OBJECTIVES: To explore the prevalence and severity of Indigenous and non-Indigenous child dental disease in relation to age, sex, residential location and socio-economic status in three Australian states and territories. DESIGN: Children aged 4-14 years who were enrolled in a school dental or screening service in New South Wales, South Australia and the Northern Territory, Australia, were randomly selected to take part in this cross-sectional study. Bivariate and multivariate analyses were used to assess outcomes. RESULTS: A total of 328,042 children were included, of which 10,517 (3.2%) were Indigenous. Some 67.1% of Indigenous children lived in rural areas and 47.3% lived in areas of high disadvantage. About 37.5% of 4- to 10-year-old Indigenous children had no experience of dental disease in the primary dentition while 70.7% of 6- to 14-year-old Indigenous children had caries-free permanent dentitions. The mean number of decayed, missing and filled primary teeth (dmft) of Indigenous 4- to 10-year-old children was 2.9 (SD; 3.4) while the mean DMFT of Indigenous 6- to 14-year-old children was 0.8 (SD; 1.6). Across all age-groups, Indigenous children living in the most deprived areas had higher dmft and DMFT levels than their more socially advantaged counterparts, while rural-dwelling Indigenous children had higher levels of dental disease experience than metropolitan-dwelling Indigenous children. After adjusting for potential confounding, Indigenous children aged 4-10 years were over twice as likely to have caries in the deciduous dentition than similarly aged non-Indigenous children (OR: 2.25, CI: 2.14-2.36), and 6- to 14-year-old Indigenous children were over one and a half times more likely to have decay in the permanent dentition (OR: 1.68, CI: 1.60-1.77) than their non-Indigenous counterparts. CONCLUSION: Indigenous children experienced higher caries prevalence and severity than non-Indigenous children, irrespective of other socio-demographic factors. Factors concerning Indigenous social capital may have influenced our findings.