ADC Practice Question — CMS Fluoride Protocols

For at-risk children, professional varnish should be applied to which surfaces on newly erupted permanent molars?

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.

Two at-risk children need professional fluoride: Patient P (7 years) and Patient Q (11 years). Both have active lesions. For at-risk children, professional varnish should be applied to which surfaces on newly erupted permanent molars?

A. Occlusal surfaces only — this is the standard application protocol for newly erupted molars at all risk levels
B. Buccal and lingual surfaces — the most caries-susceptible sites on first molars
C. Full-crown coverage — every surface of newly erupted molars receives varnish
D. Occlusal AND approximal surfaces — at-risk children receive broader coverage than Low 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: D

At-risk: 'varnish or GIC to OCCLUSAL AND APPROXIMAL surfaces of newly erupted molars.' Low risk: occlusal only. The approximal addition addresses contact-point caries risk. SOURCE — Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Table 7

Source: Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Table 7

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

Exam preparation FAQ

How are CMS Fluoride Protocols questions structured in the ADC written exam?

ADC CMS Fluoride Protocols 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 Fluoride Protocols?

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

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For at-risk children, professional varnish should be applied to which surfaces on newly erupted permanent molars?

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