Objectives: To establish up-to-date information on the DMFT status of 12 yr.old Tongan children in 2003 and make a comparison with a similar survey done in 1998 and the Tongan National Oral Health Survey of 1986. Methods: The 2003 survey (like the 1998 survey) was performed according to the criteria set out in the WHO Oral Health Survey Basic Methods 4th. Edition 1997. It involved 246 children, in seven locations, on the main island of Tongatapu in July and August 2003 using four examiners. Results: The DMFT for 12yr olds was found to be 2.1 (n=246, 2003), 3.1 (n=252, 1998), 1.0 (n=1106, 1986) and 34.1%, 22.5%, 62.6% were caries free in the years 2003, 1998 and 1986 respectively. Conclusions: Although the DMFT appeared to decline from 1998 to 2003 it is still double that of 1986. Further planned surveys in 2008 and 2013 should more clearly establish the trends for dental caries in Tonga and the effects of current preventive measures.