ADC Practice Question — CMS Fluoride Protocols

Child B (3 years, Low risk, fluoridated water) should…

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.

Three children: Child A (15 months, Low risk), Child B (3 years, Low risk, fluoridated water), Child C (8 years, At-risk). Child B (3 years, Low risk, fluoridated water) should use which concentration?

A. 1000 ppm — standard for all children over 18 months regardless of water source
B. 400 ppm — Low risk, 18 months to 5 years, on fluoridated water uses this concentration
C. No fluoride toothpaste — children under 6 years should avoid fluoride paste in fluoridated water areas
D. 5000 ppm — high concentration needed due to thinner primary tooth enamel

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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

Low risk, 18mo-5yr, fluoridated water: 400 ppm. Conditional upgrade to 1000 ppm ONLY 'if not drinking fluoridated water.' This distinction is a key exam trap. SOURCE — Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Table 8

Source: Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Table 8

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

Exam preparation FAQ

Should I memorise guidelines word-for-word for CMS Fluoride Protocols?

Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.

How are CMS Fluoride Protocols questions structured in the ADC written exam?

ADC CMS Fluoride Protocols questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

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Child B (3 years, Low risk, fluoridated water) should…

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