ADC Practice Question — CMS Fluoride Protocols

With reclassification to Low, the complete fluoride…

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

A 55-year-old was classified High risk 18 months ago. Since then: zero new lesions, all existing radiolucencies stable (no progression), plaque score improved from 28/36 to 8/36, home care goals achieved (5000 ppm daily, good brushing technique). The dentist reassesses the risk classification and management. With reclassification to Low, the complete fluoride protocol changes. What is the new home AND professional protocol?

A. Home: 1000 ppm twice daily, no rinse, no CHX. Professional: varnish on wisdom teeth, yearly on lesions until arrested, gel at recall for maintenance
B. Home: 5000 ppm continues indefinitely once started — stepping down risks relapse. Professional: 3-monthly varnish continues for 12 months post-reclassification
C. Home: 1000 ppm twice daily, rinse once daily. Professional: varnish on all surfaces 6-monthly until all lesions regress
D. Home: no fluoride toothpaste needed at Low risk. Professional: no professional fluoride — Low risk patients receive no clinical intervention

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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: A

Integration: Home (Table 7) Low = 1000 ppm twice daily, no rinse, no CHX. Professional (Table 6) Low = varnish/GIC wisdom teeth + yearly on lesions + gel at recall for maintenance. FIVE protocol changes from High → Low. SOURCE — Evans RW et al. CMS for adults, ADJ 2008;53:83-92, Tables 6, 7

Source: Evans RW et al. CMS for adults, ADJ 2008;53:83-92, Tables 6, 7

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

Exam preparation FAQ

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.

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.

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With reclassification to Low, the complete fluoride…

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