Caries risk assessment and prevention: strategies for Head Start, Early Head Start, and WIC.
OBJECTIVE
This review updates the evidence regarding caries risk assessment for infants, toddlers, and preschool children and formulates recommendations for preventive strategies for WIC, Head Start, and Early Head Start.


METHODS
Literature on caries risk assessment and preventive strategies for infants, toddlers, and preschool children were reviewed and synthesized. Recommendations for WIC, Head Start, and Early Head Start were made based on the review.


RESULTS
Individual caries risk for children in WIC, Head Start, and Early Head Start should be based on: (1) previous caries experience, (2) precavity lesions, (3) visible plaque, and (4) perceived risk by examiners. Recommended preventive strategies for WIC and Head Start populations include: (1) daily toothbrushing in Head Start centers using fluoridated toothpaste; (2) fluoride varnish application to children enrolled in WIC, Head Start, and Early Head Start; (3) use of chlorhexidine gels and varnishes (following FDA approval); and (4) increased use of sealants on children with precavity pit and fissure lesions.


CONCLUSIONS
Early screening, risk assessment, and preventive programs in WIC, Head Start, and Early Head Start populations hold a great deal of promise for preventing dental decay in high-risk children.
Kanellis
M J
MJ
Department of Pediatric Dentistry, University of Iowa, College of Dentistry, Iowa City 52242, USA. michael-kanellis@uiowa.edu
D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002327:Cariostatic Agents / Q000627:therapeutic use; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D002710:Chlorhexidine / Q000627:therapeutic use; D004245:DMF Index; D003731:Dental Caries / Q000517:prevention & control*; D003733:Dental Caries Susceptibility; D003773:Dental Plaque / Q000145:classification; D018479:Early Intervention, Educational; D005459:Fluorides / Q000627:therapeutic use; D005460:Fluorides, Topical / Q000627:therapeutic use; D005522:Food Services; D005782:Gels; D006801:Humans; D007223:Infant; D008403:Mass Screening; D010895:Pit and Fissure Sealants / Q000627:therapeutic use; D018570:Risk Assessment; D014099:Toothbrushing; D014100:Toothpastes / Q000627:therapeutic use
D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D005460:Fluorides, Topical; D005782:Gels; D010895:Pit and Fissure Sealants; D014100:Toothpastes; D005459:Fluorides; D002710:Chlorhexidine