CLINICAL PROCESSES AND PROTOCOLS INTRODUCTION

These guidelines were established for public health programs to ensure use of the appropriate protocols. Some key assumptions include the following:

• If a child does not have caries by age 4, the probability of having caries by age 10 is very low. Therefore we do not recommend sealants on a 6-year old who has no history of caries.
  
  
• Professionally applied fluorides should not be used unless there is a polishing of the teeth due to stains, which removes the outer layer of enamel, or where there are active dental caries.
  
  
• Amalgam restorations must not be used in primary teeth, with the exception of single-surface restorations because two or more surface amalgams easily fracture.