Regular national surveys of child and adult dental health and regionally coordinated surveys of caries experience in children provide a comprehensive picture of secular changes in disease levels in England and Wales. The substantial decrease in mean dmft in 5-year-olds between 1973 and 1983, amounting to 7.7% per annum, slowed to 0.9% per annum between 1983 and 1989/90. Conversely the decline in DMFT in older children and adolescents has accelerated more than twofold since 1983. In some parts of the country, caries experience at 5 years has shown a small increase and possible reasons for this are discussed. The validity of the survey data is examined and ways of consolidating and maintaining the downward trend in disease are considered.