Effects of graded prevention intervention combined with minimally invasive restoration on the oral health trajectory of caries-susceptible children.

Caries-susceptible children show progressive oral health decline caused by ecological imbalance, poor saliva function and unhealthy habits. Conventional single-mode interventions fail to deliver precise and sustained control. This prospective, single-center, randomized controlled trial investigated graded prevention plus minimally invasive restoration for improving oral health trajectory in these children, to support precise caries control. A total of 186 caries-susceptible children aged 3-6 years were randomly assigned to observation and control groups (n = 93 each). The control group received routine oral care, fluoridation and traditional fillings. The observation group received risk-stratified prevention and minimally invasive restoration. All children were followed up for 12 months. Oral reexaminations were performed at 1, 3, 6, and 12 months after intervention, and longitudinal data were analyzed using repeated-measures ANOVA. After follow-up, the observation group had significantly lower dmfs, PLI and SBI (p < 0.01), and a much lower new caries rate (8.60% vs. 32.26%, p < 0.05). Stratified analysis confirmed better effects in 5-6-year-olds and high-risk children. Multivariate Logistic regression adjusted for socioeconomic status, caregiver education level, daily sugar intake frequency, toothbrushing frequency, and mouth breathing showed that the combined regimen and good oral hygiene were protective factors, while high caries risk, frequent sugar intake, and mouth breathing were risk factors. The 12-month restoration retention rate was also higher (96.77% vs. 82.80%, p < 0.05). This combined approach effectively delays caries, improves periodontal health, lowers new caries risk and enhances retention, especially in 5-6-year-old and high-risk children. This combined regimen effectively reshapes the oral health trajectory and may be cautiously applied in clinical practice for precise prevention and control of childhood caries.