colleague argues this child should be Low risk because…
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 9-year-old has dmfs + DMFS = 0, no white spots, no radiolucencies, no PI = 3 sites. Both upper permanent first molars show yellow-brown opacities with post-eruptive enamel breakdown consistent with Molar Hypomineralization. A colleague argues this child should be Low risk because his sugar intake is minimal and he brushes well. Which CMS principle resolves this?
- A. Protective factors should be weighted equally with clinical presentation at every visit
- B. Low sugar intake overrides clinical signs when dmfs equals zero
- C. Plaque quality modifies the risk category downward by one level
- D. Risk is determined solely by clinical signs, not exposure to risk factors
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Show the answer and cited explanation
CMS principle: risk 'determined solely on an analysis of the severity and extent of presenting clinical and radiographic signs and not from epidemiologic-type considerations.' Exposures are explored to identify causes but do not dictate the category. SOURCE — Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, p.384
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