This commentary is about one of the last great challenges facing dental public health. It is a problem I will discuss in a United Kingdom context, but the issues will, I am sure, be of relevance to all readers of this Journal wherever they practice. It is a problem that I spent many hours trying to address when I was in the early stages of my career. Now, when I am nearer the end than the beginning, it is still a problem. The issue? Preventing dental decay in those ag ed under 3 years old, who in the main, reside in areas of social and economic disadvantage.