ADC Practice Question — CMS Risk Assessment & Classification

Saliva flow is 0.8 mL per 2 minutes with High risk.…

Q: How do I approach an unfamiliar CMS Risk Assessment & Classification vignette?

Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

Q: How should I prepare for Preventive Dentistry & Cariology in the ADC exam?

Build competence across all topics. The exam tests application of guidelines to clinical scenarios, not memorisation.

Prevention and cariology questions test evidence-based decision-making — fluoride protocols, caries risk assessment, recall scheduling. This high-difficulty vignette tests your ability to work through clinical details and arrive at the correct management.

A 42-year-old new patient presents with: one untreated frank cavity on tooth 36, a C4 radiolucency on mesial of tooth 46, C3 on distal of tooth 16, extensive white spot lesions on buccal surfaces of 13-23, and stimulated saliva flow of 0.8 mL per 2 minutes. She uses 1000 ppm toothpaste twice daily. Saliva flow is 0.8 mL per 2 minutes with High risk. This combination triggers what additional action AND protocol upgrade?

A. No action — saliva testing is only performed for Medium risk patients in the CMS
B. Further investigation of hyposalivation AND upgrade to Very High fluoride protocol (5000 ppm + CHX before bedtime)
C. Further investigation only — the fluoride protocol does not change based on saliva findings
D. Immediate referral to oral medicine — all patients with <1 mL saliva require specialist management regardless of caries risk

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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

Integration: (1) <1 mL/2min = below threshold. (2) + High risk = investigate hyposalivation (p.85). (3) Hyposalivation is a Very High trigger (Table 7 footnote). (4) Very High = 5000 ppm + CHX before bed. Four steps from three different sections. SOURCE — Evans RW et al. CMS for adults, ADJ 2008;53:83-92, p.85, Table 7

Source: Evans RW et al. CMS for adults, ADJ 2008;53:83-92, p.85 & Table 7

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

Exam preparation FAQ

How do I approach an unfamiliar CMS Risk Assessment & Classification vignette?

Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

How should I prepare for Preventive Dentistry & Cariology in the ADC exam?

Build competence across all topics. The exam tests application of guidelines to clinical scenarios, not memorisation.

Every answer, traced to the source.

Remy — the AI tutor inside Reviz — drills you on 7,000+ ADC-style cited questions with spaced repetition, on WhatsApp and the web.

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Saliva flow is 0.8 mL per 2 minutes with High risk.…

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