The behaviors that are fundamental in early childhood caries are those that initiate and maintain the conditions for transmission of the cariogenic bacteria and block prevention of the disease in the presence of an unfavorable diet. These behaviors have not been the focus of interdisciplinary research involving clinicians, microbiologists, pharmacologists, and behavioral scientists. The current "health promotion product" is not selling. The problem is the "product", not the potential buyer. Evidence suggests that positive interactions with the dental care system do lead to mothers taking preventive steps. However, dentist's attitudes, knowledge, skills and experience with babies and toddlers are deficient. Primary prevention of early childhood caries will fail unless it begins in the prenatal period and addresses the health of both mother and child.