The objectives of this study were to evaluate and compare the changes of the dental caries prevalence and severity of 7 to 8 year old schoolchildren in six Lithuanian regions over the past 26 years (1983-2009) and to propose recommendations based on the results of the study. The study is based on the analysis of data, containing 576 cases of children examined in 1983 and comparison with data containing 531 cases added in 2009. The studies were conducted in the same six regions of Lithuania among the children from 7 to 8 years of age. For the study of children the WHO oral assessment methodology was used (WHO Basic methods 1997). Severity of dental caries was described by df-t and DMF-T index. The average of individual df-t and DMF-T indices was calculated for all subjects and sorted by gender. Oral hygiene status was evaluated by applying the simplified Green-Vermilion index-OHI-S (1964) The prevalence of primary dental caries among the children 7 to 8 years of age was 92.4% in 1983 and 88.7% (p=0.43) in 2009. The prevalence of permanent dental caries decreased from 49.6% in 1983 to 29.7% (p<0.001) in 2009. Mean df-t score decreased from 4.9±3.4 in 1983 to 4.1±2.7 in 2009 and DMF-T index decreased from 1.1±1.7 in 1983 to 0.5±1.0 in 2009 (p<0.001). The OHI-S index was not significantly different during 1983-2009. In the period of last 26 years a tendency towards the decrease in the prevalence and severity of dental caries was observed. That could be related to the frequent using of the toothpastes with fluoride, as well as implementation of the caries prevention program with sealants among the children of that age. The poor oral hygiene and comparatively high caries prevalence in schoolchildren show that it is still necessary to improve preventive measures in Lithuania.