ADC Practice Question — CMS Fluoride Protocols

Which home fluoride combination is correct for Patient Y (Medium risk)?

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 adults: Patient X (Low risk), Patient Y (Medium risk), Patient Z (Very High — hyposalivation with active anterior lesions). All over 18. Which home fluoride combination is correct for Patient Y (Medium risk)?

A. 1000 ppm toothpaste twice daily, no additional rinse needed, 0.2% CHX applied before bed each night
B. 1000 ppm toothpaste twice daily, 0.05% NaF rinse once daily separate from brushing
C. 5000 ppm toothpaste twice daily, 0.05% NaF rinse once daily separate from brushing
D. 1000 ppm toothpaste twice daily with no additional rinse or antimicrobial agents

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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

Adult home fluoride: Low = 1000 ppm only. Medium = 1000 ppm + 0.05% NaF rinse (separate from brushing). High = 5000 ppm, no rinse. Very High = 5000 ppm + CHX before bed. SOURCE — Evans RW et al. CMS for adults, ADJ 2008;53:83-92, Table 7

Source: Evans RW et al. CMS for adults, ADJ 2008;53:83-92, Table 7

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

Exam preparation FAQ

How do I approach an unfamiliar CMS Fluoride Protocols vignette?

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

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.

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Which home fluoride combination is correct for Patient Y (Medium risk)?

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