Caries is still to remain one of the most widespread chronic children diseases significantly influencing on decline in child's life quality. For its effective treatment it is required to estimate existence of risk of its further development and escalation as soon as possible and taking this into account to choose the necessary strategy of action. The risk-based strategy has to include a combination of techniques of treatment; materials for restoration, medicines and ways of prophylaxis, and also further aftertreatment with that frequency and in those terms which are dictated to the doctor by individual activity of caries at the child and risk of its development in the future. In article the concept of effective treatment of children of preschool age with high activity of caries and high risk of its development is offered. It is based on use of the conservative, minimally invasive and atraumatic techniques increasing resistance of tissues of temporary teeth and reducing activity of a manifestation of carious inflammation. Restriction of indications to use compomers and glass ionomer cements as restoration materials is proved in work; need of obligatory including in the protocol of pulpites treatment of temporary molars with the reduced resistance of thin-walled metal crowns is proved. Need of broader use of dental prosthetics for children is substantiated. The description of the remote results of treatment received on big clinical material, it is proved value of courses of prophylaxis prior to treatment and at medical examination stages after sanation of a mouth, in maintenance of long-term clinical effect.