High-Fluoride Toothpaste — ORE Part 1 MCQ
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Correct answer: C — 5000 ppm fluoride
Explanation lettering: B = shown as A · E = shown as B · A = shown as C · C = shown as D · D = shown as E
5000 ppm fluoride (option A) is the recommended prescription concentration for patients with active root caries in UK dental practice. Current evidence-based guidance and the REFLECT trial specifically evaluate and recommend 5000 ppm fluoride toothpaste as the high-strength prescription option for high-risk patients, particularly older adults with active root caries. Although 2800 ppm is also prescribed for increased-risk children and adults, 5000 ppm is the primary recommendation for active root caries management. Options C and D (1450 ppm and 1000 ppm) are standard over-the-counter strengths, not prescription high-fluoride concentrations. Option E (10000 ppm) exceeds safe therapeutic concentrations and is not used in dental practice.
Reference: UK Government. Delivering Better Oral Health: An Evidence-Based Toolkit for Prevention. Chapter 9: Fluoride. https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention/chapter-9-fluoride (Updated September 2025); REFLECT Trial collaborative group. Protocol for a randomised controlled trial to evaluate the effectiveness and cost benefit of prescribing high dose fluoride toothpaste in preventing and treating dental caries in high-risk older adults. BMC Oral Health. 2019.