What additional agent does Patient Z (Very High) receive that Patient Y does not?
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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Show the answer and cited explanation
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
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