ADC Practice Question — Caries risk assessment

Which factor should most influence the decision between extraction and endodontic treatment?

Caries risk assessment questions in the ADC written exam test your ability to apply the Caries Management System — risk classification, fluoride protocols, and lesion management. This exam-level vignette tests clinical reasoning, not recall.

A 17-year-old male has a grossly carious nonvital mandibular right first molar with a periapical abscess. The caries is extensive and restoration will be complex and expensive. The tooth has drifted mesially, losing its contact with the second premolar. The patient says he doesn't mind having a gap if extraction is simpler. Which factor should most influence the decision between extraction and endodontic treatment?

A. The patient's preference for extraction, which should be respected
B. The condition and long-term prognosis of the other molar teeth
C. The cost and complexity of endodontic treatment compared to extraction
D. The fact that the missing tooth would not be readily visible

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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

If other molars are also compromised and likely to be lost in the short or medium term, it makes sense to conserve whichever teeth can be successfully restored — losing multiple molars has far greater functional consequences than losing one. The decision depends on the broader prognosis of the dentition, not just this single tooth.

Source: Odell 4th Edition, Case 1: A HIGH CARIES RATE

Remy's study tip — For caries vignettes, classify risk level first — the management decision follows directly from the CMS risk table.

Exam preparation FAQ

Should I memorise guidelines word-for-word for Caries risk assessment?

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

How are Caries risk assessment questions structured in the ADC written exam?

ADC Caries risk assessment questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

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Which factor should most influence the decision between extraction and endodontic treatment?

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