OBJECTIVE: To examine retrospectively the caries-related restorative experience of at-risk individuals who received fluoride-based preventive interventions to determine if the intervention resulted in fewer caries-related procedures. METHODS: Administrative data from two dental health plans were used to determine the relationship between caries risk assessment (CRA) scores, preventive treatment and caries-related treatment procedures. We identified 45 693 adults who were consecutively enrolled for at least 1 year before and 2.5 years after the CRA. Variables representing the number of teeth with any caries-related treatment procedure and receipt of preventive treatment were created. RESULTS: The outcome variable of interest was having at least one tooth with a caries-related procedure in the 2-year follow-up period. In plan A, the recommendation for home-use fluoride was not significantly related to caries-related treatment procedures in the follow-up period for individuals at low, moderate or high risk (P > 0.300). In plan B, application of in-office fluoride was associated with having at least one tooth with a caries-related treatment procedure in the follow-up period (P < 0.001). CONCLUSIONS: We found incomplete compliance with guidelines for recommendation or administration of preventive treatment for patients at elevated risk for caries. We were also unable to identify any significant reductions in caries-related procedures for individuals receiving a fluoride intervention, compared with those who did not, when stratified by risk level.