Several cross-sectional studies report that caries in primary teeth is correlated with caries in permanent teeth. This eight-year cohort study sought to determine if caries in the primary dentition can predict caries in the permanent dentition of the same individuals and, if so, with what degree of prediction accuracy. A total of 362 Chinese children, from 3 to 5 years old at the time of the 1992 baseline study, were re-examined in 2000. The study found statistically significant associations between caries prevalence in primary and permanent dentitions (p < 0.01). Children having caries in their primary teeth were three times more likely to develop caries in their permanent teeth (relative ratio = 2.6, 95% CI = 1.4-4.7; p < 0.001). Caries on primary molars had the highest predictive value (85.4%). This study demonstrates that caries status in the primary teeth can be used as a risk indicator for predicting caries in the permanent teeth.