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Objective. This study aims to assess the caries experience among first- and second-grade children in the elementary schools of southeastern Estonia. Materials and methods. A representative sample of 485 children was studied. The mean age of children in the first grade was 7.8 years (SD = 0.35) and in the second grade 8.8 years (0.38). The clinical examinations using ICDAS criteria were completed by four calibrated examiners. The inter- and intra-examiner consistency of the examiners was high (surface and tooth-based kappa >0.9). Results. The mean caries experience of dentinal caries lesions was 0.8 (D4-6MFT) and 1.6 (D4-6MFS) among the first graders and 1.1 (D4-6MFT) and 1.6 (D4-6MFS) among the second graders. The mean caries enamel lesions among the first graders was 1.6 (D1-3T) and 2.2 (D1-3S) and among the second graders 2.1 and 3.0, respectively. The most affected surfaces were the occlusal surfaces of the lower first molars. The prevalence of sealants was very low-only 2.4% of the first molars were sealed among the first graders and 3.9% among the second graders. There were no statistically significant differences in caries experience or in the provision of restorative treatment between the schools. Conclusions. Caries experience is high in southeastern Estonia. Preventive programs are urgently needed. [ABSTRACT FROM AUTHOR]