That the extraction of carious teeth is the most common reason for hospital admission of under 18-year-olds in England suggests that a reappraisal of preventive advice in primary dental care for this age-group is now urgently needed. Dental professionals working under time constraints in areas of social deprivation and high caries prevalence need a simple approach to determining caries risk and simple, acceptable preventive messages to convey to patients. The advice not to give sugar-sweetened food or drink in the hour before bedtime and especially not to put infants to bed with a feeding bottle, other than one containing just water, coupled with supervised twice daily toothbrushing with a fluoride toothpaste containing at least 1000 ppm of fluoride might be a pragmatic way of reducing the burden of caries and the need for hospital admission for a largely preventable disease.
