ADC Practice Question — CMS Risk Assessment & Classification

Despite the favourable risk factor profile, what classification should be assigned?

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 new adult patient has excellent oral hygiene, low sugar diet, fluoridated water, no family caries history. However, bitewings reveal C4 on two approximal surfaces and extensive white spot lesions on four premolars. Despite the favourable risk factor profile, what classification should be assigned?

A. Low — excellent habits and fluoride exposure indicate minimal disease risk
B. Medium — white spots suggest some activity but the strong protective habits are offsetting risk
C. Medium — C4 radiolucencies alone cannot override strong protective factors
D. High — extensive white spots and C4 radiolucencies define this classification

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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: D

High risk: frank cavities AND/OR extensive white spots AND/OR C5. This patient has extensive white spots + C4. CMS: risk determined 'solely by clinical presentation,' not by weighing signs against factors. SOURCE — Evans RW et al. CMS for adults, ADJ 2008;53:83-92, Table 4

Source: Evans RW et al. CMS for adults, ADJ 2008;53:83-92, Table 4

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

Exam preparation FAQ

Should I memorise guidelines word-for-word for CMS Risk Assessment & Classification?

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

How are CMS Risk Assessment & Classification questions structured in the ADC written exam?

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

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Despite the favourable risk factor profile, what classification should be assigned?

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