Dental caries is the most common chronic disease in childhood. If not managed properly, it may result in significant acute and chronic conditions, the most severe of which include bacteraemia and impaired development, not to mention high treatment costs and consequences to families and communities [
1‐
3]. The American Academy of Pediatric Dentistry (AAPD) classifies early childhood caries (ECC) in a broad definition as ´the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child 71-month-old or younger´[
4]. It is complicated to compare global trends of early childhood caries prevalence mainly due to inconsistencies in the methodology of observational studies in individual countries. Despite the prevailing declining trend in dental caries, particularly seen in 1980s [
5], some authors have reported that such a trend has stopped or even reversed for the primary dentition in recent years, particularly in countries that already had low caries prevalence in primary dentition [
6‐
9]. It is well documented that the distribution of ECC in the population is skewed, with about one third of the examined population bearing most of the disease burden [
10]. Cross-sectional epidemiological studies on ECC prevalence that employ standard epidemiologic measures, such as dmft index (d – number of teeth with untreated dental caries, m – number of teeth extracted due to dental caries, f – number of teeth with caries treated with a filling or crown) and a proportion of the population with intact dentition (dmft = 0) do not reflect the full scope of ECC´s impact on the society [
3]. Nevertheless, they collect elementary data necessary for planning the most appropriate preventive interventions against ECC and for evaluating their effectiveness. Oral health data for monitoring disease patterns and trends over time represent an essential component of global oral health information systems established by WHO [
11]. The aim of the study was to analyse primary data from previous epidemiological studies on the prevalence of early childhood caries in the Czech Republic, conduct a secondary analysis of trends in dental caries prevalence and discuss national oral health surveillance issues. The Czech Republic is also a country undergoing rapid social, economic and health-care transition and, as such, an interesting place to assess trends in dental caries in changing social settings.