ADC Practice Question — CMS Fluoride Protocols

What toothpaste concentration and additional agents does EACH child receive?

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.

Three siblings all classified at-risk: Child A is 15 months old. Child B is 4 years old. Child C is 14 years old. The dentist prescribes home fluoride for each. The family does NOT drink fluoridated water. What toothpaste concentration and additional agents does EACH child receive?

A. All three: 1000 ppm twice daily — the CMS uses one concentration for all at-risk children regardless of age
B. A: 400 ppm, no rinse, no CHX. B: 1000 ppm, no rinse, no CHX. C: 1000 ppm, rinse from age 10, no CHX (CHX only for at-risk-high)
C. A: no fluoride toothpaste (under 18 months). B: 400 ppm. C: 5000 ppm plus rinse plus CHX
D. A: 400 ppm. B: 1000 ppm. C: 5000 ppm plus rinse plus CHX — all at-risk children over 10 get the triple protocol

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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

Integration across Table 8 — three age bands for at-risk: (1) Before 18 months: 400 ppm, no rinse, no CHX. (2) 18 months–5 years: 1000 ppm, no rinse, no CHX. (3) 6–17 years: 1000 ppm, rinse available from age 10, CHX only for at-risk-HIGH. Three rows, one risk level, different outputs. SOURCE — Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Table 8

Source: Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Table 8

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

Exam preparation FAQ

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.

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.

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What toothpaste concentration and additional agents does EACH child receive?

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