Purpose <p>Preventive dental care is an essential part of promoting children’s oral health. The purpose of this retrospective register-based observational study was to find out whether caries risk and risk factors were individually assessed in children under school age, and whether the observed risk factors affected the recall intervals (RCs) and the implementation of preventive measures for at-risk patients.</p> Methods <p>The data consisted of patient records of Finnish children under school age (0–6 years) (<i>n</i> = 206) in oral health care and public maternity and child health clinics between 2014 and 2020. The children were born in 2014, 2016 and 2018 and lived in the City of Oulu, Finland. Data on different caries risk factors, preventive factors and measures, and RC intervals were registered for three different age groups (1–2-, 3–4- and 5–6-year-olds). Chi-squared and Fisher´s exact tests were used to evaluate registrations across three age groups.</p> Results <p>The frequency of registering of different caries risk factors varied by age group (3.7–98.3%) and the assessing of individual caries risk in patient registers was inadequate (0–3.2%). RC intervals were not systematically determined based on individual risk; however, when recorded risk factors were considered, an increase in the number of factors was associated with a shortening of the RC intervals (<i>p</i> &lt; 0.001). Prevention was not targeted toward caries-risk patients. Children in the age groups of 1–2-year-olds and 3–4-year-olds with ≥ 3 recorded risk indicators had a statistically significantly higher presence of caries lesions than others.</p> Conclusion <p>Registering caries risk factors, identifying at-risk individuals and targeting prevention accordingly form the basis of good dental care for children. All oral health professionals should be better aware of and follow national recommendations and guidelines.</p>