IntroductionAssessment of difference in caries prevalence among twins may help determine the character and the extent of the influence exercised by the environment, as a complement of the genetic constitution.AimTo investigate the inter-pair differences in caries prevalence among South Indian monozygotic twins in relation to birth weight, birth order, and gender. Possible correlation among other attributes such as breastfeeding, socioeconomic status, oral habits, frequency of brushing, and sweet intake were also assessed.Materials and methodsA sample of 40 monozygotic children between the age group of 6 and 12 was selected. The parents were asked to complete the questionnaire and report with their children. Then dental examinations were carried out and the prevalence of dental caries among the twins were assessed.ResultsAmong the total samples, 61.5% exhibited caries. Lower birth weight twins showed an increased chance of caries (72.22%), compared to higher birth weight twins (68.18%). Second of the twins had an increased risk of dental caries (70%) compared to the first (60%). 90% of the male twins and 45% of the female twins had caries. The association between dental caries and other variables were also assessed; those who were exclusively breastfed had an increased risk (70%) of caries. Evaluation of socioeconomic status and caries revealed a risk of for the high (65%), middle (62.5%), and lower groups (58.33%). Children without oral habits showed a higher prevalence (73.3%) of caries when compared to those without any habits (50%). It was noticed that the brushing frequency is not related to the severity of caries. The strongest association was noticed between excessive sweet liking and prevalence of dental caries.ConclusionThe study revealed difference in caries prevalence among monozygotic twins in relation to birth weight, birth order, and gender. It was found that variations in caries prevalence existed with other attributes also.How to cite this articleZarina R, Kuriakose S, et al. Evaluation of Inter-pair Differences in Caries among South Indian Monozygotic Twins: A Cross-sectional Study. Int J Clin Pediatr Dent 2019;12(4):318–324.