Caries protocol compliance issues.

Any caries control or caries protocol program must consider compliance as a measure of success. Lower bacterial counts on saliva tests and lower defs and DMFS scores suggest that some change has occurred. However, compliance with a caries risk protocol is about more than simple and convenient clinical outcome measures. We tend to think of compliance as an individual activity, but all influences on an individual need to be considered. Change may be from external influences rather than from the individual or even from providers interacting with an individual or community. Few studies have directly addressed caries risk protocol. The paradigm change described in this manuscript suggests six key global areas--beneficiary education, health provider network education, community and state agencies, legislative commitment, access to care, and research--as significant factors to be considered in compliance. An outline of the major areas and subheadings for a global caries protocol compliance paradigm are presented.