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ADC Practice Question — CMS Fluoride Protocols

What additional agent does Patient Z (Very High)…

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. What additional agent does Patient Z (Very High) receive that Patient Y does not?

  • A. 0.2% chlorhexidine once daily before bedtime alongside 5000 ppm toothpaste
  • B. CPP-ACP (Tooth Mousse) paste applied twice daily between meals and at bedtime
  • C. 0.05% NaF rinse three times daily combined with 5000 ppm toothpaste after meals
  • D. Silver diamine fluoride applied at home weekly between professional appointments
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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

Very High: 5000 ppm + 0.2% CHX once daily before bed. NaF rinse is NOT for High/Very High — only Medium risk. CHX targets bacteria that compromised saliva cannot control. 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 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 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.

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