Which of the following is NOT listed as a caries risk indicator?

• A. Oral Hygiene and Plaque
• B. Diet
• C. Exposure to Fluoride
• D. Sugar-Free Gum Use

Answer: (D)

Caries risk indicators are factors that increase the likelihood of decay; anything that lowers risk is not considered a risk indicator. Sugar-free gum use does not raise caries risk. In fact, it can help prevent decay by stimulating saliva flow, which buffers acids and aids in remineralization, and if it contains xylitol it can inhibit harmful bacteria. The other items describe conditions that raise risk: poor oral hygiene with plaque increases the bacterial load and acid production, and a diet high in fermentable sugars provides more substrate for acid formation. Fluoride exposure is typically protective rather than a risk factor, but the key point here is that sugar-free gum use is not a risk indicator, making it the correct choice.