White Spot Professional Intervention — ORE Part 1 MCQ

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EasyDental Public Health & EpidemiologyWhite Spot Professional InterventionORE Part 1

A 7-year-old child has a non-cavitated active white spot lesion on the smooth buccal surface of a lower first permanent molar. Which professional intervention is most appropriate for this lesion?

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Correct answer: E — Apply 2.26% sodium fluoride varnish

Explanation lettering: E = shown as A · D = shown as B · B = shown as D · A = shown as E

A is correct. A non-cavitated active white spot lesion is early enamel caries and should be managed non-operatively. UK guidance strongly recommends professionally applied sodium fluoride varnish for children aged 2 years and over; 2.26% NaF varnish is the established formulation used in preventive care. A composite restoration would unnecessarily remove tooth tissue in a reversible lesion. Silver diamine fluoride is not licensed in the UK for caries prevention or arrest and is principally supported for arresting established caries, especially in primary teeth; it also blackens carious tissue. Extraction is wholly disproportionate. Resin fissure sealant is preventive for susceptible pits and fissures, including a buccal pit where present, but it does not treat a smooth-surface buccal white spot lesion.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP). Prevention and Management of Dental Caries in Children: Professionally-delivered interventions, 2025. https://www.childcaries.sdcep.org.uk/guidance/caries-prevention/professionally-delivered-interventions/