Dental caries prevalence data were collected in Hawai'i, Palau and Guam and analyzed for dft, DMFT, unmet treatment needs, sealant utilization and various caries patterns. Data sets include examinations of 24,752 children ages 5 through 9 years of age in Hawai'i, 558 children in Palau and 1,518 children in Guam. Dental disease in early childhood is truly endemic throughout the Pacific basin. The findings of this report quantify in a standardized manner and contrast, basic oral health / oral disease indicators from each jurisdiction. While children from all three jurisdictions demonstrated dental disease prevalence rates which far exceed those found on the U.S. mainland, overall, children in Guam were found to be the poorest oral health indicators, followed by Palau and Hawai'i. Overall, young children at all sites exhibited excessively high caries prevalence and unmet treatment needs rates. Significant progress has been made at Palau in the past decade, however, at all three sites presented, more work is necessary if early childhood caries is to be brought under control. Findings also include an apparent negative correlation between dental sealants and DMFT rates.