The aim of this study was to estimate the prevalence and severity of occlusal pathologies in 12-year-old schoolchildren in Campina Grande, Brazil. The study population was composed by 553 12-year-old schoolchildren attending the municipal educational system. Information regarding occlusal alterations (Dental Aesthetic Index) and subjective perceptions on occlusal pathologies were collected by means of structured questionnaires submitted to the students. Bivariate analysis and odds ratio were used to determine the existence of association between the severity of the occlusalpathologies and the other associated factors. The prevalence and severity ofocclusal pathologies were 65.1% (n=360) and 35.1% (n=194), respectively The bivariate analysis revealed a positive association between the variable "dissatisfaction on smiling related to occlusal problems" (OR=1.92 [1.13-3.28]) and the severity of occlusal pathologies. The high prevalence and severity of occlusal alterations observed in the present study suggests that it is necessary to reformulate the current public oral health policies with the inclusion of orthodontic treatment in the set of health services provided to the population.