ADC Practice Question — CMS Lesion Classification & Diagnosis

CPI probe dropping into a hard-based recess on tooth…

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.

A 12-year-old has an existing sealant on tooth 46 with enamel breakdown along its margin judged to be caries-induced. On tooth 36, a suspect fissure shows a white area after air drying, and the WHO CPI probe ball-end drops into a hard-based recess. The CPI probe dropping into a hard-based recess on tooth 36 confirms what clinical finding?

A. A Code 2 lesion requiring fluoride varnish application only
B. Dentine exposure scored as ICDAS Code 5 requiring urgent restoration
C. Enamel breakdown — confirming the lesion as ICDAS Code 3 or higher
D. An inconclusive finding requiring bitewing radiograph for diagnosis

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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: C

WHO CPI probe: ball-end into HARD-based recess = enamel breakdown confirmed (Code 3+). Ball-end drops out of sight into SOFT-based cavity = into dentine (Code 5). Visible dentine base = Code 6. SOURCE — Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, p.383

Source: Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, p.383

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Exam preparation FAQ

Should I memorise guidelines word-for-word for CMS Lesion Classification & Diagnosis?

Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.

How are CMS Lesion Classification & Diagnosis questions structured in the ADC written exam?

ADC CMS Lesion Classification & Diagnosis questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

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CPI probe dropping into a hard-based recess on tooth…

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