Which single additional finding would reclassify this patient to Medium risk?
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 38-year-old man presents as a new patient. No visible caries, no white spots, no cavitation. Bitewings show C2 radiolucencies on mesial of teeth 36 and 46. Plaque Index 8/36. Which single additional finding would reclassify this patient to Medium risk?
- A. A Plaque Index score rising from 8 to 22 out of 36
- B. Stimulated saliva flow dropping below 0.5 mL per minute
- C. Sticky pits detected on occlusal surfaces of teeth 17 and 27
- D. A diet history revealing five or more between-meal sugar exposures daily
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Show the answer and cited explanation
Medium requires: no frank cavitation, may have sticky pits/fissures, BW ≤ C4. Sticky pits are a clinical sign that moves a patient from Low to Medium. CMS risk is determined by clinical signs, not risk factors. SOURCE — Evans RW et al. CMS for adults, ADJ 2008;53:83-92, Table 4
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