The decayed component was the most prevalent (DFT = 2.08) and the Significant Caries Index (SiC) was 5.54 double, showing polarization of dental caries in the studied population. After adjusting for appropriate covariates, preschool children of age 5 and 6 years old were more likely to have decayed tooth: adjusted OR = 3.02, (95% CI =2.01–4.54) and adjusted OR = 2.23, (95% CI = 1.55–3.20) respectively. Preschool children without visible plaque on the buccal surface of upper anterior teeth were less likely to have decayed teeth: adjusted OR = 0.21, (95% CI = 0.09–0.45)]. Regarding measurements of oral health-related quality of life using the MOHRQoL, only preschool children who reported on ‘Do your teeth hurt you now?’ and ‘Do kids make fun of your teeth?’ were more likely to have a decayed tooth – adjusted OR = 1.74, (95% CI = 1.12–2.71) and adjusted OR = 1.87, (95% CI = 1.11–3.15)], respectively.