Dental caries is a widespread global public health problem with significant health and financial implications. The purpose of this study was to determine dental caries prevalence, experience and severity, as well as to investigate disparities by geographic (urban/rural) location, dental health care utilization and oral hygiene practices in seven to eight year old Nova Scotia school children in 2006-2007. The study results demonstrated that over half (57.3%) of the seven to eight year old population was afflicted by dental caries in the overall dentition. Primary dentition caries prevalence was 55%, with a mean deft score of 2.58 ± 0.08 SE. Prevalence of permanent dentition caries was 14%, with a mean DMFT score of 0.26 ± 0.02 SE. The mean defs score was 6.86 ± 0.28 SE and the average DMFS score was 0.47 ± 0.04 SE. Geographic location was not found to have a major influence on dental caries prevalence, experience and severity in this population. However, a significant relationship was observed between dental caries and dental visit frequency, with higher overall caries prevalence and severity among those who visited the dentist less than once per year. Disparities in dental caries were also found by frequency of brushing, with significantly lower caries rates in those who brushed at least twice per day. Health promotion measures such as pit and fissure sealants and topical fluoride application in susceptible and high-risk children, and appropriate health education regarding recommended frequency of brushing twice per day using fluoridated toothpaste, as well as preventive and regular dental visits are merited to help promote children’s overall health and well-being.