7.1 Key points for audit

• Oral hygiene status and chairside preventive advice
• Number of patients at high caries risk due to social or demographic factors
• The attendance profile of high caries risk / experience children
• Toothpaste usage and therapeutic appropriateness
• Application of fissure sealants according to British Society of Paediatric Dentistry recommended categories of need
• Sealant maintenance at recall
• Sealant retention
• Use of preventive varnishes in high caries risk patients
• Bitewing radiograph usage and quality in high caries risk patients
• Management of early occlusal caries by sealant restoration
• Management strategies for patients at high caries risk due to xerostomia
• Interdisciplinary management of patients with congenital cardiac defects
• Interdisciplinary management of high caries risk patients on long-term oral medication

7.2 Recommendations for future research

During the retrieval and critical appraisal of evidence for this guideline it became apparent that there is a shortage of high quality, rigorous and methodologically sound research in many areas touching upon the remit of the guideline development group. Recommended areas for further research include:

• Development and evaluation of practical aids to caries risk assessment for 6-16 year olds in a primary care setting.
• Studies of the relative efficacy in the post fluoride toothpaste era of preventive interventions in high caries sub-groups assessing agents singly and in combination.
• Methods of assessing the activity of primary caries lesions.
• Evidence and methodologies to assess reliably the presence and activity of secondary caries.
• Studies evaluating how best clinicians might record and use the information needed for monitoring caries status and activity over time.
• Effectiveness of educating parents and carers of children at high caries risk.
• Bitewing radiograph use in a primary care setting.