PURPOSE: Dental caries is a disease that, although decreasing in the non-Aboriginal child population, remains high for Canadian Aboriginal and Native American children and adolescents. To address dental health issues in First Nations in the District of Manitoulin, Noojmowin Teg Health Centre initiated a multiphase collaborative research project with the department of community dentistry at the University of Toronto. The purpose of this paper was to identify the prevalence of dental caries in children 7 or 13 years of age and to compare these data with published data for the same age groups from other First Nations communities in Canada. METHODS: All children 7 or 13 years of age who were in elementary schools on a reserve in 7 First Nations communities were eligible for a dental health examination as part of the survey. Children attending school off the reserve in 6 of the communities were also eligible. RESULTS: A total of 66 children (56% 7-year-old children, 62% girls) were examined. The mean caries score (deft+ DMFT) for 7-year-old children was 6.2; the mean decayed, extracted, filled permanent teeth (DMFT) score for 13-year-old children was 4.1. Overall, 96% of children had 1 or more past or active carious lesion. CONCLUSION: Results indicate that dental caries is highly prevalent and increasing in severity in this population.