ADC Practice Question — CMS Lesion Management Protocols

For the C4 on tooth 26, what determines whether this Medium risk patient needs restoration?

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 45-year-old Medium risk man has tooth 16 mesial with C3 radiolucency (just beyond DEJ) and tooth 26 distal with a new C4 radiolucency (outer 1/3 dentine). No clinical cavitation visible. For the C4 on tooth 26, what determines whether this Medium risk patient needs restoration?

A. Whether the patient consents to operative treatment after risk counselling and discussion
B. Whether the radiolucency extends fully 1/3 into dentine or separation shows cavitation
C. Whether the tooth is symptomatic on percussion or cold testing
D. Whether the lesion has progressed since the previous bitewing series

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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

Low/Medium C4: restore only if (1) radiolucency extends fully 1/3 into dentine, or (2) separation confirms cavitation. Otherwise, do not restore — surface is more likely non-cavitated. SOURCE — Evans RW et al. CMS for adults, ADJ 2008;53:83-92, Table 5, C4 further consideration

Source: Evans RW et al. CMS for adults, ADJ 2008;53:83-92, Table 5

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 Management Protocols vignette?

Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

How should I prepare for Preventive Dentistry & Cariology in the ADC exam?

Build competence across all topics. The exam tests application of guidelines to clinical scenarios, not memorisation.

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For the C4 on tooth 26, what determines whether this Medium risk patient needs restoration?

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