To our knowledge, this is the first comprehensive study of dental caries among disadvantaged children of Los Angeles County that also investigates associated sociodemographic and access to care determinants. We have provided an estimate of the indirect cost of oral health on school performance and attendance of children and the school- or work-related absence of parents. Our estimate of absence as a result of oral conditions appears more con- servative than does the previous estimation by Gift et al. This might be related to an improvement in the oral health conditions during the elapsed 20-year period in the US population of children during which the prevalence of caries in the permanent dentition of 6- to 11-year-old children dropped from 9% to 7% between 1988 and 2002.19 Another limitation of this direct comparison with the previous study is that our results are based on a sample of disadvantaged children from a specific geographic region and we attempted to recall activities of the past year, whereas Gift et al.’s study was based on a representative sample of US children with only a 15-day event recall.