The principles behind risk assessment are that environmental, genetic, and behavioral factors contribute to the emergence of disease and that identification and elimination of these contributing factors can prevent or delay disease. Research has provided associations and causality of factors that can be used to predict the emergence of dental caries. The more risk factors a person has, the greater the likelihood that he or she will experience caries. Diet, fluoride status, and bacteria status can all be risk factors for dental caries.

Diet

Each time sugar is consumed and plaque is present, the pH level in the oral cavity drops. If enough plaque and sugar are present, the pH level may drop below the critical level of 5.5, which is believed to be the point of caries initiation. If this drop occurs often enough, the oral cavity environment supports demineralization of the tooth, and dental caries develops.

Instead of drinking milk or water, many young children consume beverages high in sugar (e.g., fruit drinks, soda, fruit juice). In addition, many children continue to drink from a bottle well into the third year of life and to sleep with a bottle or sippy cup or carry one around during the day. Preventive efforts aim to change these habits—or prevent them from starting—to reduce children’s overall sugar intake as well as the frequency of intake.

In assessing for dietary risk among young children, oral health professionals need to obtain the following information:

• Does the child drink beverages high in sugar (e.g., fruit drinks, soda, fruit juice) from a bottle or sippy cup?
• Does the child eat foods high in sugar (e.g., candy, cookies, cake)?
• How often does the child consume food high in sugar?

For more information about healthy feeding and eating practices for young children, see Open Wide: Oral Health Training for Health Professionals.

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