AFK Exam Study Guide (2026)
Everything the NDEB Assessment of Fundamental Knowledge (AFK) tests, topic by topic: what each section covers, the facts that come up most, and how to study it. Pair it with the free 15-question practice test.
The exam at a glance
| Questions | 200 single-answer multiple-choice questions |
|---|---|
| Time | 4 hours: two parts of 2 hours each, on one day, with one scheduled break |
| Passing score | A test-equated, re-scaled score of 75 (the NDEB's standardized passing score); there is no penalty for wrong answers |
| Format | Closed book, single-answer multiple choice, computer-based or paper booklet |
| Certifying body | The National Dental Examining Board of Canada (NDEB) |
| Test provider | 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 |
Mind map: the whole exam on one screen
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.
1. Applied Biomedical Sciences
The largest AFK area (about 20%): anatomy, biochemistry, biomaterials, cariology, growth and development, histology, immunology, microbiology, oral embryology and physiology, all applied to dentistry.
Key facts
- Trigeminal nerve: V2 supplies the maxillary teeth (posterior, middle and anterior superior alveolar nerves); V3 supplies the mandibular teeth (inferior alveolar), the anterior tongue (lingual) and the muscles of mastication.
- Taste from the anterior two-thirds of the tongue: chorda tympani (VII). Posterior third: glossopharyngeal (IX) for taste and general sensation. Tongue movement: hypoglossal (XII).
- Enamel comes from oral ectoderm (ameloblasts); dentin, pulp, cementum and PDL come from neural crest-derived ectomesenchyme.
- Caries needs a susceptible tooth, fermentable carbohydrate, acidogenic bacteria and time. Mutans streptococci are linked to initiation and lactobacilli to progression.
- Critical pH: about 5.5 for enamel hydroxyapatite, about 4.5 for fluorapatite, about 6.2 to 6.7 for root dentin.
- Dental materials: glass ionomer bonds chemically and releases fluoride; composite shrinks on polymerization; amalgam's high-copper alloys reduce the weak gamma-2 phase.
- Immunology: type I hypersensitivity (IgE) causes anaphylaxis, including latex allergy; type IV (T-cell, delayed) causes allergic contact dermatitis to latex accelerators and acrylic monomer.
Flashcards
Exam tip: AFK biomedical questions are usually one fact deep. Revise them with flashcards every day rather than by rereading textbooks.
2. Restorative Dentistry, Prosthodontics and Implants
About 16% of the AFK: operative dentistry and caries management, crowns and bridges, removable partial and complete dentures, and dental implants.
Key facts
- Tooth reduction for crowns: cast metal about 1.5 mm functional and 1.0 mm non-functional cusps; metal-ceramic and all-ceramic about 1.5 to 2.0 mm.
- Retention and resistance depend on taper (ideally about 6 degrees total), wall height, surface area and auxiliary features such as grooves and boxes.
- A ferrule of 1.5 to 2 mm of sound tooth improves the fracture resistance of post-retained teeth; posts retain cores and don't strengthen roots.
- Kennedy classes: I bilateral free-end, II unilateral free-end, III bounded, IV single anterior bounded saddle crossing the midline.
- Complete dentures: freeway space is normally about 2 to 4 mm; loss of vertical dimension contributes to angular cheilitis.
- Implant spacing: at least 1.5 mm from an adjacent tooth and 3 mm between implants.
- Peri-implant mucositis is reversible inflammation without bone loss; peri-implantitis adds progressive bone loss.
Flashcards
Exam tip: Many prosthodontics questions are numbers. Make a one-page list of reductions, distances and angles and test yourself on it weekly.
3. Oral Medicine, Oral Pathology and Oral Radiology
About 15% of the AFK: recognizing and managing mucosal disease, benign and malignant lesions, cysts and tumours of the jaws, and radiographic technique, interpretation and radiation safety.
Key facts
- Persistent white or red patches that don't resolve 2 to 3 weeks after removing a cause need a biopsy. Erythroplakia carries a higher risk than leukoplakia.
- Highest-risk intraoral sites for squamous cell carcinoma: lateral and ventral tongue and floor of mouth.
- Periapical cemento-osseous dysplasia: vital mandibular incisors, middle-aged women; no treatment, just follow-up.
- Dentigerous cyst: radiolucency around the crown of an unerupted tooth, attached at the CEJ. Odontogenic keratocyst: posterior mandible, high recurrence.
- Tube-shift (SLOB) rule: Same Lingual, Opposite Buccal.
- ALARA: justify each radiograph, use rectangular collimation, fast receptors (digital or F-speed film) and thyroid collars where they don't block the area of interest.
- Candidiasis: pseudomembranous plaques wipe off; erythematous form under dentures; angular cheilitis at the commissures.
Flashcards
Exam tip: For any vital tooth with a periapical lesion, think of a non-endodontic cause before you think of root canal treatment.
Test yourself on these topics
Take the free 15-question AFK test, then save your results to unlock your Readiness Score and the mistakes bank.
4. Pharmacology, Local Anesthesia and Medical Emergencies
About 14% of the AFK: drugs used and encountered in dentistry, local anesthetic pharmacology and doses, and recognizing and managing medical emergencies in the dental office.
Key facts
- Lidocaine 2% is 20 mg/mL; a 1.8 mL cartridge contains 36 mg. 4% articaine contains 72 mg per 1.8 mL cartridge.
- Common maximum doses: lidocaine with epinephrine 7 mg/kg (max 500 mg); articaine 7 mg/kg (max 500 mg); mepivacaine 6.6 mg/kg (max 400 mg).
Flashcards
Exam tip: Emergency questions ask for the first drug. Epinephrine for anaphylaxis, nitroglycerin for angina, glucose for hypoglycemia, salbutamol for asthma.
5. Orthodontics, Pediatric, Geriatric and Special Needs Dentistry
About 8% of the AFK: growth and development, malocclusion and interceptive orthodontics, pediatric caries and pulp therapy, space maintenance, and care of older adults and patients with special needs.
Key facts
- Angle Class I: mesiobuccal cusp of the upper first molar in the buccal groove of the lower first molar. Class II: lower molar distal. Class III: lower molar mesial.
- Primary molar pulp therapy: pulpotomy for a vital, symptom-free carious exposure; pulpectomy or extraction for irreversible pulpitis, necrosis or radicular pathology.
Flashcards
Exam tip: Space maintainer questions turn on one fact: has the first permanent molar erupted yet?
6. Periodontics and Endodontics
Periodontics (about 8%) and endodontics (about 6%): periodontal anatomy, classification, diagnosis and therapy; pulp and periapical diagnosis, endodontic treatment and emergencies.
Key facts
- 2017 classification: periodontitis is staged (I to IV, severity and complexity) and graded (A to C, rate of progression; smoking 10 or more a day or HbA1c 7.0% or more means Grade C).
- Glickman furcation grades: I incipient, II cul-de-sac, III through-and-through under soft tissue, IV through-and-through and visible.
Flashcards
Exam tip: In endodontic diagnosis, give two labels: one for the pulp and one for the apical tissues.
7. Oral Surgery, Trauma, Orofacial Pain and Dental Emergencies
About 8% of the AFK: extractions and their complications, third molars, dentoalveolar trauma, temporomandibular disorders and orofacial pain, and urgent dental problems.
Key facts
- Avulsion: replant immediately if possible; otherwise store in milk, HBSS, saline or saliva; flexible splint for about 2 weeks; root canal treatment within 2 weeks for closed apices.
- Never replant an avulsed primary tooth.
Flashcards
Exam tip: Trauma questions often hinge on whether the tooth is primary or permanent and whether the apex is open or closed. Find those facts first.
8. Evidence-Based Dentistry, Prevention, Infection Control and Ethics
About 5% of the AFK: study design and statistics, caries and periodontal prevention, infection prevention and control, and ethics and jurisprudence in Canadian dental practice.
Key facts
- Evidence hierarchy for therapy: systematic reviews of randomized controlled trials, then individual RCTs, cohort studies, case-control studies, case series and expert opinion.
- NNT = 1 ÷ absolute risk reduction. Sensitivity finds true positives; specificity finds true negatives.
Flashcards
Exam tip: Statistics questions are quick marks if you write the 2×2 table first. Do the arithmetic before reading the options.
How to pass
- 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.
Frequently asked questions
How long should I study for the AFK exam?
Most working candidates need 4 to 8 weeks at 45 to 60 minutes a day. Book your exam once your Readiness Score has stayed at 80 or higher for about a week.
Can I take the AFK exam online?
No. The NDEB doesn't offer the AFK or ACJ by remote proctoring. The ACJ is taken at Prometric test centres in Canada and select international locations; the AFK is taken at Prometric test centres or as a paper booklet at select exam sites in Canada. Format: closed book, single-answer multiple choice, computer-based or paper booklet. Check the current NDEB Protocol for the rules.
What score do I need to pass the AFK exam?
A test-equated, re-scaled score of 75 (the NDEB's standardized passing score); there is no penalty for wrong answers. The exam has 200 single-answer multiple-choice questions and a time limit of 4 hours: two parts of 2 hours each, on one day, with one scheduled break.
What are the most tested topics?
The outline covers applied biomedical sciences, restorative dentistry, prosthodontics and implants, oral medicine, oral pathology and oral radiology, pharmacology, local anesthesia and medical emergencies, orthodontics, pediatric, geriatric and special needs dentistry, periodontics and endodontics, oral surgery, trauma, orofacial pain and dental emergencies, evidence-based dentistry, prevention, infection control and ethics. Use the free practice test to see which ones you need most.
The premium AFK study path
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.
Your step-by-step study path
- 1Applied Biomedical Sciences8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Notes free with an account
- 2Restorative Dentistry, Prosthodontics and Implants8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- 3Oral Medicine, Oral Pathology and Oral Radiology8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- 4Pharmacology, Local Anesthesia and Medical Emergencies8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- 5Orthodontics, Pediatric, Geriatric and Special Needs Dentistry7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- 6Periodontics and Endodontics7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- 7Oral Surgery, Trauma, Orofacial Pain and Dental Emergencies7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- 8Evidence-Based Dentistry, Prevention, Infection Control and Ethics7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25Premium
- Final step: 6 full mock exams200 questions each, timed like test day. Pass them, then book your exam.Premium
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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
- Pass Guarantee: complete the prep, pass or 100% back
Renews once a year until you cancel. We email you before each renewal. Cancel any time from your account; you keep access until the end of the year you've paid for.
Summarized from the National Dental Examining Board of Canada's official candidate information and the rules cited, checked October 2026. Confirm current requirements with The National Dental Examining Board of Canada (NDEB).