorative dentistry, oral pathology and ethics. It runs twice a year, in February and August, and you can take it a maximum of three times.

What's on the exam

AFK
Applied Biomedical Sciences
7 key facts
Restorative Dentistry, Prosthodontics and Implants
7 key facts
Oral Medicine, Oral Pathology and Oral Radiology
7 key facts
Pharmacology, Local Anesthesia and Medical Emergencies
7 key facts
Orthodontics, Pediatric, Geriatric and Special Needs Dentistry
6 key facts
Periodontics and Endodontics
6 key facts
Oral Surgery, Trauma, Orofacial Pain and Dental Emergencies
7 key facts
Evidence-Based Dentistry, Prevention, Infection Control and Ethics
7 key facts

Each branch is a topic in the official outline. Members see every key fact on the full mind map. Read the free study guide →

How to pass the AFK exam

  • 200 questions in 4 hours is 1 minute 12 seconds each. Most AFK questions are short, so bank time on recall items for the calculation and radiograph ones.
  • Applied biomedical sciences is the biggest area at about 20%. Anatomy, microbiology, cariology and dental materials are easy marks if you revise them like a first-year student.
  • There's no penalty for wrong answers. Never leave a question blank.
  • You have only three attempts. Don't book until your timed practice scores are consistently comfortable, not borderline.

Save your results and get your Readiness Score

Create a free account after the test: your score by topic, a mistakes bank, the complete study notes for the first topic, flashcards and the High-Yield Dental Values Sheet.

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What's in the premium AFK prep

Premium AFK prep is studied one topic at a time. Each step starts with that topic's key notes and flashcard deck, then its own question sets of 25, so you master one topic before you move to the next. When every topic is strong, the 6 full mock exams show you're ready.

3,000practice questions, every answer explained
6full-length mock exams, 200 questions each, timed
800flashcards with spaced repetition, sorted by topic
60comprehensive key notes across 8 topics

Your step-by-step study path

  1. 1
    Applied Biomedical Sciences8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Notes free with an account
  2. 2
    Restorative Dentistry, Prosthodontics and Implants8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  3. 3
    Oral Medicine, Oral Pathology and Oral Radiology8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  4. 4
    Pharmacology, Local Anesthesia and Medical Emergencies8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  5. 5
    Orthodontics, Pediatric, Geriatric and Special Needs Dentistry7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  6. 6
    Periodontics and Endodontics7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  7. 7
    Oral Surgery, Trauma, Orofacial Pain and Dental Emergencies7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  8. 8
    Evidence-Based Dentistry, Prevention, Infection Control and Ethics7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  9. Final step: 6 full mock exams200 questions each, timed like test day. Pass them, then book your exam.
    Premium
Free with an account

Read the complete AFK study notes for “Applied Biomedical Sciences”

Our first full set of comprehensive notes, about 16 minutes of reading: Head and neck anatomy that gets tested · Oral embryology and histology · Cariology and microbiology · Dental materials · Immunology and physiology essentials, a worked exam example, the traps examiners use and a one-minute recap. Create a free account to read it and see how premium notes work before you decide.

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Study tools included

3,000 practice questions

3,000 exam-style questions per exam, organized topic by topic in sets of 25. Every answer explained, with the rule it comes from.

6 full mock exams

6 full-length timed mock exams per exam, with real question counts and time limits, so test day feels like practice day.

Exam Readiness Score

One 0 to 100 number that tells you when you're ready to book. Reach 80 and you're covered by our Pass Guarantee.

800 flashcards + spaced repetition

800 flashcards per exam, in a deck for each topic, that come back right before you'd forget them. Five minutes a day keeps every number fresh.

60 comprehensive key notes

60 key notes per exam, split across its topics and each explained in full: the concepts, worked exam examples, the traps examiners use and a quick recap. Your first set is free with an account.

Mind maps

See the whole exam on one screen: every topic and the facts under it.

Sample questions with answers

These are the questions in the free test above, with answers. Try the test first. You'll learn more by getting some wrong.

1. Which nerve carries general sensation (touch, pain and temperature) from the mucosa of the anterior two-thirds of the tongue?
Answer: Lingual nerve. General sensation from the anterior two-thirds of the tongue travels in the lingual nerve, a branch of the mandibular division of the trigeminal nerve (V3). Taste from the same area is carried by the chorda tympani (VII), whose fibres run with the lingual nerve. The glossopharyngeal nerve supplies both general sensation and taste to the posterior third, and the hypoglossal nerve is motor to the tongue muscles.
2. Below approximately which pH does dental plaque fluid become undersaturated with respect to enamel hydroxyapatite, so that demineralization begins?
Answer: 5.5. The critical pH for enamel is about 5.5 (it varies with the calcium and phosphate in saliva and plaque). Below it, hydroxyapatite dissolves. Fluorapatite is more resistant, with a critical pH of about 4.5, which is one reason fluoride protects enamel. Root dentin and cementum demineralize at a higher pH, around 6.2 to 6.7.
3. Which dental tissue is formed by cells derived from oral ectoderm rather than from neural crest-derived ectomesenchyme?
Answer: Enamel. Enamel is formed by ameloblasts, which come from the inner enamel epithelium of the enamel organ: oral ectoderm. Dentin (odontoblasts), pulp, cementum and the periodontal ligament all come from the dental papilla and follicle, which are neural crest-derived ectomesenchyme.
4. For a full-metal (cast gold) crown on a mandibular molar, approximately how much occlusal reduction is recommended on the functional (buccal) cusps?
Answer: 1.5 mm. Cast metal crowns need about 1.5 mm on functional cusps and about 1.0 mm on non-functional cusps, plus a functional cusp bevel. Metal-ceramic and all-ceramic crowns need more (about 1.5 to 2.0 mm). Too little reduction gives a thin, weak or over-contoured crown; too much risks the pulp and reduces retention.
5. Two implants will replace adjacent missing teeth. What is the minimum recommended distance between the two implant platforms to preserve the interimplant crestal bone?
Answer: 3 mm. At least 3 mm between adjacent implants (and at least 1.5 mm between an implant and a natural tooth) helps prevent the crestal bone loss around each implant from merging, which would flatten the interimplant bone and the papilla.
6. Two periapical radiographs of an unerupted maxillary canine are taken, the second with the tube shifted mesially. On the second film the canine appears to have moved mesially relative to the incisor roots. Where is the canine?
Answer: Palatal to the incisor roots. The tube-shift (SLOB) rule: Same Lingual, Opposite Buccal. An object that moves in the same direction as the tube is on the lingual (palatal) side. A buccal object moves the opposite way. Cone-beam CT can add detail, but parallax radiographs already answer the buccal-palatal question.
7. A 45-year-old woman has well-defined radiolucencies with central radiopacities at the apices of several mandibular incisors, found on a routine radiograph. All the teeth respond normally to cold and electric pulp testing and she has no symptoms. What is the most appropriate management?
Answer: Periodic clinical and radiographic follow-up with no active treatment. Vital teeth with mixed periapical lesions in the mandibular incisor region of a middle-aged woman are typical of periapical cemento-osseous dysplasia. It needs no treatment, just monitoring. Root canal treatment on vital teeth is wrong, and surgery risks infecting the poorly vascular sclerotic bone.
8. A patient with a history of stable angina develops crushing chest pain during treatment. You stop, sit the patient upright and call for help. The systolic blood pressure is 130 mmHg. What is the most appropriate first drug?
Answer: Nitroglycerin 0.4 mg sublingually. Chest pain in a known angina patient is treated first with sublingual nitroglycerin (0.4 mg spray or tablet), repeated every 5 minutes up to three doses, provided systolic pressure is adequate and no PDE5 inhibitor has been taken recently. If pain isn't relieved, treat as a possible myocardial infarction: call 911, give chewable ASA and oxygen if needed.
9. Articaine has a much shorter elimination half-life than lidocaine. What is the main reason?
Answer: It has an ester side chain that plasma esterases hydrolyze. Articaine is an amide local anesthetic with a thiophene ring and an ester side chain. Most of it is inactivated in the blood by plasma esterases (to articainic acid) rather than waiting for the liver, so its half-life is about 20 to 40 minutes, compared with about 90 minutes for lidocaine.
10. A healthy 5-year-old has a carious pulp exposure on 8.4 during caries removal. There is no history of spontaneous pain, the tooth isn't mobile and the radiograph shows no furcal or periapical pathology. What is the most appropriate treatment?
Answer: Pulpotomy. A carious exposure in a primary molar with a vital, non-symptomatic pulp and no radicular pathology is treated with a pulpotomy: remove the coronal pulp, achieve hemostasis, place a medicament (e.g. MTA) and restore, usually with a stainless steel crown. Spontaneous pain, swelling or furcal radiolucency would point to pulpectomy or extraction.
11. A 4-year-old needs 8.5 extracted. The permanent first molar 4.6 hasn't erupted yet. Which space maintainer is indicated?
Answer: Distal shoe. A distal shoe has an intra-alveolar extension that guides the unerupted permanent first molar into position. Without it, the first molar drifts mesially as it erupts. A band and loop needs an erupted abutment behind the space, and lingual arches and the Nance appliance are for later stages or bilateral losses.
12. On 3.6, a periodontal probe enters the buccal furcation horizontally but cannot pass through to the lingual. Which Glickman furcation grade is this?
Answer: Grade II. Glickman grade I is incipient (the probe feels the furcation entrance only); grade II is a cul-de-sac with horizontal penetration but not through-and-through; grade III goes through and through but is covered by soft tissue; grade IV goes through and through and is clinically visible.
13. A healthy adult has a localized, fluctuant swelling in the buccal vestibule next to 2.5, which has a necrotic pulp. There is no fever, no spreading swelling and no trismus. What is the most appropriate management?
Answer: Drainage (through the canal or by incision) and pulpectomy, without antibiotics. A localized acute apical abscess without systemic involvement is managed by removing the source and draining the pus: pulpectomy or extraction plus incision and drainage if needed. Current evidence-based guidance (for example the 2019 ADA guideline on antibiotics for dental pain and swelling) advises against antibiotics in immunocompetent patients without systemic signs or spreading infection.
14. A permanent incisor is avulsed and can't be replanted at the scene. Which of these is the most appropriate storage medium while the patient travels to the dentist?
Answer: Milk. Milk keeps periodontal ligament cells alive for a short time because its osmolality is close to physiological. Hanks' Balanced Salt Solution, saline or the patient's saliva are also acceptable. Water is hypotonic and kills the cells quickly, a dry tooth loses PDL viability within about an hour, and antiseptics damage the cells.
15. In a trial, 20% of control patients develop a new carious lesion within two years, compared with 15% of patients using a new varnish. What is the number needed to treat (NNT) to prevent one patient from developing a lesion?
Answer: 20. Absolute risk reduction = 20% − 15% = 5% (0.05). NNT = 1 ÷ ARR = 1 ÷ 0.05 = 20. Twenty patients must use the varnish for two years to prevent one patient developing a lesion. The relative risk reduction, 25%, sounds bigger but describes the same effect.

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  • Spaced repetition + mistakes bank
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  • One NDEB assessment of your choice: the AFK or the ACJ
  • 3,000 practice questions + 6 full mock exams per exam
  • 800 flashcards + 60 key notes per exam, by topic, plus mind maps
  • Spaced repetition + mistakes bank
  • Readiness Score & detailed reports
  • Video lessons as they release
  • Content updates during your access
  • 5 bonuses: high-yield dental values sheet, radiolucency and lesion atlas, study planner and more
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Certification guide

How to become a dentist in Canada as an internationally trained dentist: If your dental degree is from a program not accredited by the Commission on Dental Accreditation of Canada (CDAC), the usual route to practice is the [NDEB Equivalency Process](https://ndeb-bned.ca/equivalency-process/entry-to-practice-graduates-of-non-accredited-dental-programs/): three assessments (the AFK, the ACJ and the NDECC), then the Virtual OSCE for NDEB certification, then a licence from a provincial regulator. Here is the path, what it costs and where candidates get stuck.

AFK exam FAQ

How many questions are on the AFK exam?

200 single-answer multiple-choice questions, with a time limit of 4 hours: two parts of 2 hours each, on one day, with one scheduled break. Format: closed book, single-answer multiple choice, computer-based or paper booklet.

What is the passing score for AFK?

A test-equated, re-scaled score of 75 (the NDEB's standardized passing score); there is no penalty for wrong answers.

How much does the AFK exam cost?

C$1,000 per attempt (fees effective 1 July 2025), plus the one-time C$900 Equivalency Process application fee. The NDEB reviews its fees every year (the current fees took effect on 1 July 2025), so confirm on the NDEB website before you register.

Which languages is the AFK exam offered in?

English and French.

Where do I take the AFK exam?

Computer-based at Prometric test centres (in Canada and select international locations, including Australia and New Zealand) or as a paper booklet at select exam sites in Canada.

Is this AFK practice test free?

Yes. The 15-question practice test on this page is free, with an explanation for every answer and no signup. A free account also unlocks the complete study notes for the first topic. The full AFK prep is Premium at C$207 a month for this exam.

What's in the premium AFK prep?

3,000 practice questions organized topic by topic (Applied Biomedical Sciences: 375; Restorative Dentistry, Prosthodontics and Implants: 375; Oral Medicine, Oral Pathology and Oral Radiology: 375; Pharmacology, Local Anesthesia and Medical Emergencies: 375; Orthodontics, Pediatric, Geriatric and Special Needs Dentistry: 375; Periodontics and Endodontics: 375; Oral Surgery, Trauma, Orofacial Pain and Dental Emergencies: 375; Evidence-Based Dentistry, Prevention, Infection Control and Ethics: 375), 6 full-length timed mock exams of 200 questions, 800 flashcards and 60 comprehensive key notes split across all 8 topics, plus a mistakes bank and the Readiness Score.

Compare AFK with the other NDEB assessment

Related practice tests

NDEB Equivalency Process

NDEB Assessment of Clinical Judgement (ACJ)

The second NDEB Equivalency Process assessment, open once you've passed the AFK. It tests clinical judgement: diagnosis, treatment planning and decision-making from case histories, periodontal charts, photographs and radiographs, plus radiographic interpretation in every section.

15 free questions3,000 premium Qs · 6 mocks · 800 flashcards · 60 key notes
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Exam details are summarized from the official candidate information available in October 2026. the National Dental Examining Board of Canada changes formats and fees, so confirm with The National Dental Examining Board of Canada (NDEB) before you book. AFKQuizBank is not affiliated with the National Dental Examining Board of Canada or Prometric.

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