The AAP policy statement states that “even the most judiciously designed and implemented caries risk assessment tool can fail to identify all infants at risk for early dental caries.” The policy then provides a list of risk factors that should prompt automatic referral to a dentist by 12 months of age.

The following risk groups are listed in the AAP policy statement:

		Children with special health care needs
		Children of mothers with a high caries rate
		Children with demonstrable caries, plaque, demineralization, and/or staining
		Children who sleep with a bottle or sippy cup or breastfeed throughout the night
		Children in families of low socioeconomic status
		Later-order offspring

Any child determined to be at high risk for dental caries based on these risk groups, a formal risk assessment, or physical exam findings should be prioritized for referral to a dental home.

According to the AAP policy statement, “Patients who have been determined to be at risk of development of dental caries or who fall into recognized risk groups should be directed to establish a dental home
6 months after the first tooth erupts or by 1 year of age (whichever
comes first)."