An oral health promotion programme and study are currently being carried out in 9 nursery schools with children at high risk for cavities located in the deprived neighbourhoods of the city of Clermont-Ferrand (France). The programme's objective is to promote the improvement of tooth brushing habits (2 times/day) and general oral hygiene associated with the use of fluoridated toothpastes. Dental care and dental hygiene visits are also encouraged. In 2005-2006 the programme was implemented in 4 schools; another group of 5 schools constituted a control group. After one year, an evaluation of the process, the programme's effectiveness and short-term outcomes was conducted. The majority of the parents, teachers and children participated in the program but their involvement was limited, with active participation being difficult to achieve. The programme was positive in terms of its prevention component and objective. A significant improvement in children's oral hygiene habits was obtained in the programme group as compared to the control group. However, the care and treatment needs of the children in both groups were not covered, given that one child out of four remained with untreated lesions at the end of the year. These results suggest that here are many barriers that prevent children's access to care which need to be addressed.