The global pattern of caries prevalence is chaning. In Europe the number of countries showing a caries decline has increased over the last two decades. While up until 1990 only 12 countries were known to have a DMFTfor 12-year-olds below 3.0, this number increased to more than 25 from 1991 to 1997. The current caries prevalence is spread over a range, with a significant East-West gradient from 7.7 DMFT in Latvia down to 0.9 in The Netherlands. With the exception of Slovenia (1.7), East Germany (2.6) and the Czech Republic (2.7) all DMFT indices in Eastern European countries were within the range from 4.0 to more than 6.0. There are also signs in Bulgaria and Romania for the beginning of caries increase. In most of these countries implementation (or re-implementation) of oral health promotion and prevention at community level is needed.