The Association of State and Territorial Dental Directors (ASTDD) Best Practices Committee has published their updated “ASTDD Best Practice Approach Report: Early Childhood Caries Prevention and Management.” Early childhood caries is the clinical term for tooth decay that affects children younger than age six and is the most common disease in young children. This report describes a public health strategy, assesses the strength of evidence for the effectiveness of this strategy, and uses practice examples to illustrate successful and innovative implementation.