Purpose: The purposes of this study were to: (1) assess the prevalence of dental caries experience in a sample of 543 low-income children, ages six months to 17 years, in the Bronx, New York; and (2) determine the existence of any association between maternal active decay and child's caries experience. Methods: Caries risk assessment forms completed in the pediatric clinic of an urban safety-net hospital in the Bronx were analyzed. Descriptive statistics and multiple logistic regression models assessed associations between maternal active decay and child's caries experience. Results: Active decay in the past 12 months was seen in 43.8 percent of mothers or primary caregivers. Prevalence of white spots and obvious decay and presence of restorations in their children were 26.5 percent, 23.8 percent, and 16.4 percent, respectively. Children of mothers or primary caregivers who had active decay in the past 12 months had more than double the odds (odds ratio equals 2.18; 95 percent confidence interval equals 1.53 to 3.09) of experiencing dental caries (P<0.0001). Conclusions: This study highlights the significant impact that a mother's oral health has on a child's risk of experiencing dental caries. Incorporating oral health risk assessments in adult and pediatric primary care is strongly recommended.