Background: Dental caries is a multifactorial disease that remains a major dental health problem in childhood, influenced by complex interactions between cariogenic microorganisms, diet, host factors, and social and environmental factors. Caries Risk Assessment (CRA) is used to identify individual caries risk based on risk factors, protective factors, and disease indicators, thus enabling more targeted preventive interventions. Purpose: To analyze caries risk levels using the caries risk assessment in children under five years of age. Method: This observational study used a cross-sectional approach. The study sample consisted of all pediatric patients aged 0–5 years who visited two hospitals in Sidoarjo Regency between December 2025 and February 2026, using a total sampling technique and a sample size of 36 children. Caries risk assessment was conducted using the Caries Risk Assessment Form based on the American Academy of Pediatric Dentistry (AAPD) guidelines. Data were collected through direct clinical examinations and interviews with parents regarding their children's oral health habits. The data were then analyzed descriptively using frequency distributions and percentages. Results: A total of 36 children aged 0–5 years participated in this study. The distribution of caries risk levels showed that 23 children (63.9%) were in the moderate risk category, 8 children (22.2%) were in the high risk category, and 5 children (13.9%) were in the low risk category. Conclusion: The majority of children under five years of age were in the moderate caries risk category. These findings indicate the need to strengthen risk-based dental health promotion and prevention programs to prevent the development of caries in childhood. Suggestion: Further research is recommended to evaluate the relationship between caries risk categories and specific variables, such as parental education and health literacy levels, nutritional status, patterns of visits to health facilities, and to test the effectiveness of CRA-based promotive-preventive interventions. Keywords: Caries Risk Assessment; Caries Prevention; Children; Dental Caries; Early Childhood Caries.
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