ADC Practice Question — CMS Lesion Classification & Diagnosis

The caries-induced enamel breakdown along the sealant margin on tooth 46 receives which code?

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 12-year-old has an existing sealant on tooth 46 with enamel breakdown along its margin judged to be caries-induced. On tooth 36, a suspect fissure shows a white area after air drying, and the WHO CPI probe ball-end drops into a hard-based recess. The caries-induced enamel breakdown along the sealant margin on tooth 46 receives which code?

A. Code 0 — marginal defects along sealants are always coded normal
B. Code 2 — demineralization adjacent to a sealant is classified the same as a white spot
C. Code 4 — breakdown near a restoration indicates dentine involvement
D. Code 3 — caries-induced enamel breakdown along a sealant is CARS Code 3

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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

CARS: non-caries marginal defects = Code 0. Code 3 assigned when enamel breakdown along the margin is judged caries-induced, or occurs within/alongside an existing non-caries defect. SOURCE — Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Table 2, CARS note

Source: Evans RW, Dennison PJ. CMS for children, ADJ 2009;54:381-389, Table 2

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Exam preparation FAQ

How do I approach an unfamiliar CMS Lesion Classification & Diagnosis 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?

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