As reported by health managers in the Head Start Health Manager Descriptive Study (HSHMDS) (see textbox for more information), one of the major health issues confronting HS/EHS programs is tooth decay. Thus, in this brief, our primary objective is to draw on the quantitative and qualitative data collected for the HSHMDS to obtain insights into the ways in which HS/EHS programs are addressing the issues of tooth decay for the children and families they serve. In particular, we focus on the following questions: - What is the perceived burden of tooth decay on HS/EHS programs? - What health programming (e.g., services, activities, education) and policies are currently in place to address tooth decay? - What staffing models are used to address need? How is staff training addressing tooth decay? - How are programs leveraging other partners, community resources and the Health Services Advisory Committee (HSAC) to address tooth decay? (author abstract)