The aim of this study was to assess the prevalence and severity of dental caries and the need for dental treatment among schoolchildren in two small Brazilian counties. WHO criteria (1986) for the diagnosis of dental caries and treatment needs were adopted. All 6 to 12-year-old schoolchildren in both São João do Sul (n = 803) and Treviso (n = 382), both in the State of Santa Catarina, were invited to participate in the study. The response rate was 96% and 91% respectively. All kappa values for inter- and intra-examiner agreement were greater than 0.62. Prevalence of caries among 6 to 12-year-old children was 62.1% in São João do Sul and 63.6% in Treviso. Mean DMF-T for the same age group was 1.91 and 1.84 respectively. Need for treatment was high in both counties, however it was mainly related to simple clinical procedures. In conclusion, prevalence of dental caries among 6 to 12-year-old schoolchildren was lower in the two small counties studied than in other small communities in Brazil. The need for treatment was great, but it was related to simple clinical procedures. In addition, there is a need to collect further data from small towns to develop an oral health strategy appropriate to such areas.