The aim of this study was to describe the effects of the School Dental Care Service on the dental status of primary teeth, against the background of the water fluoridation program. A representative sample of Chinese children aged 6-12 yr was selected for a dental examination for caries and treatment needs. Thirty-two percent of the children aged 6-8 yr were caries free. The dmft indices for 6, 7, and 8-yr-olds were 2.8, 3.1, and 2.9 respectively, and the ratio of decayed to filled teeth declined from 3.2 at age 6 to 1.0 at age 9. The average child aged 6-8 yr needed treatment for caries on just fewer than two teeth. More teeth were in need of 1-surface fillings and such complex treatment as pulpotomy than other treatment types. It was concluded that 1) dental caries prevalence and severity in primary teeth of Hong Kong children continues to decline, 2) there has been an obvious improvement in dental fitness as a result of establishing the School Dental Care Service, 3) the risk to dental caries appears to be associated with the preschool time-frame and therefore 4) the dental service should redirect its attention to preschool children and 5) replace its restorative policy with a preventive policy.