Caries risk assessment and prevention: strategies for Head Start, Early Head Start, and WIC.

OBJECTIVES 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.