Abstract: PURPOSE: Through specialty collaboration model, an evaluation was conducted based on graded management of severe early childhood caries in infants who are aged 12-18 months in Jing'an District, Shanghai. METHODS: Using the random cluster sampling method, totally 200 children aged 12 to 18 months were selected from each of the two community health care centers in Shanghai Jing'an District during September 2021 to March 2022, allocated as the control group and the experimental group, and caries risk assessment was conducted. Children in the control group received routine oral health care at the child health department, while children in the experimental group adopted dental caries grading management based on collaboration of specialty. A re-evaluation was conducted after 18 months of intervention. RESULTS: After 18 months of intervention, totally 31 of the 400 infants were lost to follow-up, the total caries prevalence rate was 22.8%. The caries prevalence rate in the control group was 29.8%, while that in the experimental group was 16.0%, with significant difference between the two groups (P=0.002). The reduction rate of caries risk grade in the experimental group was significantly higher than that in the control group(P=0.012). The caries related factors in the control group included eating sugar-containing food or beverage more than 3 times/day (P<0.001), receiving professional fluoridation within 12 months(P<0.001) and regular oral examination(P=0.023). The caries related factors in the experimental group included eating sugar-containing food or beverage more than 3 times/day（P=0.005）, the caregiver performing floss for the child every day (P=0.022) and brush for the child every day(P=0.007). CONCLUSIONS: It is capable to effectively reduce the caries prevalence rate and the risk of severe early childhood caries in infants aged 12-18 months by adopting dental caries grading management based on collaboration of specialty.