Child caries risk
Consider past disease, diet, fluoride, access to care and social context. Prevention involves the child and carers in a non-judgemental plan.
Understand
Previous caries is a strong signal of future disease. Diet, fluoride, brushing support, saliva, deprivation and access to care shape risk and ability to act.
Assess
Ask carers about routine, not only knowledge: bedtime drinks, snacks, toothpaste concentration and supervision. Examine active lesions and plaque-retentive sites.
Apply
Agree a realistic family plan and revisit it. Treatment of cavities without sustained prevention leaves new disease likely, especially after care under GA.
Key distinctions
Risk assessment includes past lesions, but also family routines, sugar availability, toothpaste use, supervision, saliva and social barriers. A child with several active cavitated lesions may need immediate operative care and intensive prevention in parallel. Use non-judgemental questions so carers can describe real routines instead of what they think the clinician wants to hear.
Think through a case
A child has several new lesions after hospital GA. The clinical question is what family routine and access barriers were left unchanged, as well as which teeth need care.
The distinction to remember
Do not let a complete operative episode be mistaken for control of the disease process.
Test your recall
Is an early childhood lesion simply a local tooth problem?
Show answer
No; it signals a broader disease-risk and support need.