What toothpaste concentration and additional agents…
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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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
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