| Summary: | We explore the determinants of dental ill‐health as measured by the occurrence of caries. A recursive bivariate probit model that was derived from health production and demand theory is employed to model caries, while taking account of dental care use. The data are from a follow‐up questionnaire used in a longitudinal study of the Northern Finland 1966 Birth Cohort, with respondents aged 31 (n = 5020). The factors controlled for relate to family background and health behavior during their youth, current socioecononomic variables and dental health stock. The total effects on the occurrence of caries of the explanatory variables are computed. Among females, factors increasing caries are body mass index and intake of alcohol, sugar and soft drinks, and those reducing caries are birth weight and adolescent school achievement. Among males, caries is positively related to the metropolitan residence and negatively related to education and healthy diet. Smoking increases caries, whereas dental care use, regular dental attendance and brushing teeth at least twice a day decrease caries. To promote oral health, attention should focus on policies to improve dental health education and to reduce the impacts of common risk factors. Copyright © 2007 John Wiley & Sons, Ltd.
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