The aims were to estimate the quality of dental restorations in Lithuanian adolescents and to relate differences in quality of restorations to gender, urbanization and residency. A total amount of 885 adolescents in 22 randomly pre-selected areas were clinically examined. The California Dental Association Quality Evaluation System was used for the assessment of the quality of dental restorations. 60.35 % of all restorations were not acceptable and had to be changed. 47.58 % of them must be replaced because of not acceptable anatomic form. Only in 8.9 % of participants all their fillings were considered as satisfactory, while in 24.8 % of adolescents all their fillings had to be changed. Regarding the reasons for the need to replace restorations substantial differences among different geographical regions were found, whereas in relation to gender and urbanization the differences were less pronounced.