The study was done to identify toddlers who have an increased risk of developing dental decay at school age. Six variables-Cariostat score, mother's ethnicity, evidence of baby bottle tooth decay, mother;s dental health status, toddler's age at first tooth, and frequency of brushing - showed a significant association with decay status at school age with odds ratios ranging from 1.89 to 2.63. The Cariostat score and the frequency of brushing remained significant in a logistic regression. No interaction terms were significant. The Cariostat caries activity test would be a useful screening tool for identifying toddlers most likely to develop decay or could be used periodically as the deciduous molars erupt and become colonized with oral bacteria. The findings confirm that good oral hygiene practices can have an impact on future dental health, and caregivers should be encouraged to brush young children's teeth regularly.