The aim of the present study was to describe in detail the distribution of caries lesions among tooth types and surfaces in the primary dentition of young children with different levels of disease. A total of 125 children (between 2 and 6 years old) attending the pediatric dental clinic of the University Hospital of Leuven was allocated to three groups based on their caries experience: dmft = 1-5 formed the low caries experience group (LC, n = 27), dmft = 6-9 the moderate caries experience group (MC, n = 61) and those with dmft > = 10 the high caries experience group (HC, n = 37). Caries experience (at patient level, tooth and tooth surface level) and oral hygiene were evaluated. Oral health habits were recorded using a questionnaire (completed by parents). Caries lesions were not evenly distributed among different tooth types. Teeth most frequently affected were lower (first and second) primary molars. Primary incisors were rarely found to be carious. The distribution of the lesions followed a comparable pattern, irrespective of the disease level of the child. Decay on primary canines and buccal/lingual surfaces of primary molars was strongly indicative of a high caries experience. There was a clear link with reported oral hygiene habits and the use of a pacifier and baby bottle with sugared content.