Dental caries is a multifactorial disease that includes behavioral and cultural components. The study’s purpose was to determine the caries experienced (as measured by dmft) in a group of 2-5 y/o children, assess their family and home environment including consumption of fluoridated drinking water, use of a fluoride containing dentifrice, and level of caregiver formal education. Parents of children referred for dental treatment under general anesthesia and who either spoke and read English or Spanish were recruited and consent obtained. Selected information on the family home, parental education and selected fluoride contact data was obtained. An oral clinical examination of the child assisted by intraoral radiographs was completed and the number of decayed, missing, filled primary teeth (dmft) recorded for each child. Bitewings were obtained if posterior or anterior teeth contacts were closed but only periapical radiographs were obtained if contacts were open. Children of English speaking caregivers had statistically more dmft after controlling for the effect of the child’s age and years of parental education (p=0.04). English speaking families had lived in their current home longer and the parent had more formal education than did the Spanish speaking parent. When available, the English children drank municipal tap water more often than did the Spanish children. Spanish speaking parents often chose bottled drinking water. No difference between the two groups was found in the use of tap water for cooking or the use of fluoridated dentifrice. In conclusion, increased parent education, language spoken by the parents and time living in the current home were not associated with lower dmft. Drinking fluoridated drinking water did not affect the dmft. However, using fluoridated water when available to cook and using fluoride containing dentifrice by both groups may have been mutually beneficial.