The purpose of this study was to determine if there was a significant relationship between adjusted body mass index (BMI) percentiles and the frequency of decayed, missing, and filled primary teeth (dmft) in a retrospective cohort of 3- to 5-year-old children.Data was collected from 215 3- to 5-year old children with an American Society of Anesthesiologists class I or II physical status who had received dental treatment under general anesthesia at a university hospital between 2007 and 2008. The diagnosis of dental caries and dmft scores were confirmed by oral and radiographic examination.BMI percentile was a statistically significant explanatory variable for dmft after controlling for race, gender, and age ( P<.001). When BMI percentile increased by 10 units, the dmft score increased by an estimated 1.1 after adjusting for the other covariates.Young children with elevated BMI percentiles who have caries may be at risk for an increased number of carious teeth in the future. Providing nutritional and weight counseling may potentially lower the risk for dental caries in young children while improving their general health.