In 1972, a school-based fluoride program was initiated in elementary schools in Nelson County, VA, a fluoride-deficient area. For 11 years, participating children ingested daily in school a 1-mgm fluoride tablet and rinsed weekly with a .2% sodium fluoride solution. They also received fluoride dentifrice and toothbrushes for home use. The program was extended into junior high school in 1978 and into high school in 1980. In 1983, dental examinations of children aged 6 to 17 years, who had continuously participated in the program for 1 to 11 years depending on school grade, showed a mean prevalence of 3.12 DMFS, which was 65% lower than the corresponding score of 9.02 DMFS for children of the same ages at the baseline examinations. The preventive program inhibited decay in all types of surfaces: 54% in occlusal surfaces; 59% in buccolingual surfaces; and 90% in mesiodistal surfaces.