Validated standard-setting methods for multiple choice questions in dental education will ensure fairness and defensibility. However, many tertiary institutions in Nigeria still depend on arbitrary cut off scores. Written assessments in dental and medical education increasingly rely on multiple choice questions (MCQs) that target higher levels of Bloom’s taxonomy rather than simple recall. This study explored the familiarity, training and current practices of clinical dental teachers regarding established standard setting approaches and examined their Angoff judgments for two clinical vignette MCQs designed to assess higher order cognition. A descriptive cross sectional electronic survey was completed by 65 clinical teachers across major dental specialties. Sample reflected established teachers rather than novices. Many respondents reported low familiarity with standard setting method particularly for the Ebel, borderline, contrasting groups and blueprinting methods.44.6% reported attending workshops, courses or seminars on standard setting or MCQ construction, whereas 55.4% reported only self study or no training at all. The pattern across methods suggests that formal training is particularly impactful for familiarity with the Angoff method. Challenges identified included time constraint, insufficient training opportunities, limited access to materials and software, and absence of formal standard setting panels. Participants expressed strong interest in workshops, guidelines, mentorship, and analytical tools. The findings highlight critical gaps in the application of standard setting methods in Nigerian dental education and underscore the need for institutionalised faculty development, clearer definitions of borderline competence, and routine psychometric analysis to enhance the validity and defensibility of MCQ based assessments.