Despite zero caries experience, what is this child's…
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. Despite zero caries experience, what is this child's risk classification?
- A. At-risk — hypomineralized first molars elevate risk even with zero caries
- B. Low — zero caries and no radiolucencies satisfy all Low criteria
- C. At-risk High — structural defects indicate the most severe category
- D. Low with monitoring — hypomineralization is noted but does not change class
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Mixed/permanent risk includes: 'dmfs + DMFT = 0 but 6s or 7s are hypomineralized or hypoplastic' → At-risk. This criterion is unique to the children's CMS. SOURCE — Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Table 4
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