OBJECTIVES: To assess whether it was possible to implement an oral health programme in Kuwait which followed guidelines underlying the public Danish Child Oral Health Service, and thereby improve the oral health of Kuwaiti children. DESIGN: Successive cross-sectional surveys were carried out in one governorate in Kuwait (Al-Ahmadi) during the period 1986-97 interrupted by the Gulf War. Data were collected by clinical examinations. SETTING: The programme was initiated by the Ministry of Health in Kuwait in order to improve the community services through a school-based oral health care programme. PARTICIPANTS: The study population comprised incrementally all children in the four primary school classes in the governorate. INTERVENTIONS: The children received bi-weekly tooth brushing instructions with fluoridated toothpaste and fluoride rinsing, fissure sealing, oral health education, and restorative treatment of dental caries. OUTCOME MEASURES: The children were clinically examined each year before the start of the treatment. Dental caries was scored at surface level in accordance with the Danish registration system, using the WHO criteria for dental caries. RESULTS: The average participation rate was 94%. The percentage of caries-free children, exemplified by second class, increased from 64% in 1987 to 78% in 1990, dropped to 71% in 1992 and increased again to 79% in 1997. CONCLUSION: It is concluded that it has been possible to adapt the principles from the Danish Child Oral Health Service programme to Kuwait, that parents and teachers accepted the principle of treating the children during school hours, and that the oral health of the children improved. Whether the improvement in the oral health is due to the programme or to changes in the society is discussed.