What is her risk classification?
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 6-year-old at-risk girl uses 1000 ppm twice daily. Her mother asks about adding a fluoride rinse. At 6-month recall, dmfs unchanged, no new lesions, but existing ICDAS lesions may still be active. At recall, no new lesions but existing ICDAS lesions may still be active. What is her risk classification?
- A. At-risk High — she has been At-risk for a full 6 months without any measurable dmfs improvement
- B. Remains At-risk — existing lesions need confirmed arrest before any reclassification
- C. Low — no new lesions in 6 months satisfies the Low recall criterion directly
- D. Cannot reassess — minimum 12 months must pass before risk is rechecked at all
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Show the answer and cited explanation
Recall risk needs both: <1 new lesion/year AND no progression of existing lesions (arrest confirmed). Without confirmed arrest, she remains At-risk with continued monitoring. SOURCE — Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Tables 3 & 9
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