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ADC Practice Question — CMS Risk Assessment & Classification

recall, no new lesions but existing ICDAS lesions may…

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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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

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

Source: Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Tables 3 & 9
Remy's study tip — Identify the patient’s risk level first, then match the intervention to the risk.

Exam preparation FAQ

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.
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.

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