ADC Practice Question — CMS Risk Assessment & Classification

With 3 new lesions in 12 months, what risk category should be assigned now?

Prevention and cariology questions test evidence-based decision-making — fluoride protocols, caries risk assessment, recall scheduling. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

A 6-year-old recall patient classified At-risk 12 months ago has developed 3 new approximal lesions (C1+) in the last year. She also has Plaque Index = 3 on two sites despite dmfs = 0 at original classification. With 3 new lesions in 12 months, what risk category should be assigned now?

A. Remains At-risk — the At-risk category has no upper boundary for new lesion rate
B. At-risk High — more than 1 new lesion per year at recall triggers this category
C. High — the same term used in adult classification applies identically to children
D. At-risk with intensive management — a sub-category indicating accelerated protocols

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Sources cited

Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more

Show the answer and cited explanation

Correct answer: B

At-risk High (recall only): '>1 new lesion per year.' This child has 3 new in 12 months (>1). Critically, At-risk High is NEVER assigned to new patients — only at recall. SOURCE — Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Table 3

Source: Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Table 3

Remy's study tip — Identify the patient’s risk level first, then match the intervention to the risk.

Exam preparation FAQ

How should I prepare for Preventive Dentistry & Cariology in the ADC exam?

Build competence across all topics. The exam tests application of guidelines to clinical scenarios, not memorisation.

How do I approach an unfamiliar CMS Risk Assessment & Classification vignette?

Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

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