ADC Practice Question — CMS Fluoride Protocols

Should fluoride gel be used for this Medium risk patient's professional application?

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 dental assistant prepares 1.23% NaF gel for a 35-year-old Medium risk woman at her 6-month recall for professional fluoride. Should fluoride gel be used for this Medium risk patient's professional application?

A. Yes — gel is the standard agent for professional fluoride in all adults
B. Yes — gel at 12,300 ppm is preferred because it covers more surface area
C. No — gel is not appropriate for any adult and should only be used in children
D. No — gel is only for Low risk adults at recall to maintain arrested lesions

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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: D

Adult professional fluoride: gel is ONLY for Low risk adults at recall for maintenance. Medium and High: 'NOT APPLICABLE.' These patients receive varnish (Duraphat 5% NaF, 22,600 ppm). SOURCE — Evans RW et al. CMS for adults, ADJ 2008;53:83-92, Table 6

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

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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Should fluoride gel be used for this Medium risk patient's professional application?

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