ADC Practice Question — CMS Lesion Classification & Diagnosis

Code 1 findings alone, is Sophie classified as at-risk?

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.

Sophie's only findings are the Code 1 white spots. No radiolucencies, dmfs + DMFS = 0, no PI = 3 sites, no hypomineralized molars. She drinks fluoridated water. Based on Code 1 findings alone, is Sophie classified as at-risk?

A. No — Code 1 is excluded from risk assessment due to diagnostic unreliability
B. Yes — any visible demineralization on the surface of permanent molars elevates risk level
C. Yes — Code 1 represents the earliest detectable sign of active caries
D. No — but only because she drinks fluoridated water, neutralising the finding

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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

ICDAS Code 1 'not considered to indicate a higher than low risk rating' — two reasons: (1) unreliable diagnosis (poor inter-examiner agreement), (2) fluorosis may mimic Code 1 in fluoridated communities. SOURCE — Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Discussion, p.388

Source: Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, p.388

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

Exam preparation FAQ

How do I approach an unfamiliar CMS Lesion Classification & Diagnosis 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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Code 1 findings alone, is Sophie classified as at-risk?

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