School-based programs in the United States are very limited. Other countries in the world have established programs for many years which provide comprehensive services to school-age children. In this country philosophical and professional pressures have maintained school-based programs only in the area of primary prevention. Most treatment programs involving secondary prevention are not school-based and are targeted at specific population groups rather than all children. The basic questions of whether primary and secondary preventive school-based programs can be successful have been examined in this paper. The evidence based on the pilot program presented here is that these programs can be successful. They are well accepted by parents and children, they provide quality care at a reasonable cost, and, most importantly, they can reduce dental disease. It's time for a committment by the profession and the nation to establish school-based dental programs for the health and welfare of our children.